America's insurance system is broken — and patients are rightfully frustrated. But Democrats are exploiting that frustration to push for a cure that would be worse than the disease: socialized medicine. U.S. Democrat Rep. Alexandria Ocasio-Cortez (NY-14) recently suggested that the solution to America's insurance woes is to simply "allow everyone to buy into Medicare."
What this conveniently ignores is that Democrats' years-long push for socialized health care created the mess we're in today.
Democrats shoved the Affordable Care Act through Congress and expanded it into a vast system of healthcare subsidies. That disastrous legislation created perverse incentives that have fueled insurer consolidation, driven up costs, and left patients with fewer, worse options.
Doubling down with policies like "Medicare for All" would only break the system further.
Democrats don't have a real plan to fix the insurance system. By contrast, Republicans have spent President Trump's second term working to solve the root causes of dysfunction. GOP leaders should not only continue to press those efforts forward, but also make clear to the public who is driving real change — and who is merely stoking outrage.
The biggest problems with today's health insurance market stem from consolidation. A small number of companies now control nearly every step of the healthcare process, from insurance coverage to pharmacies to the delivery of care itself.
That level of control makes transparency nearly impossible. And it allows insurers to shuffle patients between subsidiaries, inflate internal costs, and capture profits with little accountability. UnitedHealth Group, for instance, generates roughly 40 percent of its profits by steering patients across nearly 2,700 affiliated entities.
Those shady practices are the direct result of the system Democrats created through the Affordable Care Act, which rewards regulatory gaming over competition and quality care.
Instead of incentivizing insurers to compete by lowering prices or improving service, the ACA's requirements encourage them to extract as much money as possible from the government. That has made owning each part of the care chain a central strategy. When insurers control the drug middlemen, the pharmacies, and the providers, they can push patients onto needlessly expensive drugs and treatments while cashing checks from the government at every step.
The law also encouraged insurers to restrict patients' access to treatment. To limit their own costs, insurers have narrowed coverage and enacted barriers such as prior authorization requirements that make it harder for patients to access the care their doctors recommend. As a result, patients often face more delays and fewer choices even as costs rise.
As Democrats have expanded federal insurance subsidies, wasteful spending has grown dramatically. More than half of all eligible Medicare beneficiaries are now enrolled in Medicare Advantage, the federal program in which private insurers offer publicly subsidized plans. Many of these plans lure enrollees with non-medical perks like golf clubs and ski passes. They are also notorious for exaggerating patients' diagnoses to collect higher reimbursements, a practice that contributes to nearly $80 billion in taxpayer-funded overpayments per year.
Socialized health care would only worsen the current system's misaligned incentives. The real solution involves aggressive, targeted reforms — and that's where Republicans are now making progress.
The Department of Justice is currently investigating UnitedHealth Group for inflating patient diagnoses in order to maximize government payments — a crucial step toward restoring accountability.
President Trump also recently signed legislation, spearheaded by many Republicans, to mandate transparency among pharmacy benefit managers, which control the lists of drugs insurers cover. The law aims to fix PBM incentives so that they no longer profit from steering patients toward higher-cost drugs.
Republicans should — and will — build on this work with even more decisive reforms. They should crack down on harmful coverage restrictions, prevent insurer-owned pharmacies from imposing enormous markups on drugs, and ensure that taxpayer dollars actually reach the patients they're intended for.
But just as important, Republicans must be active in making a case to the public. Nearly 85 percent of Americans say they would support a candidate who takes on health insurers directly. Becoming the party of insurance reform is a major political opportunity for Republicans, and a necessity to keep Democrats from enacting policies that would only make the problem worse.
The answer to insurance consolidation is not socialized medicine, but more transparency, competition, and accountability. Republicans have both the policy vision and the governing record to lead on insurance reform. They should get the credit, too — and they shouldn't let Democrats avoid blame.
Drew Johnson is a budget and healthcare policy analyst, government watchdog, and political columnist. He is currently a candidate for Nevada State Treasurer.