A conversation with Lauren Crawford Shaver on the opposition to Medicare for All

Single-payer, Medicare for All, and public option proposals have become staples in the national conversation surrounding health care reform. What were once considered fringe, far-left proposals are now central to the health care debate among Democratic presidential candidates. 

As these reforms have pushed into the mainstream, organized opposition has coalesced in response. In the summer of 2018, a coalition of health industry groups including insurance providers, pharmaceutical companies, hospitals, and physicians banded together to form the Partnership for America’s Health Care Future. The Partnership brought together these groups with disparate interests to oppose drastic changes to the health care system.  

But opposition within the industry is not universal. 

 

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The American College of Physicians (ACP), the second-largest doctors group in the US, announced last week its endorsement of two major health care reforms – a single payer system or a public option plan. In a series of papers published in ACP’s Annals of Internal Medicine, the physician group identifies these system changes as a means to increase health care coverage, affordability, and quality of care in the US.

The move to endorse these reforms marks a significant departure from the majority of health care industry players who have long stood in opposition to overhauls of the health care system.

The country’s largest physician group, the American Medical Association (AMA), also put a crack in the industry opposition when it left the Partnership for America’s Health Future in August. The AMA’s House of Delegates also narrowly voted down a measure that would have overturned its long-held opposition to single-payer proposals, signaling a lack of unity within the group.

As policy proposals, support, and political realities continue to evolve, we caught up with Lauren Crawford Shaver, Executive Director of the Partnership, for an update on the status of the Medicare for All opposition in DC.

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Emily Boerger: To start off, can you talk to me about the Partnership for America’s Health Care Future mission and goals?

Lauren Crawford Shaver: “The mission of our organization is to identify what’s working in health care, build upon that, fix what’s not, and make sure that we put our patients first. And inherently, when we look at proposals like Medicare for All, Medicare buy-in, or the public option, we think they are one-size-fits-all proposals that don’t actually put the patient at the center of their care, don’t address costs, and don’t actually better our current health care system or strengthen what we have today.”

EB: What kind of work does the partnership engage in to address those goals and that mission?

LCS: “We are very active online in making sure we educate people about what these proposals mean for them. As you’ve seen through a variety of research we’ve released, we’ve looked at proposals like Medicare buy-in, the public option, Medicare for America, and spend our time educating people about what they mean through research and through information. We are not in the business of trying to scare anyone or have a negative campaign. We want to have a serious campaign that connects to people. And it kind of mirrors what we’re seeing in public polling from the Kaiser Family Foundation that once you introduce what Medicare for All means to an individual who currently has care today — that they will lose the care they currently have and go on to a one-size-fits-all plan — the support drops drastically. People want information about what these proposals mean. They don’t know what it is and our job is to get that information out there.”

EB: The Partnership recently published a paper on the impacts of introducing a public option and it predicted some major impacts. How do these predictions fit into the conversation around a public option being a more moderate or more incremental type of reform compared to Medicare for All?

LCS: “I think that one of the things that I first ask about proposals that come out is, what is the proposal inherently trying to solve for? … 

A lot of these proposals make an assumption that the private market can no longer exist. And we disagree. We think that 180 million Americans already have employer-sponsored coverage and like it and want to keep it. So, when these proposals come out, does it disrupt that care? Does it better the care for patients? … And a Medicare for All proposal creates a one-size-fits-all government run system. And that’s not what patients want and that’s not what 180 million Americans who have employer insurance want.”

EB: What’s your involvement on the state level? In Washington State, the legislature recently passed a public option. I’m assuming you’re keeping an eye on that, but I’m curious about your involvement at the state level.

LCS: “There are several states that have proposed single payer or public option proposals and we look closely how that impacts patients and how that impacts the employer-sponsored system that we have today. I think what’s unique in Washington is that it’s not a true public option — it actually contracts with private insurance companies to create Cascade Care. That passed before we formed as an organization so we did not engage in that work.”

EB: Looking to the future and a potential Democrat in the White House, all of the frontrunners have proposed these kind of reforms. What does the outlook for the Partnership look like then? What kind of work will you all be engaged in?

LCS: “So, we’re looking to have a very serious conversation on health care as everyone’s proposals shift and change and come from being a couple paragraphs on a website to much more fleshed out plans. I think one thing you hear from candidates across the country is that they want to build upon our health care system and strengthen it. It’s not perfect but throwing the baby out with the bath water isn’t a good path forward. So, we’re going to continue to educate people about what these proposals mean and make sure we’re contributing to the health care conversation for the long run. I’ll also just flag that we don’t endorse candidates and we don’t endorse political parties so our effort is one of public education and not about candidates.”

EB: What are some changes to the system that could increase access or affordability for people in the U.S.? I know what you are against, but what are you for?

LCS:  “We firmly believe that every American, no matter where they live or how much they make, should have access to affordable health care and we want to find ways to continue to do that. We want to make sure to protect the most vulnerable which means we’re going to keep the promise of Medicare for our nation’s seniors. We want to strengthen Medicaid and even point to states that have not expanded Medicaid to do so because it will further get more coverage and help people get the care that they need. We want patients to have more control and choice over their health care decisions. And we want to strengthen the employer-provided coverage market.”

This interview was edited for clarity and length.