Conservatives like to pretend that the United States enjoys the best private health care system in the world, where some may have trouble purchasing insurance coverage, but everyone has access to care when they absolutely need it. Case in point, Sarah Kliff’s interview this morning with House Majority Leader Eric Cantor (R-VA) about his support for Marilyn Tavenner, the administration’s nominee to oversee the Center for Medicare and Medicaid Services:
“I could absolutely work with her,” Cantor told me in an interview this morning. “She would be a real benefit for patients. Obviously she’s operating within a context, within the structure of a law that I didn’t support, but I do think she will bring to the job a perspective of the American health care system that has made it so great, a system that’s based on the private sector.”
Most health care providers work in the private sector, but it’s hard to argue that the American health care system is “based in the private sector” when the government finances almost half of national health care spending.
For instance, in 2010, growth in private health insurance premiums remained low, as 5.1 million enrollees lost their jobs or simply couldn’t afford to maintain their coverage. Many enrolled in safety-net health care programs like Medicaid, resulting in a spending increase of 7.2 percent. By 2014, private growth is projected to accelerate — thanks to health care reform — but even then, “private health insurance is anticipated to account for roughly 31 percent of national health spending, or about the same share as was expected without enactment of the Affordable Care Act,” actuaries at CMS estimate. “For 2011–13, government outlays (averaging 5.2 percent growth) are projected to roughly maintain a 45-percent share of total health spending.”
So in truth, ours is a hybrid public/private health care system, but if lawmakers like Cantor succeed in vouchering Medicare, block granting Medicaid and repealing the Affordable Care Act, then their mythology may become reality.