John Geyman on the Growing Costs of U.S. Health Care

You know health care costs are starting to hit home when Congresswoman Marjorie Taylor Greene raises the red flag.

John Geyman

In a posting on Twitter last week, the Republican Congresswoman from Georgia broke from Republican leadership in the House.

“I’m going to go against everyone on this issue because when the tax credits expire this year my own adult children’s insurance premiums for 2026 are going to double, along with all the wonderful families and hard-working people in my district,” she wrote.

“No I’m not towing the party line on this, or playing loyalty games. I’m a Republican and won’t vote for illegals to have any taxpayer funded health care or benefits.”

“I’m carving my own lane.”

“And I’m absolutely disgusted that health insurance premiums will double if the tax credits expire this year.”

“Also, I think health insurance and all insurance is a scam, just to be clear!”

“Not a single Republican in leadership talked to us about this or has given us a plan to help Americans deal with their health insurance premiums doubling.”

“Our country sent $30 billion to Israel in 2024 alone killing countless innocent children and sent hundreds of billions to Ukraine in the past few years.  By the way, I voted no to all of that murder. America has funded the Ukrainian government, Ukrainian pensions, and Ukrainian businesses during this entire stupid war that America should have nothing to do with.”

Anxiety driven Americans are watching Congress closely to see if their health insurance premiums are going to double.

John Geyman spent most of his public life as a practicing physician. On the side, he advocated for single payer. Now that he is no longer practicing, he has time to look at the big picture. And what he sees is not pretty.

His new book – Growing Costs of U.S. Health Care, Corporate Power vs. Human Rights, Is Reform Finally Within Reach? – lays out the reasons why health care costs are scheduled to double. 

“My book looks back fifty or sixty years,” Geyman told Corporate Crime Reporter in an interview last week. “And every time this issue comes up as a national issue, the question is asked – what can we do differently? And every time, the corporate and financial interests in health care win.” 

“Compared to other countries in the world, we are not doing well in terms of health outcomes. And that is because we continue with a multi-payer system while other countries have some version of a single payer system. Every time this question comes up, the result is a continued multi-payer system that just doesn’t work. We always turn down national health insurance.”

“But for a real fix, we need single payer national health insurance to assure access for everyone in the country to health care. It’s also a morally correct way to administer that health care.”

Fifteen years ago, when there was an opportunity to institute that single payer system, President Obama, who at one time supported single payer, backed off and instead implemented this insurance company backed Affordable Health Care legislation that kept the insurance companies in the game. 

The Democrats in Congress were aligned with the private health insurance companies, big Pharma, and what you call organized medicine. Obamacare passed and the American people now hate it. They blame Obamacare for their ills. 

They blame the Democrats for getting us into this situation. Why fifteen years ago did the Democrats get co-opted?

“Over the past sixty years, we’ve had a class war between the very wealthy corporations and the rest of the population. And the corporate powers have won,” Geyman said.

In 2010, the Democrats, led by Senator Max Baucus, worked with the insurance industry to write the Affordable Care Act. They wouldn’t even allow advocates for single payer to get a hearing.

“It’s not going to change until we get the political power at the state level and nationally,” Geyman said. “Physicians for a National Health Program has been effectively advocating for single payer over the years. But we haven’t broken through yet.”

On page 119 of your book, you quote Dr. Marcia Angell as saying this: “The fatal flaw of Obamacare is that it is inherently unstable. Unfortunately, Republicans are right that it is unravelling, but wrong about the reason and certainly wrong about the solution. Obama made the mistake of trying to increase access to better health insurance without fundamentally altering the features of our health care system that made it so inflationary, expensive and inadequate in the first place.”

That was Obama, who was a corporate liberal.  

“I agree. There currently is single payer legislation in the Senate introduced by Bernie Sanders and in the House by Pramila Jayapal.” 

But the reality is there is not one Republican co-sponsor of those bills. There are not even a majority of Democrats who support those bills. 

“About sixty percent of the American people are in favor of single payer,” Geyman says. 

