One Reason We Won’t Get a Single Payor System – The Government Doesn’t Want It

The best way to solve complicated problems?  Break them down into their basic parts and analyze them one by one.  Josh Raskin’s report titled One Reason We Won’t Get a Single Payor System – The Government Doesn’t Want It”  takes on one of those parts.

To be clear, we’re not claiming to have solved the single-payor debate, but we do have the luxury of taking an apolitical and dispassionate view here at Nephron.  And data – we loooooove the data.  For his part, Raskin has been collecting and analyzing that data for a couple of decades now.  Throughout that time, it has been clear that the commercial segment of health insurance subsidizes the government programs of Medicare and Medicaid. We have known that rates paid to providers are significantly higher for employers than for those on government programs. What we didn’t know, was the magnitude of this subsidization and how pervasive it is across all providers.  Based on a recent RAND study and other sources Raskin breaks down in a report to clients today, it is clear that providers rely on, perhaps need, the higher payments from commercial sources.

The takeaway: We estimate that 94% of hospitals would be losing money if commercial rates shifted to Medicare rates, up from 33% today.

Please contact for more information on this analysis which follows on to several other pieces Raskin and his team have put out to help clients navigate this fraught topic including:

  • 3/21 – “The Politics of Healthcare Services and Why the Market is Wrong”
  • 3/14 – Managed Care & Facilities Weekly: “Medicare for All Support Trends”