During Wednesday night's Democratic presidential primary debate – the first in a two-night event viewed as the de facto launch of the primary season – health policies, which range from “Medicare for All” to efforts to curb skyrocketing drug prices, were one of the key issues the 10 hopeful candidates onstage accustomed to help differentiate themselves in the pack.
Health care dominated early, with Sens. Elizabeth Warren (Mass.) and Cory Booker (N.J.) using questions about the economy to take aim at pharmaceutical and insurance providers. Sen. Amy Klobuchar (Minn.) emphasized the difficulties many Americans face in paying premiums.
But the candidates broke ranks around the details and never all their claims stayed strictly within the lines.
Only two candidates – Nyc Mayor Bill de Blasio and Warren – raised their hands in favor of banishing private insurance to install a government-sponsored Medicare for those approach.
Klobuchar, a single-payer skeptic, expressed concern about “kicking 1 / 2 of America business medical health insurance in four years.” (That's correct: In 2021, most Americans had private coverage, with 49% getting that insurance through work, based on the Kaiser Family Foundation.)
Former Texas Rep. Beto O'Rourke, who also supports maintaining a personal insurance system, outlined his own universal health care plan, based on a “Medicare for America” bill in Congress.
The single-payer talk set off other discussions concerning the role of health insurance and the cost of care. We fact-checked a few of the biggest claims.
Warren: “The insurance providers last year alone sucked $23 billion in profits out of the healthcare system. $23 billion. Which doesn’t count the cash that was paid to executives, the cash which was spent lobbying Washington.”
We contacted Warren's campaign, who directed us to some report from the National Association of Insurance Commissioners, a nonpartisan group of industry regulators. It supports her assessment.
The report says that in 2021, health insurers posted $23.4 billion in net earnings, or profits, compared with $16.1 billion annually prior.
This came up poor Warren's support for eliminating private insurance within Medicare for those system. However, the financing and price tag of these a system is unclear.
Booker: “The overhead for insurers they charge is 15%, while Medicare’s overhead is only at 2%.”
This is a flawed comparison. Booker said administrative overhead utilizes a lot more for private carriers of computer does for Medicare, the government insurance program for seniors and the disabled. But Medicare piggybacks off the Social Security Administration, which provides coverage for costs of enrollment, payments and keeping track of patients.
Also, Medicare relies on private providers for some of their programs, and overhead charges there are higher. Medicare's overhead is under those of private carriers, but exact figures are elusive.
The insurance companies' trade group, America's Medical health insurance Plans (AHIP), reported in 2021 that 18.1% of private health care premiums visited non-health care services. That includes taxes of four.7% and profits of two.3%. The Medicare trustees reported that in 2021, total expenses were $740.6 billion, with administrative expenses of $9.9 billion. That comes to at least one.3%, under Booker said.
Warren: “I spent a big chunk of my entire life studying why families go bankrupt, and one of the No. 1 reasons is the price of health care, hospital bills. And that's not only for those who don’t have insurance. It’s for those who have insurance.”
Is no. 1 reason people go broke the price of healthcare? We've rated similar statements Half True – partially accurate but lacking important context.
A 2005 study Warren co-authored and a 2009 paper both found that healthcare expenses were a number one reason for individual bankruptcy. But these claims have come under dispute, particularly from academics who claim that people may overstate the role medical bills play in their financial problems. Other research suggests a much narrower impact, though that, in turn, continues to be criticized for focusing only on adult hospitalizations.
That said, research in the Consumer Financial Protection Bureau found that hospital bills are a leading reason for personal debt – in 2021, the CFPB discovered that nearly 20% of credit history included a medical debt tradeline.
But Rep. Tulsi Gabbard (Hawaii) drew on types of universal coverage of health far away to explain why she still supported some private insurance options.
Gabbard: “If you appear at other countries in the world who have universal health care, each of them has some type of a role of private insurance.”
This is true. Virtually every country with universal health care features a role web hosting insurance. Some let it cover services not addressed by the national plan. Others take as a way to obtain care faster. Others heavily regulate it as being a principal source of coverage.
For instance, Canada, the model for that principal Medicare for those bill, allows private insurance to deal with prescription medication coverage, private rooms in hospitals and vision and dental care. (It's not permitted to compete with the federal government plan.) In England, about 10% of individuals – mostly wealthier people – elect web hosting coverage, which could yield faster use of care. Countries such as the Netherlands and Switzerland heavily regulate private coverage.
Beyond Medicare for those, candidates discussed ways of bring down drug prices as well as other issues.
Klobuchar: “2,500 drug prices have gone up in double digits since [Donald Trump] took office.”
This is accurate, based on a study from Pharmacy Benefits Consultants, an industry group, which listed a number of pharmaceutical products experiencing price increases up to 1,468%.
And the numbers are less flattering than Klobuchar suggested.
An analysis through the Associated Press found that, between January and July 2021, a lot more than 4,400 branded prescription medications experienced price increases. Meanwhile, data compiled by Rx Savings Solutions found that the list cost of more than 3,000 drugs increased this year.
O'Rourke: “In Texas, the only largest provider of mental health care is the city jail system.”
This is correct.
Texas jails are the largest mental healthcare systems in the state, according to a study in the University of Texas at Austin. The Harris County jail, with a 108-bed unit, identifies itself as the largest mental health care facility in Texas.
This is not a Texas-specific issue. According to a 2011 NPR report, it's more prevalent to see Americans getting mental healthcare in jails and prisons than hospitals or other dedicated treatment facilities.
Election Day is 495 days away.