

Should the U.S. Have a Public Health Insurance Plan?
Jul 18, 2025
David Goldhill, CEO of Sesame and author of 'Catastrophic Care,' debates Jacob Hacker, Yale professor and political scientist. They tackle whether a public health insurance plan could effectively compete with private options. Hacker advocates for enhanced coverage and systemic improvements, critiquing current inefficiencies. Goldhill counters with concerns about market regulation and the need for competition. The discussion delves into healthcare disparities and explores innovative solutions while debating the balance between public and private systems.
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Public Option Improves Value
- The public health insurance option can improve value by leveraging Medicare's ability to bargain lower prices than private insurers.
- It provides a popular, familiar, and simple plan that enhances competition and choice in the insurance market.
Public Option Counters Provider Power
- High healthcare prices in the U.S. are driven largely by hospital and provider consolidation, not patient or insurer choices.
- A strong, broad public option could counterbalance provider power to reduce overall healthcare costs.
Flaws in US Health Insurance
- The U.S. health insurance system is flawed, with high premiums and costs reaching $27,000 per family annually.
- The current system functions more like loan sharking than insurance, and it drives wage stagnation and inequality.