‘Medicare buy-in’ is really a subsidy to private insurers: Harvard professor

See also "An Unworkable Mess," (New York Times, Room for Debate Blog, Dec. 11, 2009) by Drs. Steffie Woolhandler and David Himmelstein.

Dec. 10, 2009

Steffie Woolhandler, M.D., M.P.H.
Mark Almberg, Physicians for a National Health Program, (312) 782-6006,

The Senate proposal to allow uninsured people over age 55 an opportunity to buy into Medicare constitutes yet another government subsidy to the private health insurance industry, a leading health policy analyst and single-payer advocate says.

Dr. Steffie Woolhandler, co-founder of Physicians for a National Health Program and professor of medicine at Harvard Medical School, told a radio host Wednesday morning, “One of the better provisions of the reform legislation was that it prohibited charging older people more than twice (or thrice in the some versions) as much as you charge younger people in the individual market. But by saying everyone over 55 in the individual market can be picked up by Medicare, you’ve really let the insurance industry off the hook.”

Woolhandler continued: “That is, the highest-cost patients in the individual market will be taken off their hands and paid for by the taxpayers; and private insurance will remain the only option for people under the age of 55 and for anyone who gets their insurance through their employer. Another way of saying that is: if you now have private health insurance and you don’t like it, you’re forced to keep it.

“The buy-in to Medicare is only for those 55 to 64 and it’s only for people who are not offered private health insurance through an employer. So it turns into just a subsidy to private health insurance: the taxpayers will pay for the high-cost patients and the health insurance industry can take the lower-cost patients.”

Woolhandler, who also practices primary care at Cambridge Hospital in Massachusetts, is a prominent advocate for single-payer national health insurance, sometimes called an expanded and improved Medicare for All. She says research has demonstrated that replacing today’s multi-payer system, with its wasteful paperwork and bureaucracy, with a streamlined single-payer system would save about $400 billion annually, enough to assure everyone comprehensive, quality care.

“I want to remind people that at its core, this bill takes $450 billion in new taxes from the taxpayers, and hands it over to the private health insurance as subsidies. So, the core of the bill is a financial strengthening of the private health insurance industry. Now, one of the small things that was good about the plan, that is, forcing the insurance industry to lower the prices for older enrollees, has been taken out of the bill, essentially.”

Woolhandler also said the proposal for an exchange of private, nonprofit insurance plans for those under 55 will be of little benefit, noting, “It’s similar to the menu that is offered to federal workers, but of course federal workers actually get money to buy the health insurance. They don’t just get the menu, they get the money.”

A full audio recording of the interview, conducted by an affiliate of KPFK Pacifica radio in Los Angeles, is available here.

Woolhandler is also co-author of several studies published in prominent medical journals this year, including one showing 62 percent of personal bankruptcies are linked to medical bills or illness and another showing that nearly 45,000 excess deaths annually are attributable to lack of health insurance.

Dr. Woolhandler and other leaders of Physicians for a National Health Program are available for interview on the most recent developments in the emerging health reform legislation.

Physicians for a National Health Program ( is an organization of 17,000 doctors who support single-payer national health insurance. To speak with a physician/spokesperson in your area, visit or call (312) 782-6006.

See also "An Unworkable Mess," (New York Times, Room for Debate Blog, Dec. 11, 2009) by Drs. Steffie Woolhandler and David Himmelstein.