It's Time to Break Up Big Medicine - BIG by Matt Stoller

The saga of the UnitedHealth Care CEO assassination has, as could be expected, now turned into a discussion of our health care system. Elizabeth Warren, for instance, is making the obvious point that people hate the health care system.

Then, productively, she proposed, along with Republican Senator Josh Hawley, legislation to split apart some of these monster companies from their pharmacy subsidiaries, thus reducing conflicts of interest in health care. While this legislation was in the works long before the killing, it didn’t stop Wall Street investors from saying that any discussion of health care reform was a de facto endorsement of murder.

These kinds of discussions are always done in bad faith, since people who make a lot of money from killing people with spreadsheets like to pretend to be very offended when anyone points out health care is a matter of life and death. That said, moral hypocrisy isn’t the primary reason our health care system is so problematic. A more important objection to reform is from a certain dominant strain of thinking among economists and health care wonks, who question whether the health insurers are really that bad. Economics blogger Noah Smith epitomized this view when he wrote a piece titled “ Insurance companies aren't the main villain of the U.S. health system.”

Anger at insurers reflects, in his word, “deep-seated popular misconceptions about the U.S. health care industry. A whole lot of people — maybe even most people — seem to regard health insurance companies as the main villains in the system, when in fact they’re only a very minor source of the problems.” In other words, insurers are hated not because they do bad things, but because they do something that is necessary: rationing.

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