THE LIE OF THE "LEVEL PLAYING FIELD."

Earlier today, Ron Pollack, the director of Families USA, made a nice point before the Senate Finance Committee. "We keep on talking about a level playing field," he said, "but in Medicare, we don't have a level playing field. The payments to private plans in Medicare Advantage are considerably larger than they would be for someone in traditional Medicare."

To just take a second to explain this, Medicare offers private insurance options called Medicare Advantage plans. The basic idea was the government would pay them the same amount of money it pays the Medicare program to cover seniors. If the private market could outcompete Medicare, then it could prosper. But it didn't. Instead, it lobbied for more and more reimbursement, until the government was paying private plans 119 percent what they were paying Medicare. That's almost 20 percent more per beneficiary.

Which is all to say that the private insurance industry is not interested in level playing fields as a matter of principle. It's simply a convenient concept to use as a cudgel against a public plan. But when private insurers were thrown into competition with Medicare, they demanded an unlevel playing field in their favor.

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