By NextBestFitAllow supplemental only (non-covered items)
Private insurance only for things not covered (private rooms, cosmetic).
Private insurance only for non-covered extras.
To review: Decide where the line between extras and core care sits.
Review ledgerHow this path connects
This path
Allow supplemental only (non-covered items)
Concrete changes if chosen
What would actually have to change in law, agencies, payment rules, or systems.
- Allow private insurance only for non-covered items
Effects
Each effect has its own page: the evidence, the case that it is or isn't a real cost, and whom it affects.
What it fixes
- Two-tier care: a private fast lane for those who can pay
Limiting private insurance to uncovered extras keeps core care equal while allowing private rooms and cosmetic services. It also preserves some insurer jobs.
What it creates or worsens
- Requires difficult enforcement
Restricting private insurance to extras is difficult when the boundary between extras and core care blurs.
- Solves only part of the problem
Private insurance limited to uncovered extras offers little relief from waits for core care.
Who's affected
Who gains
- People relying on publicly funded care
- Two-tier care: a private fast lane for those who can pay: Private fast lanes draw provider time away from public care.
- People with employer coverage
- Two-tier care: a private fast lane for those who can pay: Limiting private insurance to uncovered extras keeps core care equal while allowing private rooms and cosmetic services. It also preserves some insurer jobs.
Who loses
- High earners
- Two-tier care: a private fast lane for those who can pay: Paying privately buys faster care.
- Cash-pay and private care practices
- Two-tier care: a private fast lane for those who can pay: They earn revenue from the private fast lane.
Where it has been tried
- Taiwan, Canada: Supplemental only.
- Canada: Private supplemental insurers in Canada covered 27 million people and paid $53.3 billion in health claims in 2024.