Insurers are now quantifying what experts long warned would happen: healthier consumers are leaving the marketplace, premiums are rising, and affordability is deteriorating.
As we have spent twice as much on healthcare with worse healthcare outcomes, commercial private for profit health insurance industry lobbyists continue to place every imaginable hurdle to care. We now demand passage of Medicare for all acts.
Curative, compassionate, and comfort care that is free at the point of service, free of all middle men, and therefore free of all profit. Funded entirely by a progressive tax. (so the wealthy pay their fair share)
Medicare for ALL acts are funded by a progressive tax income based siding scale, so wealthy pay more than those with very low income pay nothing. A lot more care for ALL. A lot more patients for ALL. A lot more money for ALL physicians and providers. A lot Less money for wALL street.
Important and sobering analysis. The distinction you draw between a full market collapse and a self-reinforcing affordability spiral is exactly the kind of clarity this debate needs. Too often, policymakers wait for a crisis to become irreversible before acting on evidence already at hand. Keep it up, Wendell. America needs many more journalist advocates like you.
It is absolutely the time to Divest & Drop. Drop your plan and divest from commercial health insurance investment banks as unethical shareholders.
What comes immediately after this collapse? The immediate passage of Single Payer Universal Healthcare / National Improved Medicare for All. We are leveraging people onto the hill now who prioritize and value Health First / One Health legislation instead of corporatized medicine.
It is time for all Americans to aid in the collapse of the commercial health insurance investment bank industry. These incremental band-aid and triage policies will not slow the quicksand. Americans who continue to prop up the commercial health insurance investment bank industry—the most insidious and criminal industry in the United States—they are complicit in the ongoing and ever-escalating preventable harm and death
A few important Editorial Style Guideline notes for everyone publishing on United States healthcare policy:
1) “Insurance companies” should read “commercial health insurance investment banks.” Why? Big Insurance companies are not "healthcare" companies. They mint money by implementing The Float.
2) “The uninsured” and “insured” are no longer legitimate or valid terms. Why? Americans pay premiums to commercial health insurance investment banks who then execute the Denial of Care Harm-for-Profit business model aka The Float. Even when Americans pay premiums to commercial health insurance investment banks they are not fully “insured” or “covered” in any way. Being “covered” is a fallacy. When unions and other groups are “fully covered” for every medical need 100%, they pay dearly for it.
3) Instead of “Corporate Malfeasance” the term is “Board Room Violence.” Imposing preventable harm and death by weaponizing administrative chaos is lethal. Lawmakers in Pennsylvania introduced legislation last month to hold commercial health insurance investment bank CEOs and executives accountable for Harm-for-Profit. Under the new law they will be charged with criminal aggravated assault. This is the first legislation of its kind in the United States.
4) Instead of “denials” and “appeals” or “prior-authorization” the term is “mechanisms for Denial of Care Harm-for-Profit.”
Gee, maybe the Obama Dems who negotiated with the criminal Republicans to keep Insurance industry fingers in the pie, even though they always pull a Lucy, should have told them to fuck off and actually created a national healthcare plan like the other 32 allies have done for decades. Now even Mexico is beating us to the punch.
nope: once again We the People get screwed in favor of corporate campaign contributions.
Of course this was predictable! Either way, premiums were going to increase. When a service or product is subsidized the price invariably will increase. This has been proven with college tuition. Look what happen to inflation when the government literally handed out money during and after COVID. The result was inevitable.
Again, we were told that if the ACA was passed, the cost of healthcare and health insurance would decrease. That didn't happen, and the cost of both has continued to increase without interruption, which was also predicted.
And the clarion call for M4A just gets louder! we are told by many this will solve the affordability and access issues. But we are always told that government is the answer to every problem. Yet government intervention always leads to higher costs and lower quality.
This is a common belief, and has been debunked every time. The truth is that health insurers despised the PPACA, and had absolutely no say in its design. However, after 10 years insurers figured out how to exploit it. And that is the point, it was designed to be exploited so insurers would eventually support it's continuation. We are now stuck with it.
The other thing about the ACA: When legislation of that magnitude is passed, it generally is refined by Congress as problems, shortfalls, and loopholes arise. However, in this case, the GOP has spent its entire time trying to destroy the ACA rather than improve it. Never forget, the GOP led House voted to repeal "Obamacare" 56 times.
