Reply to comment

Mr. Potter,

I applaud your decision to leave the health insurance industry and speak out on our failed health care enterprise. I too am an insider having worked for 25 years as a senior manager and consultant for a variety of regional and national health plans, Blue Cross companies and others. I came to the conclusion 10 or 12 years ago that a single payer, government solution was the only one that can work in health care. I won't belabor why I support this approach, but I would like to suggest respectfully to you that your focus on health insurers misses a big part of the reason that our current system won't work, namely, a fractured and unregulated delivery system.

While it is true that for-profit health insurers (though I would argue non-profits aren't much better) are a big part of the problem in health care, providers are the other, and arguably bigger part of the problem. After all, even if administrative costs in health insurance are 20 percent, we still spend the other 80 on providers. And they are just as protective of the status quo, despite their protests to the contrary.

I'm sure you are familiar with John Wennberg's work at Dartmouth and that of others who have written about the variation in costs throughout the country. Reforming the payer community would certainly go a long way toward solving some of our problems, but the provider world must be reformed as well.

It is because of this twin dilemma that I support national health care--there is no way to rationalize the entire enterprise without changing the fundamentals of both payers and providers. I would be interested in your thoughts on providers and other issues. I have written a 5,000 word essay on this issue that I would share with you if you are interested. I would value your comments and thoughts.

Please accept my genuine support for your courage to speak out.

Steve Williams