The head of Aetna, the health insurance giant, not only slammed the gains being made in the push for universal Medicare, but also mocked its proponents as misguided. But in the process, Mark Bertolini got basic facts wrong about single-payer health care.
Bertolini, the CEO of Aetna, the third-largest health insurance company in the U.S., rejected the Medicare for All proposal released last week by Sen. Bernie Sanders, I-Vt., and a group of 16 Senate Democrats. He at times used disparaging comments and outright falsehoods about neighboring countries’ national health systems to criticize the plan.
Bertolini, speaking at the Strategic Investor Initiative conference in New York on Tuesday in response to a question from The Intercept, said that the Sanders single-payer bill does “nothing to fix the underlying cost structure” of the health care system. “So if we refinance a lousy product, what do we get? A lousy result,” Bertolini said.
The Aetna CEO also ridiculed proponents of single payer, suggesting that they are confused. Some supporters, Bertolini warned, are in fact “talking about socializing all the hospitals and doctors — everybody’s going to work for the government.” He asked the room of investors and analysts to “name a country that has single payer.”
When several participants named Canada, Bertolini disputed the answer and claimed that Canada has a “government-run health care system. They’re not single payer, they’re single everything.”
The suggestion, however, that Canada has a completely government-run health care system under which all medical professionals “work for the government” is false. In Canada, medical claims for virtually all non-dental health care are paid by the government, but doctors and hospitals work in the private sector.
“Doctors in Canada are not employed by the government. They are self-employed, they are independent business people,” said Karen Palmer, an adjunct professor at Simon Fraser University. “The system is publicly funded but privately delivered.”
Bertolini appeared to be confusing single payer with a single-provider system, such as the National Health Service in the United Kingdom, under which doctors and providers work directly for a government entity.
That’s not what Sanders is proposing. Under Sanders’s bill, all Americans are incrementally enrolled into Medicare, and patients would be free to choose their private-sector health care providers. The legislation also provides a range of cost-cutting measures, including provisions to lower drug prices.
During his response to our question about the Sanders proposal, Berolini noted that he is “a little infamous for this conversation,” referencing a leaked recording of a company-wide discussion in April, in which he appeared to signal openness to a debate over adopting single payer.
Immediately following the leak, Bertolini moved to distance himself from the idea. “There’s nowhere in the Constitution that says we will need to provide people health care,” he said shortly after the tape came out. “I think government-run health care would be a bad idea, because I think then you end up with the central planning problem that has crushed the Soviet and Russian economies.”
The private health insurance system has been particularly lucrative for companies like Aetna. During his talk, Bertolini boasted that Aetna’s stock price surged from $29.85 per share in November 2010 to $162 per share this week. His performance as CEO has also been handsomely rewarded: In 2016, he received a compensation package worth $41 million.
The majority of Bertolini’s talk was centered on his work to stimulate better workplace practices at his company, from raising wages of the lowest-paid Aetna employees to providing in-house yoga programs.
Bertolini has been praised for promoting employee wellness and corporate philanthropy programs at the health insurance giant. But the firm has also engaged in dubious political efforts. In 2012, Aetna inadvertently revealed that it funneled more than $7 million to GOP dark money campaign groups that specialize in electing Republicans without any disclosure of their donors.
Bertolini said the Aetna stock price was down yesterday over health care discussions in Congress, but he turned it into a joke: “It’s a good time to buy.” Asked repeatedly by The Intercept if he supports or has an opinion on Graham-Cassidy, the last-ditch Republican effort to repeal and replace the Affordable Care Act, Bertolini demurred, noting he has “no prediction” on whether it would pass.
Bertolini is the latest health care CEO to voice concerns about the rising popularity of single payer. As The Intercept reported, Brent Saunders, the chief executive of Allergan, worried that Americans are getting so fed up with the health care system they may one day embrace single payer. A number of lobbyists for other health care interests have also slammed the idea, claiming that the system proposed by Sanders is unworkable.