Mitchell noted that employers, which offer coverage to more than 160 million Americans, are a big player in the nation’s healthcare system — a role they came into because of “an accident of history,” she said.

“They weren’t looking to get into the healthcare business,” she continued, but “they were looking for alternatives to wages when there were limits on what they could offer, and they started with what was a pretty inexpensive offering — helping pay for hospital care — and that has now grown to be the second-largest line item in their budgets after payroll.”

Rovner and Mitchell discussed the fact that while large employers do have market power, the rest of the healthcare system banded together in response.

“There’s been this arms race of consolidation, meaning that even the largest employers in the world are smaller and don’t have the leverage many times,” Mitchell said.

Asked to identify the systemic changes large employers would like to see, Mitchell pointed to boosting primary care and referring patients to high-quality specialists. She said changes to business policies — in particular, banning anti-competitive practices and increasing price transparency — would help, too.

“We have a very real affordability crisis,” she said.

An abbreviated version of this interview aired July 16 during Episode 455 of What the Health? From ºÚÁϳԹÏÍø News: “States Start Their Medicaid Cuts.”

This article first appeared on ºÚÁϳԹÏÍø News and is republished here under a .

They discussed the pivotal role the president of the United States plays in health policy — whether it is building support for or opposition to new plans and proposals. “Presidents have a level of authority which is often underappreciated, especially in health care,” Blumenthal said.

Blumenthal and Rovner also discussed the historical reasons the U.S. has been unable to enact universal health care, incrementalism versus sweeping change, and what he described as “the dance” between proponents and opponents — usually a clear party-line split between Democrats and Republicans — of major health care reforms.

Today, the split seems to have come to a head, as public health, science, and expertise are being viewed by one end of the political spectrum as “the opposition,” Blumenthal said, which will complicate efforts. Still, he outlined ideas for moving forward.

An abbreviated version of this interview aired April 23 on Episode 443 of What the Health? From ºÚÁϳԹÏÍø News: “RFK Jr. vs. Congress.”

Blumenthal’s latest book, Whiplash: From the Battle for Obamacare to the War on Science, co-written with James A. Morone, offers a behind-the-scenes look at how three presidential administrations pursued very different health policy goals.

This article first appeared on ºÚÁϳԹÏÍø News and is republished here under a .

On What the Health? From ºÚÁϳԹÏÍø News, distributed by WAMU, chief Washington correspondent and host Julie Rovner sat down with Drew Altman, president and CEO of KFF, to talk about the likelihood of a national health care debate to rein in costs.

As the midterm elections approach, the cost of health care is the public’s , Altman said. Although past reforms have significantly increased the number of people with health insurance, they have not successfully addressed affordability, he said.

Altman said the U.S. health system poses two major problems: Americans’ concerns about how to pay for their own medical care, and the significant share of national spending it consumes.

Rovner and Altman also discuss the downstream effects of change, including the impact of the Trump administration’s cost-cutting on states, employers, and individuals, and lessons learned from past attempts at government reform.

This is the first in a new interview series, “How Would You Fix It?” In the months to come, Rovner will interview experts and decision-makers from a variety of backgrounds and perspectives, asking each how they would repair the health care system.

An abbreviated version of this interview aired March 19 on Episode 438 of What the Health? From ºÚÁϳԹÏÍø News: “RFK Jr.’s Vaccine Schedule Changes Blocked — For Now.”

Altman’s “Beyond the Data” columns — including the column discussed in this interview, “” — can be read .

This article first appeared on ºÚÁϳԹÏÍø News and is republished here under a .