Rep. Alexandria Ocasio-Cortez (D-NY) joined more than 100 House members this month in a renewed push for single-payer health care, saying the pandemic strengthened the case for reform by exposing disparate outcomes for patients across race and class differences, the Washington Post reported.
“It’s more affordable to treat everybody, it’s possible to treat everybody, and people can get higher quality care than they ever could under our current privatized for-profit system,” Ocasio-Cortez tweeted on Tuesday.
But the CEO of a health care software startup, Jonathan Bush, says the pandemic has rebuked the value of single-payer health care, also known as Medicare for All, since a government-run system risks stymying a moment of industry innovation amid the rise of telemedicine.
Addressing Ocasio-Cortez directly, Bush said: “Right now is a bad time to freeze time” in health care.
Bush cited a frequent line of industry criticism that he said dates at least as far back as the early 1990s, when then-First Lady Hillary Clinton pushed for health care reform aimed at insuring every American.
“All the way back to ‘Hillary Care,'” says Bush, CEO of Zus Health. “The retort to the single payer people was you need flexibility, you need the market to be able to evolve and germinate, and you need room for product agility.”
“What you’ll do is freeze time and have some Soviet-esque thing that sounded great in a PowerPoint or a keynote, but atrophies into something horrific over time with coffee lines or black markets for gasoline or pap smears,” adds Bush, the nephew of late former Republican President George H.W. Bush and cousin of former Republican President George W. Bush.
Industry opposition to single-payer health care remains a powerful force in Washington. In recent years, a push for single payer among some Democrats in Congress has faced coordinated pushback from various segments of the health care industry, including hospitals, drugmakers, and insurers, Politico reported in 2019.
The following year, more than 50 economists signed an open letter warning that Medicare for All would lead to “innovation-stifling price controls.”
In response to the concern that a single-payer system would impede innovation, proponents of reform note that a major funder of medical research is the National Institutes of Health (NIH), a federal agency. In 2020, NIH invested roughly $40 billion in medical research, making it the largest public funder of medical research in the world.
Debate over the government’s role in medical research has risen to the fore during the COVID pandemic. An ongoing patent dispute between NIH and pharmaceutical company Moderna (MRNA) over the COVID-19 vaccine has centered on the competing roles of public and private sector institutions in the development of a crucial treatment.
To be sure, the pandemic has brought a major industry shift toward telemedicine. By February 2021, even after telemedicine appointments had leveled off, the visits still accounted for a share of U.S. insurance claims 38 times larger than they had pre-pandemic, a McKinsey & Company report found.
Virtual medicine could become a $250 billion industry with “sustained consumer and clinician adoption,” the report said.
“What’s been interesting about the digital health movement is we’re seeing now sort of disproportionate evolution,” Bush says. “So I hope AOC is paying attention. Maybe she can demand nationalized digital health, or whatever.”
Bush cautioned that a single-payer system would hamper an industry on the brink of major growth. He compared the newfound abundance of patient data to the surge of U.S. natural gas with the emergence of a method of extraction called fracking.
“Because after a long, long stagnation, we’re seeing … a real liquidity in data,” Bush says. “I mean, we’ve been trying to liquefy medical record and health data forever — it’s only now just starting to frack and leak out.”
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