Wendell Potter, author, journalist and former corporate public relations executive, spent more than two decades in the health insurance industry, leaving in 2008 after a crisis of conscience. 

“Beautiful coverage.”

We can all breathe a sigh of relief. Yes, Obamacare will be repealed, president-elect Trump assures us, but not to worry, everybody—yes everybody—will soon be insured.

What an improvement that will be, folks. Under Obamacare, more than 20 million people who were previously uninsured now have coverage, but 30 million others still don’t. That’s nowhere close to the universal coverage our president-elect is promising.

Here’s what Trump told The Washington Post recently:

“We’re going to have insurance for everybody. There was a philosophy in some circles that if you can’t pay for it, you don’t get it. That’s not going to happen with us.”

That’s fantastic news, but it gets even better.

Trump said that health care provided on his watch would come “in a much simplified form” and would be “much less expensive and much better.”

Wow.

Almost too good to be true.

The thing is, it isn’t. Countless studies have shown that people in countries with single payer systems pay less for care and have better outcomes than Americans do, and they don’t have to deal with the private insurance industry’s complex bureaucracy.

When he was a candidate, Trump praised the single payer systems that Canada and Scotland have had in place for many years and said that, ideally, we should have a system like theirs.

He also did some truth-telling about the health insurance industry, my employer for nearly two decades.

“The insurance companies are making a fortune because they have control of the politicians,” he said during one of the Republican primary debates.

So, will Trumpcare be single-payer health care?

We’ll have to wait and see, of course. As The New York Times reported:

In the (Washington Post) interview, Mr. Trump provided no details about how his plan would work or what it would cost. He spoke in the same generalities that he used to describe his health care goals during the campaign — that it would be “great health care” that left people “beautifully covered.”

He also offered no explanation of how he would persuade Congress to pass his plan, though he indicated that it would have the backing of the House speaker, Paul D. Ryan of Wisconsin, and the Senate majority leader, Mitch McConnell of Kentucky. Mr. Trump said only that “I won’t tell you how, but we will get approval.”

Folks, there are only two ways that every American will be “beautifully covered”: We’ll either have a single-payer system or something like it or Trump, Ryan and McConnell will be giving my former colleagues in the insurance industry the keys to the Treasury. And if it’s the latter, there’s no way Trumpcare would be “much less expensive and much better.”

Current Republican plans are not “beautiful coverage.”

Despite what the president-elect says, the reality is that if Obamacare is repealed and replaced with anything like what the Republicans have been talking about for the past several years, millions of people will lose the coverage they have now, and comprehensive policies on the individual market will once again become unaffordable for all but the healthiest and wealthiest.

As a reminder, here are a few reasons why Obamacare was passed in the first place:

• Premiums were increasing rapidly
• Insurers and employers were shifting more and more of the cost of coverage and care to individuals and families
• One of every six Americans, young and old alike, had become uninsured, primarily because coverage had become too expensive for them
• Young people in most states were being kicked off their parents’ policies when they turned 18
• People on Medicare were having to pay more for prescription drugs than many of them could afford
• People in their 50s and 60s were being charged up to 10 times as much as younger people for the same policy in some states
• Women were having to pay considerably more for coverage than men simply because they were born female
• Millions of people with preexisting conditions couldn’t find policies they could afford because insurers took health status into consideration when setting prices; many people with preexisting conditions couldn’t buy coverage at any price because insurance companies considered them “uninsurable”
• Growing numbers of Americans, including women newly diagnosed with breast cancer, were getting cancellation notices from their insurers because they needed expensive care
• Insurers could sell junk insurance—policies that offered little protection in the event of an illness or accident
• Many insurers were devoting more and more of our premium dollars to overhead expenses like sales, marketing and executive compensation and to boost profits
• The U.S. led the world in health care spending per capita, yet outcomes on most measures were worse than in other developed countries
• Many people were victims of “job lock,” afraid of quitting a job they didn’t like out of fear of not being able to find affordable coverage elsewhere

Obamacare Achievements

Despite its many shortcomings, Obamacare at least addressed those problems in one way or another.

• Premiums are still going up, but not as rapidly for most people
• Insurers and employers are still shifting costs to their workers, but the law at least put some limits in place
• The percentage of Americans without coverage is the lowest it’s ever been
• Young people can stay on their parents’ policies until they turn 26
• The Medicare prescription drug benefit has been improved as the so-called “donut hole” is gradually being eliminated
• Insurers can’t charge older Americans more than three times as much as they charge younger people for the same policy
• They can’t charge women more than men
• They can’t charge people who’ve been sick in the past more than anybody else, and they can’t declare anyone “uninsurable” anymore
• They can’t cancel someone’s policy just to avoid paying for expensive care
• They can no longer sell junk insurance
• They must spend at least 80 percent of our premium dollars on medical care
• Health care inflation has slowed somewhat
• “Job lock” has largely been eliminated because of the availability of coverage on the exchanges and the subsidies now available to help low- and middle-income people afford insurance

If Obamacare is repealed, most if not all those patient and consumer protections will go away.

Really, Mr. Trump?

Will Trump really be able to replace it with something that is simpler, less expensive and much better? Will all of us soon be “beautifully covered?”

Sure, if he signs a single-payer bill into law. Otherwise, not a chance.

— Wendell Potter      

From the HEAL Team:

If you want to see California take the lead with our own Medicare for All system, take action! Join us on Twitter and Facebook, and