3 reasons doctors want Medicare For All, not a public option

At town hall meetings, conferences, and on the campaign trails, I am often asked: “Why not a public option?” As a physician who cares for patients and families struggling with our current health care “system,” here’s why I want Medicare For All, not a public option or “Medicare for all who want it.”

1. A public option does not lead to universal health care – or savings.

Back in 2013, the Congressional Budget Office reported that a public option “would have minimal effects … on the number of people who would be uninsured.” That’s cold comfort to the 30 million uninsured today, who are disproportionately poor and working class, and disproportionately people of color.

To make matters worse, a public option will not save us money in health care. Billions of dollars will continue to flow away from needy patients and toward greedy profiteers. With a public option, we can’t join together and push back against Big Pharma to lower prescription drug prices.

Medicare For All achieves colossal savings. By eliminating the private insurance industry’s obstacle courses and busy work, Medicare For All saves over $500 billion a year in administrative spending. Through Medicare For All, we will confront Big Pharma corporations and negotiate on behalf of all 327 million of us, saving $113 billion a year.

2. A public option adds another fragment to an already ridiculous amount of fragmentation in health care.

Every day, patients and doctors are grappling with endless obstacles from multiple insurance companies. For example, after difficult trial and error, my patients and I find a set of prescriptions to manage a problem like asthma, only to find out that the insurance company no longer covers some of the inhalers prescribed.

My patients with “good” insurance find their network of providers is shrinking. Specialists whom my patients have seen for years are no longer covered. Finding new prescriptions and specialists is time-consuming and puts my patients’ health on the line.

Multiply these problems (and the frustration of receiving timely reimbursements from insurance) across several insurance companies and a doctor’s many, many patients and the cost is staggering: $83,000 per year for the average practice. An American physician spends on average three weeks of every year haggling with insurance companies. A public option just adds one more fragment in an overly fragmented health care system and furthers the prioritization of profits over patients.

Doctors and nurses should spend their time and effort with patients, not paperwork. By eliminating private insurance, Medicare for All ends the costly and time consuming fragmentation of the current healthcare system.

3. A public option will not stop the greed machines of the insurance industry.

Even with the Affordable Care Act, dire financial consequences remain for those who face a health crisis. Four in 10 Americans struggle to pay premiums, medical bills, or out-of-pocket medical costs. Half of us have a family member who avoids necessary medical care or prescriptions because of cost. Meanwhile, insurance corporations’ profits grow: one company (UnitedHealth) is projected to make over $260 billion in revenue this year.

We have to be real with ourselves about working with insurance companies and Big Pharma. Good-faith partners in our health would not deny patients health care for the sake of profits. Good-faith partners in health would not spend millions of dollars on lobbyists to undermine the provisions and regulations in the Affordable Care Act.

Politicians supporting a public option want it to co-exist with the greed machines of the insurance industry, thinking these multibillion dollar corporations will play fair or wither away quietly. There is no reasoning with the avarice of private insurance corporations. They must be defeated.

For the sake of our patients, more and more health care providers are joining the Medicare for All movement to fight the insurance industry and Big Pharma. Together, we can make health care a human right.

Dr. Sanjeev Sriram is senior adviser to Social Security Works.