Harvard Business School January 2, 2020
Regina E. Herzlinger and James Wallace

A public insurance option could use its scale to hold prices down, but only if the approach avoids the financing gimmicks that are undermining Medicare, say Regina E. Herzlinger and James Wallace.

The United States has serious health care problems: More than 27 million uninsured people, costs that are growing faster than income, and a staggering $37 trillion of unfunded liabilities in the Medicare program.

Perhaps most alarming: The US ranks lowest among developed nations in avoiding preventable deaths, despite its world-class resources and medical technology.

The Democratic presidential candidates have been debating the benefits of the “Medicare for All” approach versus a public insurance option. The former would force all of us onto the...

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