May 15, 2017

Aetna CEO: 'Single-payer, I think we should have that debate as a nation'

Daily Briefing

    Aetna CEO Mark Bertolini on Thursday said he is open to a public debate on transitioning the United States to a single-payer health care system.

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    Bertolini first made the comments were at a private Q&A with Aetna employees. Vox received a partial video of the comments from an attendee.

    Bertolini's comments

    The video shows Bertolini responding to a question about such a transition and how it could affect Aetna. Bertolini said, "Single-payer, I think we should have that debate as a nation."

    He added, "If the government wants to pay all the bills, and employers want to stop offering coverage, and we can be there in a public private partnership to do the work we do today with Medicare, and with Medicaid at every state level, we run the Medicaid programs for them, then let's have that conversation." But, he questioned, "if we want to turn it all over to the government to run, is the government really the right place to run all this stuff? And that's the debate that needs to be had."

    Aetna spokesperson T.J. Crawford later clarified that Bertolini was not "advocating" for a single-payer system, but instead was "encouraging debate while pointing out that public-private partnerships have been the backbone of the more successful government health care programs."

    Bertolini elaborated on his comments during an earnings call with health care analysts on Friday, saying he felt "government-run health care would be a bad idea." But, he said public-private partnerships, such as one used in Germany, could be beneficial.

    Bertolini discussed the current debate surrounding health care, with liberal groups calling for a single-payer system and conservative groups working to reduce the government's role in health care. Bertolini said policymakers instead should "discuss what single-payer means. Is it a single source of financing, which does not yet get at the cost structure? Is it a health care system where the government owns the doctors and hospitals and operates them as well, like the [National Health Service] in the [United Kingdom]? What is that?"

    According to Vox, Bertolini's comments highlight the fact that there are several different types of single-payer models. The one Bertolini appears most interested in, Vox reports, is a single-payer model in which the federal government contracts with private companies to run certain health care benefits (Scott/Kliff, Vox, 5/12; Kliff, Vox, 5/12; Humer, Reuters, 5/12).

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