Hillary Clinton said over the weekend during a Democratic presidential primary debate that she thinks the government doesn’t have “enough oversight over what the insurance companies are charging everybody right now.”
What’s interesting is that she’s saying this as some commercial health insurers seem to be fleeing from the Patient Protection and Affordable Care Act (PPACA) public exchange system, and others seem to be sticking with it mainly out of a sense of civic duty or, possibly, in an effort to hang on to their Medicare and Medicaid contracts.
Of course, some have speculated since PPACA came to life that the main goal of the drafters was to cause a commercial health insurer death spiral that would lead to a single-payer Medicare-for-all system.
Bernie Sanders said during the debate that he thinks shifting to a single-payer system would save the country a great deal of money.
On the one hand, it’s a great big world, and it’s hard to know how well or how poorly a single-payer health insurance system would work for U.S. residents under the age of 65.
The United States already has what amounts to a universal safety-net program plus a private supplemental products market for the Medicare-age medical, disability and long-term care insurance (LTCI) markets. Some of those markets function better than others, but the existence of the safety-net programs hasn’t, at this point, turned the United States into a Marxist-Leninist dictatorship of the proletariat.