Newspapers across the country are reporting that health insurance premiums are set to skyrocket next year. From the New York Times:



Health insurance companies around the country are seeking rate increases of 20 percent to 40 percent or more, saying their new customers under the Affordable Care Act turned out to be sicker than expected. Federal officials say they are determined to see that the requests are scaled back. Blue Cross and Blue Shield plans — market leaders in many states — are seeking rate increases that average 23 percent in Illinois, 25 percent in North Carolina, 31 percent in Oklahoma, 36 percent in Tennessee and 54 percent in Minnesota, according to documents posted online by the federal government and state insurance commissioners and interviews with insurance executives. The Oregon insurance commissioner, Laura N. Cali, has just approved 2016 rate increases for companies that cover more than 220,000 people. Moda Health Plan, which has the largest enrollment in the state, received a 25 percent increase, and the second-largest plan, LifeWise, received a 33 percent increase.

First, to be fair, health care is expensive in America -- really bloody expensive . So, if insurers are paying the big bills, some degree of sympathy is necessary. But let's the cut the crap right there. The reason we have such insane health care prices in this country is because we have a thousand different health plans without the bargaining power that a single-payer would have -- in Canada, France, Italy, England, Australia and most other major countries, "Big Government" negotiates cheaper hospital and drug prices -- to discipline provider prices.

Now, the uninspiring message from the Obama Administration for Americans encountering these insane increases is, well, "shop around."



Sylvia Mathews Burwell, the secretary of health and human services, said that federal subsidies would soften the impact of any rate increases. Of the 10.2 million people who obtained coverage through federal and state marketplaces this year, 85 percent receive subsidies in the form of tax credits to help pay premiums. In an interview, Ms. Burwell said consumers could also try to find less expensive plans in the open enrollment period that begins in November. “You have a marketplace where there is competition,” she said, “and people can shop for the plan that best meets their needs in terms of quality and price.”

But, really, can Americans shop around? The same holiday weekend that we learned of these absurd premium increases, we also learned that Aetna is shopping for Humana -- and others insurers are shopping around, too -- yes, think Comcast merger, but big-profit corporate health insurance. Do we really have robust insurance "marketplaces" in the state exchanges?

On Friday, Aetna said it would acquire its smaller rival Humana to create a company with combined revenues of $115 billion this year. Anthem is stalking Cigna. UnitedHealth Group, now the largest of the five, is looking at its options. At the end of the maneuverings, three national behemoths are likely to emerge.

There is also a scramble among the smaller insurers. On Thursday, Centene, which specializes in offering Medicaid coverage, said it planned to buy Health Net, a for-profit insurer with headquarters in Los Angeles.

As insurers grow larger, will consumers benefit from the companies’ ability to bargain with hospitals and doctors for lower prices? Will diminishing competition translate to fewer choices of plans? And what effect will mergers have on innovation in health care?

Multi-million dollar health insurance CEOs claim the consolidation is necessary to -- as we discussed above -- better be able to negotiate with providers. But, if consolidation is needed to negotiate with providers, aren't big-profit health insurers really just using the logic of single-payer Medicare-for-all to justify oligopoly? I would submit the answer is yes. Soon, we will be close to single-payer, but with all the rent-seeking, greedy and inefficiency of private insurers.

These premium increases being announced in the middle of a robust Democratic Primary should be a good reminder that elections matter -- even in the primary.

As I told you before, Bernie and Hillary reacted to the King v. Burwell ruling in two very different ways. Bernie proposed a legitimate policy -- used in countries all around the world to control costs and ensure universal coverage: single-payer, Medicare-for-all, while Hillary simply asked us to agree that "affordable health care is a right."

With dramatic increases in premiums on tap, anti-consumer mergers brewing, and tens of millions of Americans still un- or underinsured, it is not hyperbole to state that while the Affordable Care Act has made things a bit better, the American health care non-system absolutely remains in a state of extreme crisis.

What is Hillary's plan for disciplining insurers? Has she even proposed a public option yet in this campaign? If so, where? When?

With single-payer Medicare-for-all, Bernie is obviously proposing the ideal, he's being aspirational. That said, Bernie is a man who compromises, as we saw with the VA scandal, where he actually introduced a kind of "private option" for veterans. Perhaps I'm wrong, but this leads me to believe that, if elected, Bernie might not achieve single-payer, but he would work his butt off to achieve a public option or Medicare buy-in program.

Massive premium increases, millions uninsured -- American health care is still a nightmare, albeit slightly less of a nightmare than it was when insurers could retroactively cancel coverage to breast cancer patients.

It will take courage to take on insurers unafraid of continuing to greedily screw over Americans.

Choose wisely, my friends.

Choose wisely.