By NextBestFitPhase 3: Waves 2 & 3: working-age adults · Step 3.3
Wind down the private health insurers
Years 1–5 · State insurance commissioners; NAIC; UHADiscuss this step
How other countries handled this same piece of implementation, what happened, and what it means for this plan.
Side by side
| Country | Approach | Result | Lesson for this plan |
|---|---|---|---|
| This plan (U.S.) | Insurers' UHP-duplicative business ends. They must process all claims for prior coverage (run-off), protect policyholders, and convert or close in an orderly way. The 'Net cost of insurance' line falls from $306.0B to $26.4B. | ||
| Canada | Provincial medicare (1960s–70s) displaced private medical insurers for physician and hospital care; insurers shifted to supplementary drug, dental, and vision coverage. | A large supplementary market survives (about 2/3 of Canadians have it). | Insurers adapt by selling what the public plan doesn't cover. |
| United Kingdom (1948) | Approved societies and friendly societies lost their role in national health insurance. | Absorbed without compensation for lost business. | Losing a line of business to a public program isn't compensated. |
Canada
- What they did
- Provincial medicare (1960s–70s) displaced private medical insurers for physician and hospital care; insurers shifted to supplementary drug, dental, and vision coverage.
- What happened
- A large supplementary market survives (about 2/3 of Canadians have it).
- Lesson for this plan
- Insurers adapt by selling what the public plan doesn't cover.
United Kingdom (1948)
- What they did
- Approved societies and friendly societies lost their role in national health insurance.
- What happened
- Absorbed without compensation for lost business.
- Lesson for this plan
- Losing a line of business to a public program isn't compensated.
More precedent
- Blue Cross conversions in California, New York, and elsewhere created large health foundations.
- UK, 1948: voluntary hospitals and friendly societies were absorbed into the NHS.