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health insurance
A National Single-Payer Healthcare System Would Be Good for Employers, Too
Job-based insurance poses health-related and financial burdens on company employers and employees. These burdens would disappear with universal healthcare.
May 17, 2025
The National Day of Action is set for May 31, 2025, as a call to action in communities across the United States. The goal is to unite people locally and nationally to eliminate profit-based healthcare. This nonviolent campaign is a collective effort that aims to put National Single Payer on the national agenda. Everyone has a basic human right to healthcare.
This opinion piece shares research findings to advocate for a single-payer healthcare system. Among wealthy countries, the U.S. has by far the most expensive healthcare system, and yet the only one without universal coverage. It is fundamentally broken. The system is inequitable due to differences in insurance availability based on work status, income, and other factors. Individuals of different backgrounds don’t have the same level of access to quality healthcare services. Excess administrative costs for insurers and providers add to an estimate of $504 billion out of $1.1 trillion. The time that it takes providers to complete billing tasks can compromise patient-provider relationships and care delivery.
Employer-sponsored insurance plans are the mainstay of U.S. health insurance. More than 156 million Americans (workers and their families) are covered by job-based insurance. The plans can incur high costs for employees and their families. It also places a burden on employers, including premium payments, time spent managing insurance, and potential compromises to hiring and worker productivity. One study estimated annual transactions costs to companies of $21.6 billion. Time spent by employees dealing with insurance issues may constitute the “sludge” that reduces productivity.
“All my employees are friends of mine. It really pains me to see them not go to the doctor, especially for specialists.”
Researchers at the University of California, Berkeley and the University of California, San Francisco studied the consequences of the U.S. system of health insurance on employers. We conducted seven company case studies, with companies in various industries and of varying sizes. Companies were qualitatively and quantitatively explored for the burdens imposed on employers by providing health insurance to their workers and dependents. We interviewed company owners and managers. Below are summaries of the findings:
- All of the companies care about employee health and financial well-being. They strive to provide reliable health insurance, though employees often have other options (spousal coverage or Medicaid).
- Strategies vary widely in terms of types of coverage. Most companies reported substantial management time overseeing the insurance process. Several companies have utilized brokers or consultants for assistance.
- The two largest companies (both in the manufacturing industry) incurred unique costs related to being self-insured.
- Premium and other financial costs represented 4% to 27% of labor costs. The management cost component is up to 50% of the premium cost. Employee productivity lost to insurance activities was not significant. While there hasn’t been a significant impact on business operations, such as strategies to increase production to meet demand surges, it does affect hiring and can lead to significant costs.
Below are direct quotes from some of those interviews:
“Where [health insurance] really has an impact is who we can hire. The people who would want to work for us would want insurance and so that was always a big barrier to getting talent.”—Owner, Custom Gifts and Products company
“The cost of health insurance has limited, I mean that there’s a certain limit to my profit margin and particularly with other factors such as supply chain issues... I’m getting squeezed on a lot of different fronts, and if my health insurance didn’t go up 10% every year, I could pay people 10% more every year... They don’t want to give up their health insurance, but I think they know that it’s suppressing the wages that we can pay.”—Owner, Print and Design company
“All my employees are friends of mine. It really pains me to see them not go to the doctor, especially for specialists... And our specialist cost is very high... And for some of our employees, especially the warehouse employees, they’re not super high compensation.”—Owner, Aviation Distribution company
To conclude, job-based insurance poses health-related and financial burdens on company employers and employees. These burdens would disappear with the implementation of a national single-payer healthcare system.
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GOP Cuts to Medicaid 'Will Kill People,' Advocate Warns and New Research Bolsters
A working paper from the National Bureau of Economic Research found that Medicaid expansion saved over 27,000 lives since 2010.
May 16, 2025
Critics who say extensive cuts to Medicaid being pushed by the Trump administration and House Republicans will result in the deaths of people were bolstered Friday by new reporting on a recent study detailing how the key health program for the nation's poor saves live.
As Republicans in Congress pressed ahead this week with a plan that would cause at least 8 million Americans to lose Medicaid as part of a sweeping tax and spending bill desired by U.S. President Donald Trump, a recently published working paper from the National Bureau of Economic Research, first reported on by The New York Times, shows that Medicaid expansion saved over 27,000 lives since 2010.
A provision in the 2010 Affordable Care Act, which went into effect in 2014, allowed states to expand eligibility for Medicaid to all low-income adults regardless of disability or parenthood status. The change is part of the reason that enrollment in the program rose roughly 50% between 2010 and 2021, according to the authors of the study.
The study, which used a dataset of 37 million low-income American adults, found that expansions increased Medicaid enrollment by 12 percentage points. The study estimates that people who enrolled in Medicaid were 21% less likely to die compared to those not enrolled.
"These expansions appear to be cost-effective, with direct budgetary costs of $5.4 million per life saved and $179,000 per life-year," according to a summary of the working paper.
The researchers told the Times that the timing of the release of the working paper was not connected to Congress' current conversation around Medicaid, though they told the outlet that the debate made their findings especially relevant.
The Times described the research as "the most definitive study yet" on Medicaid's health effects and health economists not involved with the research described it as the most persuasive proof so far that Medicaid and other types of health insurance save lives.
Meanwhile, on Friday, efforts to pass the GOP megabill hit a stumbling block when a handful of Republican so-called "fiscal hawks" voted with Democrats on the U.S. House Budget Committee to block the reconciliation package from advancing through a key committee vote. The Republican hardliners voted no because they want more cuts to Medicaid.
