Americans may hate their health insurance, but they don’t hate it as much as not having health insurance.

Kevin Drum:

Are Americans really in love with their health insurers? Given the way health insurers treat people, that’s hard to believe. Americans do seem to be in love with their doctors, but that’s an entirely different thing.

But maybe I’m wrong. If so, what’s needed is a scorched-earth, Republicanesque jihad against health insurers. Blanket the airwaves with horror stories of insurance companies denying claims. Get some telegenic doctors to show off their staff and tell us that these people spend 100 percent of their time arguing with insurance companies to get fair treatment for their patients. “It adds $50 to every visit,” or something like that. Pan over to gravestones of people who died because their insurance company refused treatment.

You get the idea. I truly don’t think it would take much to turn insurance companies into pariahs. People already bitch about them endlessly, after all. At a guess, every single person reading this knows someone who has personally had to spend dozens or hundreds of hours on the phone with an insurance carrier to adjudicate some complicated bit of medical care.

Yes, health insurance companies are uniformly awful, and dealing with them is exhausting and terrible.

However, the problem here is not that Americans love private health insurance companies, but rather that, for people who have private health coverage—especially through their employers—it is a known quantity. Yes, my employer-provided plans are expensive, the paperwork is frustrating, and trying to figure out the right plan and find providers each year when open enrollment rolls around is a huge pain in the ass. I hate all of it, but I mostly know what to expect.

Overall, the private health insurance and healthcare system in the United States sucks, and I think we ought to replace it with a single-payer public system. However, I continue to believe that, while the health insurance and healthcare industries are obviously major obstacles to real reform, a significant and often unacknowledged blocker to any such reform is going to be the segment of the public that currently has health coverage through their employers.

Single-payer advocates are going to have to convince these folks why a public system will be better, and arguments about how bad the health insurance system are will not be terribly effective. We all already know that.