In the fall of 2019, a poll published by Gallup awarded America’s health care sector the ignoble distinction of being among the most hated industries in the country. With a net approval rating of -10, only the federal government and Big Pharma (itself a health care–related enterprise) elicited greater hostility. Even the likes of oil companies, advertising agencies, and lawyers registered as more popular.
You’d never have known it listening to many of America’s leading liberal politicians discuss health care in the various Democratic primary debates held that year: each one dominated by misleading talking points seeded by industry propagandists to stave off the mortal threat of socialized medicine (and punctuated, for good measure, by a barrage of ads from insurance companies during each and every break). The casual viewer could have been forgiven, in fact, for coming away with the impression that millions of Americans harbor deep affection for multibillion-dollar private providers — an affection matched only by their quivering fear that the evil federal government might step in and replace their plan with a public alternative.
This has never really been the case, of course, as illustrated in numerous polls showing majority support for a health care system that’s both universal and public. The Democratic debates were skewed not because people actually love their privately purchased or employer-provided insurance but because the multibillion-dollar health care industry has leveraged its bottomless war chest to buy off a sizable chunk of the political class and protect its profits in the process. By way of pushback, Medicare for All advocates often pointed (and still do point) to the popularity of public health insurance programs abroad — a tactic that makes perfect sense considering the ironclad approval ratings they enjoy in places like Canada and the UK.
Another option, however, is to compare the experience of private plans in America to that of public alternatives like Medicare. In this respect, a new study published by the Journal of the American Medical Association offers a remarkable and comprehensive glimpse into the popularity of existing government-funded options — and the relative dissatisfaction that characterizes the more prevalent private ones. Making use of a vast sample size (149,290 people across seventeen states and the District of Columbia), the survey analyzed individuals’ experiences of health care in relation to access, cost, and overall satisfaction, applying these three metrics to each of the five major forms of health insurance coverage (Medicare, Medicaid, military coverage, individually purchased, and employer-provided).
The study’s top-line finding is about as clear and direct as they come:
Individuals with employer-sponsored and individually purchased private insurance were more likely to report poor access to health care, higher costs of care, and less satisfaction with care compared with individuals covered by publicly sponsored insurance programs.
Medicare in particular scored remarkably well in the survey when compared with private alternatives, individuals covered by the program reporting higher levels of satisfaction, greater stability, less difficulty in finding a physician or accessing care, and lower levels of medical debt. The popularity of private health insurance plans, in short, is a myth — as is the idea that millions of Americans live in perpetual fear that the creeping hand of big government will step in and “take away” their inadequate, costly, and sometimes inaccessible private care.
Public alternatives, especially Medicare, are more efficient, stable, and patient-friendly: a reality confirmed by what patients and those covered under the program report themselves (a fact that’s still more incredible given the repeated efforts by Democrats and Republicans alike to undermine it and cut its budget). You don’t have to look abroad, in other words, to observe the overwhelming popularity of publicly funded health insurance compared to for-profit private options. The evidence has been in America all along — and no one should let insurance industry apparatchiks, or the politicians who supply their talking points, say otherwise.