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Ignagni: Government Role In Health Care Is Fine…As Long As It’s For Supporting Health Insurance Industry

AHIP’s President and CEO Karen Ignagni (pronounced ig-NAH-nee) walks a tight rope when discussing the government’s role in the health care system. While rejecting direct competition between public and private insurance plans, Ignagni argues that the government should subsidize the industry’s insurance product (she calls it making health care “affordable”), provide coverage for the the poorest and sickest Americans, and require everyone to purchase insurance:

For government, then, as we think about responsibilities, our responsibility to get everybody in, to sustain coverage, to do it affordably, government, to begin to step in, require personal responsibility, but at the same time provide this helping hand or provide this assistance for people who are going to need help.

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The government, Ignagni argues, should serve as a “helping hand” and provide peace of mind — but only so far as it benefits insurer interests. For instance, Ignagni and AHIP endorse a government-public hybrid health care system on one hand, but reject direct private/public competition on the other. Private insurers should have the exclusive right of insuring Americans under 65, because giving Americans a choice between a private and public plan would drive private insurers out of business, Ignagni argues.

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But the stance is grounded in opportunism, not principle. While Ignagni is trying to keep a viable public program from entering the under 65 market, she strongly lobbied to increase the role of private insurers in Medicare — and argued that public-private competition in the over 65 market would increase patient choice. (Note that she did not ask for fair competition. Private plans participating in Medicare Advantage receive a 13–17 percent government subsidy). Here is Ignagni defending the subsidy:

Are we going to maintain choices [in Medicare] in all markets or reduce or eliminate and the particular thing I would like to leave you with, I will be talking about the history in a moment. [Kaiser Foundation, 7/16/2007]

– But if you have the goal of maintaining choices in all the areas and if you have monopoly systems that refuse to contract with the health plans, if you are going to achieve that goal of maintaining choices in all areas, you have very few choices and that is also why private fee for service was developed. [Kaiser Foundation, 7/16/2007]

In short, Ignagni wants to play in the government’s sand-box but is desperately trying to keep the under-65 playpen all to herself.

Transcript:

PAGE: What about the idea that this is a pretty big government step for the government to say to every American, whether you want insurance or not, whether you think you can afford it or not, you must buy insurance, and if you don’t, you’ll be subject to government penalties. Is that an appropriate role for the government to take?

IGNAGNI: Well think of the alternative. If we want to have a health reform program that gives Americans the peace of mind and the health security that they can find coverage, notwithstanding whether they are old, young, sick or well, then we need to take the step of all being part of a system.

For government, then, as we think about responsibilities, our responsibility to get everybody in, to sustain coverage, to do it affordably, government, to begin to step in, require personal responsibility, but at the same time provide this helping hand or provide this assistance for people who are going to need help.