After the vote, Rep. Pramila Jayapal (D-Wash.), a panel member, vowed that Democrats would "keep fighting to protect Medicaid and the American people."
In response to the House Budget Committee vote, Alex Lawson, executive director of the advocacy group Social Security Works said on Friday: "Make no mistake, Republicans still plan to bring it to the House floor next week."
Lawson blasted the proposed Medicaid cuts, writing that "their plan will kill people."
"The ripple effect of these cuts will hit every single person in this country," he added. "Unless you are a billionaire, your standard of living and your health care will get worse if this despicable plan becomes law."
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Heal This Sick Country: ‘Hands Up’ for the National Day of Action for Single Payer
Over 70 local and national organizations have endorsed the National Day of Action. On May 31, focus the outrage to move the engine of change and put single payer on the nation’s agenda and remove profit from healthcare.
Apr 27, 2025
On Jan 17, 2025, on the heels of the shooting of UnitedHealthcare CEO Brian Thompson, we wrote about the failed system of our corporate controlled healthcare and the outrage against the health insurance industry the shooting spawned. We mentioned the possibility of setting a National Day of Action in 2025 to demand freeing healthcare from profit and covering everyone under a national single payer plan.
Today, we call on people across the country to gather on May 31, 2025, to put their “Hands Up” for:
- The recognition by our government that healthcare is a human right;
- The elimination of private health insurance and the banning of for-profit delivery of care;
- The enactment of a publicly financed, national single-payer program that would provide comprehensive coverage to everyone; and
- The transformation of care delivery from profit-seeking ventures into services organized to serve the people of our country, a system in which all caregivers are freed from corporate control.
President Donald Trump’s inauguration has introduced the prospect of severe hardships to working class and low-income people, people with disabilities, the elderly, and children with proposed cuts to Medicaid, Medicare, and Social Security necessary to fund tax cuts for the wealthy. This moment demands more than the protection of our public programs; it demands a national, single-payer healthcare program, free from profit, for everyone. One people, one plan.
The complicity of our government in the profit-making enterprise of health insurance has been exposed once again when, on Monday April 7, the Trump administration raised payment rates for Medicare Advantage insurers by 5.1%, significantly more than the Biden administration’s proposed increase of 2.2%, which was bad enough. This rate increase has the potential to increase payments to MA by $25 billion next year. However, the final sum will be closer to $60 billion, when the impact of gaming the system through risk scoring is included.
Paying health insurance premiums to a for-profit company that has been given permission to restrict and withhold necessary care is the great scam of modern U.S. healthcare.
As predicted, Medicare Advantage continues to gain enrollment because they offer lower premiums compared to Traditional Medicare. Now they can expect payment from the Medicare trust fund at a higher rate as they have almost every year under Democrat and Republican administrations since 2016. Early this month, while the rest of the market spun out of control due to the announcement of tariffs, insurance stocks soared after the Centers for Medicare and Medicaid (CMS) announced the Medicare Advantage rate hike.
Despite rate increases, Medicare Advantage will continue to operate within narrow networks that often don’t include specialty care, such as Cancer Centers of Excellence. Unlike Traditional Medicare, beneficiaries in Medicare Advantage must accept pre-authorization requirements to receive care that create the delays and denials of care. Many seniors are unaware that in all but four states, once they have enrolled in a Medicare Advantage plan, they cannot change to Traditional Medicare without being subjected to underwriting and the potential of very high premiums if they have preexisting conditions. Paying health insurance premiums to a for-profit company that has been given permission to restrict and withhold necessary care is the great scam of modern U.S. healthcare.
Medicare is only one part of the privatization of government sponsored health insurance: Medicaid is now largely privatized in 42 states, subjecting children from low-income families and low-income adults to the delays and denials that are the mainstay of cost controls in managed care private insurance plans. Seventy five percent of all Medicaid beneficiaries now are enrolled in a Medicaid Managed Care Organization (MCO), and Medicaid MCO denials are twice as high as denials in Medicare Advantage. Five Fortune 500 health insurance companies enroll 50% of all Medicaid beneficiaries, all publicly traded and high performing profit makers.
Over 90 million Americans eligible for government supported healthcare, both Medicaid and Medicare, are now captives of private insurance managed care schemes that control their access to healthcare. Many more millions on Traditional Medicare are being “aligned” by CMS into profit-seeking Accountable Care Organizations. The underlying profit extraction inherent in these schemes prevents critical services from reaching the right people at the right time.
The same can be said for employer-based insurance where workers are paying excessive premiums to health insurance companies to be given the privilege of paying deductibles and coinsurance that make accessing care so expensive that many forgo needed services. According to the Commonwealth Fund, premiums and deductibles consume 10% of the median household income in the U.S. This means that every household with employer health insurance making $80,610 per year or less is underinsured. Employers are faced with increasing insurance premiums for their employees that challenge their ability to stay in business, or in the case of public schools, the ability to keep schools open.
Enough is enough! Over 70 local and national organizations have endorsed the National Day of Action. On May 31, join an action or plan an action in your community. Focus the outrage to move the engine of change and put single payer on the nation’s agenda and remove profit from healthcare. On May 31, put your “Hands Up” for National Single Payer—an Improved Medicare for All free from profit with everybody in and nobody out. Nothing less can heal the nation.
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