If I were still working for a big health insurance company, I would have been busy over the past week writing talking points — some would even have a kernel of truth — for the industry’s allies to use during the House Rules Committee Medicare for All hearing today.

The propaganda I used to churn out — and that my former colleagues still churn out — was intended to mislead, deceive and obscure the truth about the health care system in the United States. You can trust me on this. I was an insurance industry propagandist for nearly two decades.

The objective of my work back then was to manipulate public opinion so that the Congress and the public, too, would carry water for health insurers, just like the industry’s allies will gladly do at tomorrow’s hearing. (The difference is they are paid water carriers.)

Much of what will be said against Medicare for All at the hearing will be based on something people in the propaganda business call FUD. FUD stands for fear, uncertainty and doubt. The industry and its allies want Americans to fear Medicare for All, feel uncertain about it and doubt that it will be in patients’ best interests.


Here is some of the FUD lawmakers are likely to hear — courtesy of the entrenched special interests in health care — followed by the truth the industry’s allies aim to obscure.

FUD:We can’t afford Medicare for All. 

Truth: We can’t afford the status quo.

One of the witnesses at the hearing will be from the corporate-funded Mercatus Center, which published a report last year that estimated the cost of Medicare for All would be something like $32 trillion over 10 years. That number is intended to strike fear in citizens’ hearts. But here’s the thing: That number obscures the fact that the U.S. already spends more than $3.5 trillion a year on health care — twice as much as the average of other developed countries. Do the math. Even if health care costs didn’t rise a penny over the next decade, we’d spend $35 trillion. Factor in the expected 5.5% annual increase in spending and Medicare for All would cost less, not more.

FUD: Medicare for All will be too disruptive.

Truth: Insurers and employers have been disrupting Americans for years to protect profits.

Back in the ’80s, employees across the U.S. had health benefits diminished when they were forced into restrictive managed care plans. By the early 2000s, those plans were no longer profitable enough, so workers were forced into high-deductible plans. And millions of Americans every year find their access to health care disrupted when they lose or change jobs. Every one of us with employer-sponsored health insurance is just a layoff away from being uninsured.

FUD: Americans don’t want “one-size-fits-all” health care. They want choice.

Truth: It is not choice of health insurance plans that Americans want, it is choice of doctors and hospitals.

That clever “one-size-fits-all” talking point obscures the reality that before and after the Affordable Care Act was passed, employers were reducing insurer and health care provider options. A common feature of most of today’s health plans is a constantly changing and shrinking network of doctors and hospitals. Under Medicare for All, Americans would be able to choose doctors and hospitals of our choice, not those imposed on us by insurers and employers.

FUD: Americans who have employer-sponsored health insurance love it and don’t want anything to replace it.

Truth: The truth is that Americans are paying more and more every year for their employer-sponsored coverage and getting less and less value for the money they and their employers are spending for it.

There is a term for that, but I’m betting you’ve never heard it before, and I’m certain the industry’s allies won’t bring it up at the congressional hearing. That term is “benefit buydown.” Members of Congress and the media should ask witnesses about it — and then investigate it.

Benefit buydown is a term that describes the many ways insurers have methodically devalued coverage while charging more and more for it, year in and year out. Here are some examples:

  • Ever-increasing deductibles mean people pay thousands of dollars out of their own pockets before their coverage kicks in.
  • Moving prescription drugs from one tier to another forces patients to pay more for their medications.
  • They limit patients’ choice of health care providers by kicking doctors and hospitals out of health plan networks. Insurers call this “blowing up the network.”

The truth that the health insurers’ allies will try to obscure at tomorrow’s hearing is this:

Americans would love to have coverage that isn’t diminished in value every year.

They would love to have coverage for what they and their family need now and might need in the future.

They’d love to have coverage that won’t disappear if they lose or change jobs.

They’d love to have coverage that gives them access to the doctors and hospitals of their choice.

They’d love to have coverage that doesn’t require emptying a bank account or declaring bankruptcy to get the care they need.

They’d love to have coverage that can’t be denied by an insurance company bureaucrat, like the “denial nurses” insurers hire by the thousands to say “no” to patients and doctors.

We can do better if we don’t let the health insurers set the agenda with FUD.