Having spent many years equipping politicians with health care industry talking points, I can tell when one in high places has been recruited to use them.
I spotted one yesterday on NBC’s Meet the Press.
My former colleagues undoubtedly were cheering when they heard Sen. Michael Bennet (D-Colo.) come to the defense of private health insurers and trash the idea of improving and expanding Medicare to cover all Americans, which several of the Democratic presidential contenders have endorsed.
Bennet, who says he, too, is considering a run for the 2020 nomination, told Chuck Todd that Medicare for All “seems like a bad opening offer.” He prefaced that by saying that, “what the (other) Democrats are saying is, ‘If you like your insurance, we’re going to take it away from you,’ from 180 million people that get their insurance from their employer and like it, where 20 million Americans who are on Medicare Advantage, and love it.”
I checked to see where Bennet has been getting his campaign cash over the years and wasn’t surprised to see that a lot of it has come from insurance companies and other entrenched special interests in health care, including big drug companies and hospitals and their political action committees. All of those contributors have good reason to protect the status quo: it’s very profitable for all of them.
Sen. Michael Bennet (D-Colo.) on NBC’s Meet the Press
Among Bennet’s major contributors over the past few years are pharmaceutical companies like Amgen, Pfizer and Gilead Services, the maker of the hugely expensive hepatitis C medications Solvaldi and Harvoni. Another big contributor is the drug companies’ powerful lobbying group, the Pharmaceutical Research and Manufacturers of America (PhRMA). Yet another big contributor is CVS, which recently completed its $69 billion acquisition of Aetna, the big health insurer.
It’s worth noting that, according to data compiled by the Center for Responsive Politics, the vast majority of Bennet’s campaign contributions have come from PACs and large individual donations. Relatively little has come from small donations.
One of the reasons Bennet is a favorite of health care moneyed interests is because he serves on the Senate Health, Education, Labor and Pensions (HELP) Committee, which has jurisdiction over legislation pertaining to the U.S. health care system.
Back to those talking points Bennet used on Meet the Press: they are straight out of the insurance industry’s PR and lobbying shops—and those shops are increasing in number as the debate on Medicare for All intensifies.
Drug companies, for-profit hospitals and insurance companies are so determined to keep Medicare for All from being enacted that they are pouring money into a new front group they call the Partnership for America’s Health Care Future, which is being run out of Blue Engine Message & Media, a PR shop in Washington with close ties to Democrats.
America’s Health Insurance Plans, the industry’s largest trade association and lobbying group, last year launched a big public relations campaign—called Coverage@Work—with the goal of keeping the U.S. employer-based health system intact. Medicare for All would replace that system, which has become increasingly expensive and unreliable but continues to be the primary source of most big insurers’ revenues and profits from the private sector.
That 180 million figure Bennet used is the same one AHIP uses in its campaign and in the Partnership’s recent video attacking Medicare for All.
It’s notable also that Bennet mentioned Medicare Advantage plans. It’s true that a lot of Medicare beneficiaries in recent years have enrolled in Medicare Advantage plans—which are operated by private insurance companies—but two out of three Americans have opted instead for the traditional, government-run Medicare program.
(Insurance companies spend millions of dollars every year to entice Medicare-eligible Americans to enroll in their MA plans for one big reason: they have become cash cows for insurers, at the expense of taxpayers. In fact, some of the biggest insurers are now getting a majority of their revenues from public programs like Medicare and Medicaid.)
The industry’s campaign to protect the employer-based system and the Medicare Advantage program obscure some important realities—realities the industry and their spokespeople and friends on Capitol Hill like Sen. Bennet do not want you to know about. In their quest for Wall Street-pleasing profit margins, insurers have surely but steadily made employer-based insurance and Medicare Advantage coverage increasingly less valuable for patients and increasingly more restrictive.
- Unlike Medicare, employer-based and MA plans have defined networks of doctors and hospitals. If you go out of network, you will be on the hook for most if not all of the cost of your care.
- Those networks are becoming increasingly “skinny” as insurers exclude more and more doctors and health care facilities from their provider lists, and they change their lists frequently. The doctor you’ve been seeing for years might be in your network today but not tomorrow.
- It gets even more tricky because many of the doctors who treat patients in in-network hospitals are not in insurers’ physician networks. As a consequence, thousands of people are getting bills from doctors they assumed were in network because they were treated by them in their in-network hospitals.
- Both employer-based and MA plans are notoriously unreliable. If you get your coverage through your employer, if you lose your job, you also lose your employer-subsidized coverage. Enrollees in MA plans can be—and often are—dumped and left scrambling as well. Insurers that operate MA plans frequently leave markets when they decide they are not profitable enough.
- In both private and MA plans, final decisions about whether you will get coverage for the treatment and medications your doctor recommends are often made not by your doctor, as in traditional Medicare, but by your insurance company.
- Similarly, insurers have discrete lists of drugs they will cover, and they change those lists frequently. You might get full coverage for a medication today and only partial or no coverage tomorrow.
And here’s another thing about employer-sponsored health insurance. More and more employers are throwing in the towel. In 1999, 69 percent of non-elderly Americans were enrolled in employer-sponsored plans, according to the Kaiser Family Foundation. By 2014, it was down to 56 percent. It has become increasingly difficult for small and mid-sized employers to stay in the game. Just 30 percent of firms with fewer than 50 employees are now offering coverage to their employees. (For more on the decline in employer-sponsored health coverage, read this Commonwealth Fund analysis.)
And to say that most people in employer-sponsored plans are happy with their coverage ignores this growing problem: because insurers and employers are shifting more of the cost of care to their workers every year in the form of higher deductibles, millions more of us are winding up in the ranks of the under-insured. They have coverage but many can’t use it because of what they have to pay out of our own pockets before that coverage kicks in. The Commonwealth Fund just last week released a study that showed that 28 percent of people in employer-sponsored plans are now under-insured.
Are Americans really as content with the status quo as Sen. Bennet and the industry’s other allies want us to believe? I don’t think so. I’m betting that many if not most of those folks would prefer to have a system in place that gave them greater value and security—greater peace of mind—than what they have now.