But is the health insurance industry’s grip over Congress weakening at all?

“I wish I could say it differently, but I doubt we have enough political power there yet.” 

At one time, Trump supported single payer. In a 1999 interview, he told Larry King – “I’m very liberal when it comes to health care. I believe in universal health care. I believe in whatever it takes to make people well and better.” In a 2000 book, The America We Deserve, he called for universal health care and said that the Canadian system helps people live longer and healthier lives than Americans.

Might he come over and become a single payer supporter?

“In 2017, before his first inauguration, he said this – ‘We’re going to have insurance for everybody. People can expect to have great health care. It will be in a much simplified form. Much less expensive. Much better.’ It didn’t happen. And I don’t see that happening. He gave in and will continue to give in to the corporate power block that has prevailed so far.”

On page 91, you quote Churchill as saying – “Americans will always do the right thing after they exhaust all alternatives.”

“When will that happen? I don’t know. In my book I lay out the case for single payer. In order to achieve the most efficient health insurance coverage, we need to have the largest possible risk pool. The larger and more diverse the risk pool, the more effective insurance can be in having healthier people share the costs of sicker people and keeping down costs. That’s why we say – everybody in, nobody out. We know that 30 percent of the population accounts for 80 percent of all health care spending, while five percent of the population uses almost one half of total spending.” 

“As long as we have a large private insurance industry with some 1,300 insurers trying to avoid sicker patients, with millions of younger healthier people choosing to be uninsured, we will have segmented risk pools that prevent the efficiencies of a large risk pool. As other advanced countries found out years ago, sharing risk across their whole populations is the only way to provide universal coverage at affordable costs to patients, families and taxpayers.”

A friend of mine is so frustrated with the privatization of Medicare and how Medicare no longer covers basic necessities that he called me the other day and told me that we had to stop saying Medicare for All because people now hate Medicare because of its increased premiums and loss of coverage.

“Well a big scandal has been how Medicare has been privatized. The elderly are being squeezed by the insurance industry’s efforts to maximize profits by selecting healthier patients (cherry picking) and avoiding less healthy patients (lemon dropping).”

There is a business case for single payer. The U.S. automakers are paying for private health insurance for their workforces, while over the border in Canada, the government pays. You would think that those corporations would be pushing for single payer.

“You would think, but it would not be enough political power to counter the power of the insurance companies, big Pharma and the medical industrial complex as a whole.”

You list the big four corporate powers in this field – insurance, pharma, hospitals and organized medicine. What do you mean by organized medicine?

“It’s the physicians and other health care professionals. There are some within the American Medical Association who have been supportive of single payer. But in general, the AMA is not in favor of single payer. Physicians for a National Health Program is the group that pushes for single payer.”

What percentage of doctors favor single payer? 

“A majority of physicians are now no longer in private practices and are now working for the medical industrial complex. So they are compromised. But physicians are unhappy with the current system and they are not politically powerful enough to reverse it. That’s got to change.”

You quote Professor Malcolm Sparrow as saying that up to ten percent of health care costs are fraudulent – up to $270 billion.

“Yes and I document the extensive fraud in my book. For example, federal audits of 37 private Medicare Advantage programs revealed overspending due to inflated risk scores that overstated the severity of such conditions as diabetes and depression for a majority of elderly patients treated. Overpayments to privatized Medicaid plans were found to be endemic in more than 30 states, often involving unnecessary or duplicative payments to providers. And an investigation by the Washington Post of the for profit hospice industry found the industry riddled with fraud and abuse, commonly seeking out less sick patients who need less care and live longer.”

“There is a fix to this escalating bureaucracy, waste, corruption and fraud in an increasingly unaccountable corporatized system. And that’s single payer financing with everyone having a national health insurance card. This would eliminate most of this while saving more than $600 billion a year through simplified administration, negotiated fees for health professionals, and global budgets for hospitals.”

[For the complete q/a format interview with John Geyman, see 39 Corporate Crime Reporter 39(14), Monday October 13, 2025, print edition only.]

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