A health insurer takes on his own industry: Describe clearly what we favor, not attack what we oppose
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As CEO of a health insurance plan, I have been dismayed this year to see the health industry resurrect familiar and misguided tactics to oppose Medicare for All. It is time for health leaders to learn from our history, acknowledge our system fails many Americans, and describe clearly what we favor, rather than attack what we oppose.

First, the history. In the 1930s, President Roosevelt considered including health care in the New Deal’s safety net. The medical industry killed that idea, fearing it would upend the traditional practice in which patients paid physicians directly. In 1948, President Truman called for “a comprehensive insurance system to protect all our people equally against insecurity and ill health.” The physicians’ lobby broke records with its opposition campaign, branding Truman’s plan “socialized medicine.” In the 1960s, after President Kennedy supported expanded health insurance for seniors, the health industry warned Medicare would “put the government smack into your hospital.” Then, in the 1990s, insurance companies ran the “Harry and Louise” ads on television, convincing the public to oppose President Clinton’s universal health care plan. 

It took almost a century of reform attempts before the Affordable Care Act passed in 2010, extending coverage to tens of millions. Those were decades without a vital safety net for vulnerable Americans.


Today, too, health interests are mounting a campaign opposing Medicare for All before any bill has been scheduled for a vote. Web ads, Tweets and videos echo the language of past attack campaigns. Before more money is spent, those of us in the health field should say what we stand for, instead of rushing to condemn the ideas of others.

This is what I believe: Everyone in our country should have health insurance. It should be affordable and high-quality. It is morally, politically and economically unacceptable to leave nearly 30 million people without coverage. And we can achieve progress if we overcome our divisions.

My state, Massachusetts, is proof.

Our leaders, as in the rest of America, have diverse views. Physicians, unions, hospitals, consumers, businesses and local not-for-profit health plans debated for 30 years before uniting around a core belief that our community shares responsibility for health care for all. Our state’s landmark law was signed in 2006 by Republican Gov. Mitt RomneyWillard (Mitt) Mitt RomneyTrump-backed bills on election audits, illegal voting penalties expected to die in Texas legislature The Memo: Conservatives change their tune on big government Defense & National Security — Military starts giving guidance on COVID-19 vaccine refusals MORE, and subsequent Democratic and Republican governors have supported and improved our legislation.

It has worked. Today, more than 97 percent of residents in our state have insurance, the highest rate in the nation. We have some of the country’s most impressive public health rankings on measures of mortality, adult obesity, smoking, suicide rate and infant mortality. And every year since 2010, Massachusetts has outperformed the national average in constraining cost growth.

Small wonder that the Affordable Care Act was inspired not only by Massachusetts’ legislation, but also by our model of collaboration. Longtime opponents listened to each other, and accepted compromises. Today, 12 million people have insurance through exchanges and 17 million gained Medicaid coverage through state expansion.

Yet work remains: approximately 12 percent of American adults still lack insurance, struggle to pay for medications and other care out of pocket, and often end up buried in debt. The number of people without coverage rose by 1 million last year amid continuing challenges to the ACA. Even many Americans with insurance struggle to cover their own health care expenses.

To my health industry colleagues: let’s begin by recognizing the flaws in our system. Let’s welcome ideas from all sides of the ideological spectrum, left and right.  And while the long-term debate ensues, let’s work to improve what we have.

Let’s fund public reinsurance programs to stabilize the individual insurance market in the face of high claims from the 1 percent of patients who generate nearly 20 percent of spending. That would make coverage more affordable for all others.

Let’s adjust financial assistance to make coverage more affordable for our low-income neighbors.


And let’s agree we do not want to clone any other nation’s health care model. Most countries, including our own, have a complicated hybrid of market-driven and government-regulated care and coverage. We can aspire to the universal coverage offered by most developed nations without abandoning the bold private-sector innovation that sets our country apart.  Let’s build on our strengths.

We have done it before. In 1997, after the bitter battle over the Clinton health plan, Sen. Ted Kennedy (D-Mass.) teamed up with Sen. Orrin HatchOrrin Grant HatchLobbying world Congress, stop holding 'Dreamers' hostage Drug prices are declining amid inflation fears MORE (R-Utah) to expand insurance for millions of children. They collaborated with imagination, pragmatism and urgency. Let’s repeat that history.

Physicians, pharmaceutical companies, hospitals and health plans should have common ground with those who support Medicare For All. We all believe we can forge a uniquely American solution.  

We should begin by listening to each other.

Andrew Dreyfus is president and CEO of Blue Cross Blue Shield of Massachusetts, which provides health insurance coverage for 2.8 million people.