Actually, this legislation was essentially a shell, that outlined broad parameters. It was left up to HHS to fill in the blanks. That is why Nancy Pelosi said before the vote: "we have to pass it to see what's in it". Unelected bureaucrats given the responsibility to determining what the final product will be, instead of Congress doing the heavy lifting.
It's time to end the incessant healthcare access policy whiplash and non-comprehensive incrementalism in the United States. It’s time to enact Single Payer Universal Healthcare / National Improved Medicare for All. Read more from Kimberly J. Soenen in the Minnesota Reformer>
If you are a single payor fan, let me reconfirm that I agree single payor is the way to go for those expenses that create too great of a burden on individuals or their employers. That is, single payor is the best solution to deal with ever increasing costs, and arrest the "death spiral" - by removing and separately funding those expenses which are appropriate for society to fund and bear - catastrophic expenses. I believe we should have a national stop loss coverage for expenses in excess of $25,000/year/person, funded by an individual, per capita, excise tax (where the tax is assessed for each individual, but could be shouldered by any entity, employers, NGOs, state governments, etc.) Covered expenses would be limited to Medicare or Medicaid Allowable with no balance billing, but modest point of purchase cost sharing.
My experience is that, in most years, expenses in excess of $25,000 a year represent about 2/3rds of all medical spending, incurred by less than 10% of the American population.
I would couple that mandatory stop loss coverage with a reinvigoration of the individual mandate to apply to all who are lawfully present indefinitely in America (excluding those who are here temporarily, those who are here pending resolution of immigration or asylum claims, those here on vacation, and those here illegally). Indefinite means you can stay here for the rest of your life.
I would set out a minimum level of coverage where all would be eligible to contribute to a Health Savings Account (for current and future year out of pocket spend, long term care insurance premium, Medicare premiums, etc.), defaulting individuals into a public exchange option each November, where the individual could opt out of the public exchange by showing other coverage (employer sponsored plan, individual coverage, Medicare, Medicaid, VA, or by posting a $25,000 bond, or confirming a $25,000 HSA account balance).
Vermont's experience shows both the failure of single payor for all individuals and all expenses (too expensive) as well as the failure of the ACA design/structure.
Let me draw your attention to this article in today's WSJ.
"... A little over a decade ago, the home state of Sen. Bernie Sanders tried to implement a single-payer healthcare system, only to balk at the staggering cost to taxpayers. ..."
"... Now Vermont is bringing a measure of market-based sanity to health insurance. ...'
"... In coming months, (Vermont) will roll back mandates that force young people to pay disproportionately high premiums, identify barriers to affordable health coverage for small businesses, and apply for a federal reinsurance program that has lowered premiums in other states. I estimate the reinsurance program alone will lower the average premiums in Vermont’s individual market by 10% to 15%, as it has in New Hampshire. ..."
"... That’s what Vermonters need, because the state’s individual market for ObamaCare plans is the worst in the nation. Vermont has the highest average premiums in America—$1,299 a month for the benchmark silver plan. That’s nearly 60% more than in neighboring New York, and three times as high as in New Hampshire. Even the cheapest tier in Vermont averages $824 a month, with a nearly $10,000 deductible. ..."
"... This combination of foolish policies has driven Vermont’s market into a death spiral. ..."
"Even with these reforms, Vermont’s healthcare system has far to go. But the state has come a long way since its failed attempt to implement a single-payer model. If the home state of America’s most infamous socialist can bring a measure of sanity back to healthcare, then the rest of the country can too. ..."
this cynical and downright evil nonsense has to end. Middlemen are garnering obscene profits while patients and providers are being nickeled and dimed literally to death.
I plan on dropping my health insurance after it covers my routine colonoscopy. Republicans killed the ACA when they did away with the individual mandate all those years ago.
Interesting article Wendell. I think the government subsidies should prevent a death spiral. The next issue to debate is how blank that check should be and how many resources it will consume.
entitled "Of course ACA premiums are rising The government encourages higher prices through policy"
while being notable in making no constructive recommendation, is also notable in pulling numbers off a certain graph used 8 months ago by John Thune and Mike Johnson to justify non-renewal of the ACA expanded subsidies.
