Health Care Reform From The Insurer's Perspective Opposition to President Obama's plan for a public health insurance system includes some in Congress, the American Medical Association and private health insurers who argue that a government plan would draw customers away from private insurers. What's their side of the story?
NPR logo

Health Care Reform From The Insurer's Perspective

  • Download
  • <iframe src="" width="100%" height="290" frameborder="0" scrolling="no" title="NPR embedded audio player">
  • Transcript
Health Care Reform From The Insurer's Perspective


This is WEEKEND EDITION from NPR News. I'm Scott Simon.

Coming up, analog TV off the air forever. But first, President Obama went to Wisconsin this week for a town hall meeting on his plan for a public health insurance system. His remarks drew applause from some and denunciation from others who decried the plan as a step towards government control.

President BARACK OBAMA: So what you've heard is some folks on the other side saying I'm opposed to a public option because that's going to lead to government running your health care system.

SIMON: Karen Ignagni is president and CEO of America's Health Insurance Plans, a group that represents nearly 1,300 health insurance companies and joins us in our studios. Thanks so much for being with us.

Ms. KAREN IGNAGNI (America's Health Insurance Plans): Thank you so much.

SIMON: I suspect there are many Americans who would say if a government plan draws customers away from private insurers, so what? So - so what?

Ms. IGNAGNI: The question is, what is the best way to accomplish the goal that I believe most Americans share - to get everybody in to the health care system, contain costs, bend the curve, as the president has said so eloquently on so many occasions, and improve quality. Those are the goals.

Now the question is what's the best way to achieve those goals. The issue of whether we should have a government-run plan running side-by-side with health plans, private health plans, is a question that people feel very passionate about, without a doubt.

SIMON: There are people get concerned about a phrase like containing costs because they think that that translates to not offering as much coverage.

Ms. IGNAGNI: We have - again, I think it's important - you ask a very important question and no doubt there will be a great deal of focus on that in the debate.

SIMON: I mean, you know…


SIMON: …in practical terms, somebody who says, well, they're not going to test me for this because I'm 45 and the odds are that I don't have it, and yet they might be that relatively small percentage that has a certain affliction and they don't get treated until it's too late.

Ms. IGNAGNI: Here's what the literature shows: we have overuse, we have underuse, and we have misuse. By underuse I mean, for people who don't have coverage or don't have coverage for prevention, we're missing opportunities to intervene early. They end up in the emergency room - most expensive component in our delivery system.

We have an overuse problem because there isn't consensus about what is best practice, and we need to do more in terms of getting that information distributed into practice more quickly and effectively so that the physicians at the bedside are armed with the latest in scientific information and they don't have to spend their nights going through 20 journal articles.

So what we have done, Scott, is not say let's keep the system the way it is. We've recognized that people are falling through the cracks. People are worried about continuity of care. We have proposed a full-scale and comprehensive redesign of the regulatory structure. This is not a voluntary effort. We are committed to doing this through legislation. We have proposed new rules and we've worked very hard to work with members of Congress on both sides of the political aisle.

SIMON: What about the argument that President Obama and others make that a public option will keep down costs?

Ms. IGNAGNI: Well, if you underfund…

SIMON: By making companies such as yours compete.

Ms. IGNAGNI: Well, if you underfund, surely you definitely keep down costs. Medicare right now is paying on average 88 cents on the dollar. If you ask, bring in a number of hospital administrators, anyone here, and ask them if they can run their hospital that way, they can't.

So the question is, how do we achieve the objectives of bending the curve, which we think is - there's significant opportunities, and doing it in a way that begins to redesign the delivery system to value best practice, to reward best practice, to get the incentives right so the incentives aren't just do more.

SIMON: You know, interesting, it's still not clear to me whether or not you're in favor of a public option.

Ms. IGNAGNI: We are not in favor of a public option because we haven't seen a public options that wouldn't be tilted toward essentially creating a single payer system. It's a shortcut to a single payer system because of the economics.

First of all, the major hospitals in this country that you can name will go bankrupt, number one, and that's a societal concern. Number two, I'm very concerned that we're having a discussion about so-called public option, but recognizing the economics, there's no way we're going to end up with side-by-side competition. It is going to be a single payer system because of the pull from the perspective of an employer. Why wouldn't - because of the rate differential.

SIMON: They would pick the cheaper option.

Ms. IGNAGNI: Well, why - and not just cheaper, it's significantly cheaper. And that's just something that I think we need to talk about.

SIMON: Karen Ignagni, who's president and CEO of America's Health Insurance Plans, thanks very much.

Ms. IGNAGNI: Thanks so much for having me.

Copyright © 2009 NPR. All rights reserved. Visit our website terms of use and permissions pages at for further information.

NPR transcripts are created on a rush deadline by Verb8tm, Inc., an NPR contractor, and produced using a proprietary transcription process developed with NPR. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.