(I am fairly confident the graph is wildly in error, or was prepared in order to deceive.
The graph was the topic of a post on HEALTH CARE un-covered some months ago, probably as a response to seeing my comment on the graph. Though, in the HEALTH CARE un-covered post, the graph was referred to, I think, as "deceptive" or "highly deceptive", but my main issue in my post was an omission of cost-sharing-reduction costs for certain years only for the tracked ACA plans.
Entitled: "Washington Post Editorial 7/10/26--I see Where That $5,898 Increase Comes From--I can't believe they would do that!: This Democracy Seems to be Really Failing Here--Should We Call It "Stupefied"?"
This is a broken system. Continuing to subsidize it further will only result in the need for another additional subsidy, and then another. This will continue to make the insurance companies and hospitals billions of dollars, but unfortunately will also continue to hurt the tax-payers and the people who actually pay their own premiums.
So what if … instead of trying to implement single payer healthcare, they just implement the affordable healthcare act again??? Democrats had this opportunity before and chose not to take it !! This is how the affordable healthcare came into being , it was their solution rather than single payer!! I guarantee there are democrats gathered somewhere trying to figure out how to fix it and implement it as a better plan, rather than developing a way to make single payer work. Also let not forget how many politicians became rich when the investments went into healthcare companies and stocks.
As we have spent twice as much on healthcare with worse healthcare outcomes, commercial private for profit health insurance industry lobbyists continue to place every imaginable hurdle to care. We now demand passage of Medicare for all acts.
Curative, compassionate, and comfort care that is free at the point of service, free of all middle men, and therefore free of all profit. Funded entirely by a progressive tax. (so the wealthy pay their fair share)
Call Congress at 202 224–3121
How will you pay the heavily indebted doctors and nurses? I have yet to see a plan that even mentions medical providers.
There will be so much more money to fund training, communities and physicians/providers.
Medicare for ALL acts are funded by a progressive tax income based siding scale, so wealthy pay more than those with very low income pay nothing. A lot more care for ALL. A lot more patients for ALL. A lot more money for ALL physicians and providers. A lot Less money for wALL street.
Important and sobering analysis. The distinction you draw between a full market collapse and a self-reinforcing affordability spiral is exactly the kind of clarity this debate needs. Too often, policymakers wait for a crisis to become irreversible before acting on evidence already at hand. Keep it up, Wendell. America needs many more journalist advocates like you.
A few comments:
It is absolutely the time to Divest & Drop. Drop your plan and divest from commercial health insurance investment banks as unethical shareholders.
What comes immediately after this collapse? The immediate passage of Single Payer Universal Healthcare / National Improved Medicare for All. We are leveraging people onto the hill now who prioritize and value Health First / One Health legislation instead of corporatized medicine.
It is time for all Americans to aid in the collapse of the commercial health insurance investment bank industry. These incremental band-aid and triage policies will not slow the quicksand. Americans who continue to prop up the commercial health insurance investment bank industry—the most insidious and criminal industry in the United States—they are complicit in the ongoing and ever-escalating preventable harm and death
A few important Editorial Style Guideline notes for everyone publishing on United States healthcare policy:
1) “Insurance companies” should read “commercial health insurance investment banks.” Why? Big Insurance companies are not "healthcare" companies. They mint money by implementing The Float.
2) “The uninsured” and “insured” are no longer legitimate or valid terms. Why? Americans pay premiums to commercial health insurance investment banks who then execute the Denial of Care Harm-for-Profit business model aka The Float. Even when Americans pay premiums to commercial health insurance investment banks they are not fully “insured” or “covered” in any way. Being “covered” is a fallacy. When unions and other groups are “fully covered” for every medical need 100%, they pay dearly for it.
3) Instead of “Corporate Malfeasance” the term is “Board Room Violence.” Imposing preventable harm and death by weaponizing administrative chaos is lethal. Lawmakers in Pennsylvania introduced legislation last month to hold commercial health insurance investment bank CEOs and executives accountable for Harm-for-Profit. Under the new law they will be charged with criminal aggravated assault. This is the first legislation of its kind in the United States.
4) Instead of “denials” and “appeals” or “prior-authorization” the term is “mechanisms for Denial of Care Harm-for-Profit.”
**Divest & Drop now.
Brilliant
Gee, maybe the Obama Dems who negotiated with the criminal Republicans to keep Insurance industry fingers in the pie, even though they always pull a Lucy, should have told them to fuck off and actually created a national healthcare plan like the other 32 allies have done for decades. Now even Mexico is beating us to the punch.
nope: once again We the People get screwed in favor of corporate campaign contributions.
It’s time to finally get this done. I’ve been uninsured/underinsured my whole life.
Of course this was predictable! Either way, premiums were going to increase. When a service or product is subsidized the price invariably will increase. This has been proven with college tuition. Look what happen to inflation when the government literally handed out money during and after COVID. The result was inevitable.
Again, we were told that if the ACA was passed, the cost of healthcare and health insurance would decrease. That didn't happen, and the cost of both has continued to increase without interruption, which was also predicted.
And the clarion call for M4A just gets louder! we are told by many this will solve the affordability and access issues. But we are always told that government is the answer to every problem. Yet government intervention always leads to higher costs and lower quality.
The ACA wasn't written by the "government." It was written by the INSURANCE COMPANIES 🤦♀️
Good point. Let us not forget it.
This is a common belief, and has been debunked every time. The truth is that health insurers despised the PPACA, and had absolutely no say in its design. However, after 10 years insurers figured out how to exploit it. And that is the point, it was designed to be exploited so insurers would eventually support it's continuation. We are now stuck with it.
No it hasn't.
The other thing about the ACA: When legislation of that magnitude is passed, it generally is refined by Congress as problems, shortfalls, and loopholes arise. However, in this case, the GOP has spent its entire time trying to destroy the ACA rather than improve it. Never forget, the GOP led House voted to repeal "Obamacare" 56 times.
Actually, this legislation was essentially a shell, that outlined broad parameters. It was left up to HHS to fill in the blanks. That is why Nancy Pelosi said before the vote: "we have to pass it to see what's in it". Unelected bureaucrats given the responsibility to determining what the final product will be, instead of Congress doing the heavy lifting.
It's time to end the incessant healthcare access policy whiplash and non-comprehensive incrementalism in the United States. It’s time to enact Single Payer Universal Healthcare / National Improved Medicare for All. Read more from Kimberly J. Soenen in the Minnesota Reformer>
https://minnesotareformer.com/2026/07/22/health-insurers-use-a-whole-arsenal-of-tools-to-deny-care-increase-profit/
If you are a single payor fan, let me reconfirm that I agree single payor is the way to go for those expenses that create too great of a burden on individuals or their employers. That is, single payor is the best solution to deal with ever increasing costs, and arrest the "death spiral" - by removing and separately funding those expenses which are appropriate for society to fund and bear - catastrophic expenses. I believe we should have a national stop loss coverage for expenses in excess of $25,000/year/person, funded by an individual, per capita, excise tax (where the tax is assessed for each individual, but could be shouldered by any entity, employers, NGOs, state governments, etc.) Covered expenses would be limited to Medicare or Medicaid Allowable with no balance billing, but modest point of purchase cost sharing.
My experience is that, in most years, expenses in excess of $25,000 a year represent about 2/3rds of all medical spending, incurred by less than 10% of the American population.
I would couple that mandatory stop loss coverage with a reinvigoration of the individual mandate to apply to all who are lawfully present indefinitely in America (excluding those who are here temporarily, those who are here pending resolution of immigration or asylum claims, those here on vacation, and those here illegally). Indefinite means you can stay here for the rest of your life.
I would set out a minimum level of coverage where all would be eligible to contribute to a Health Savings Account (for current and future year out of pocket spend, long term care insurance premium, Medicare premiums, etc.), defaulting individuals into a public exchange option each November, where the individual could opt out of the public exchange by showing other coverage (employer sponsored plan, individual coverage, Medicare, Medicaid, VA, or by posting a $25,000 bond, or confirming a $25,000 HSA account balance).
Vermont's experience shows both the failure of single payor for all individuals and all expenses (too expensive) as well as the failure of the ACA design/structure.
Let me draw your attention to this article in today's WSJ.
https://www.wsj.com/opinion/free-market-health-reform-in-bernie-sanderss-vermont-32a2ba68
Excerpts:
"... A little over a decade ago, the home state of Sen. Bernie Sanders tried to implement a single-payer healthcare system, only to balk at the staggering cost to taxpayers. ..."
"... Now Vermont is bringing a measure of market-based sanity to health insurance. ...'
"... In coming months, (Vermont) will roll back mandates that force young people to pay disproportionately high premiums, identify barriers to affordable health coverage for small businesses, and apply for a federal reinsurance program that has lowered premiums in other states. I estimate the reinsurance program alone will lower the average premiums in Vermont’s individual market by 10% to 15%, as it has in New Hampshire. ..."
"... That’s what Vermonters need, because the state’s individual market for ObamaCare plans is the worst in the nation. Vermont has the highest average premiums in America—$1,299 a month for the benchmark silver plan. That’s nearly 60% more than in neighboring New York, and three times as high as in New Hampshire. Even the cheapest tier in Vermont averages $824 a month, with a nearly $10,000 deductible. ..."
"... This combination of foolish policies has driven Vermont’s market into a death spiral. ..."
"Even with these reforms, Vermont’s healthcare system has far to go. But the state has come a long way since its failed attempt to implement a single-payer model. If the home state of America’s most infamous socialist can bring a measure of sanity back to healthcare, then the rest of the country can too. ..."
this cynical and downright evil nonsense has to end. Middlemen are garnering obscene profits while patients and providers are being nickeled and dimed literally to death.
I plan on dropping my health insurance after it covers my routine colonoscopy. Republicans killed the ACA when they did away with the individual mandate all those years ago.
Interesting article Wendell. I think the government subsidies should prevent a death spiral. The next issue to debate is how blank that check should be and how many resources it will consume.
A day later than this Potter post.
Possibly still of use.
The Washington Post editorial today
(https://www.washingtonpost.com/opinions/2026/07/10/aca-premium-increases-show-that-health-care-remains-unaffordable/ )
entitled "Of course ACA premiums are rising The government encourages higher prices through policy"
while being notable in making no constructive recommendation, is also notable in pulling numbers off a certain graph used 8 months ago by John Thune and Mike Johnson to justify non-renewal of the ACA expanded subsidies.
(I am fairly confident the graph is wildly in error, or was prepared in order to deceive.
The graph was the topic of a post on HEALTH CARE un-covered some months ago, probably as a response to seeing my comment on the graph. Though, in the HEALTH CARE un-covered post, the graph was referred to, I think, as "deceptive" or "highly deceptive", but my main issue in my post was an omission of cost-sharing-reduction costs for certain years only for the tracked ACA plans.
Oh, here it is, the old Potter post on the graph:
https://healthcareuncovered.substack.com/p/the-misleading-chart-that-killed
)
Due to my prior post on the 8 month ago graph, I was able to quickly do a post on the Wa Po editiorial of today. For those interested:
https://normspier828307.substack.com/p/washington-post-editorial-71026-i
Entitled: "Washington Post Editorial 7/10/26--I see Where That $5,898 Increase Comes From--I can't believe they would do that!: This Democracy Seems to be Really Failing Here--Should We Call It "Stupefied"?"
Wasn't Obama such a great president? What an asshole.
NO MORE NEOLIBERALS
We are in New Mexico, and we are very grateful to be here in this beautiful blue state.
This is a broken system. Continuing to subsidize it further will only result in the need for another additional subsidy, and then another. This will continue to make the insurance companies and hospitals billions of dollars, but unfortunately will also continue to hurt the tax-payers and the people who actually pay their own premiums.
So what if … instead of trying to implement single payer healthcare, they just implement the affordable healthcare act again??? Democrats had this opportunity before and chose not to take it !! This is how the affordable healthcare came into being , it was their solution rather than single payer!! I guarantee there are democrats gathered somewhere trying to figure out how to fix it and implement it as a better plan, rather than developing a way to make single payer work. Also let not forget how many politicians became rich when the investments went into healthcare companies and stocks.
THANKYOU Wendell!.