Emanuel penned this at The New Republic:
Americans hate health insurance companies. They are easy targets for everyone to beat up on. When premiums go up, we blame insurance companies; we do not blame the underlying hospitals or physicians who charge high prices that drive up insurance costs. When people with cancer, heart attacks, or other diseases are denied insurance, we blame insurance companies; we do not blame the underlying voluntary insurance market that necessitates underwriting. When our wish for a new high-priced drug is denied, we blame insurance companies; we do not blame drug companies that set the price at over $100,000. Politicians can always elicit an applause by attacking the health insurance companies, reinforcing this bad-guy image of insurance companies.
This is not to say that insurance companies are angels, but they are also not the devil incarnate. A lot of what people consider to be their bad behavior is the inevitable result of the way the health care system is structured and how it incentivizes and forces certain behaviors.
The good news is you won’t have insurance companies to kick around much longer. The system is changing. As a result, insurance companies as they are now will be going away. Indeed, they are already evolving. For the next few years insurance companies will both continue to provide services to employers and, increasingly, compete against each other in the health insurance exchanges. In that role they will put together networks of physicians and hospitals and other services and set a premium. But because of health care reform, new actors will force insurance companies to evolve or become extinct…
…In January 2012 Jeffrey Liebman and I predicted in The New York Times the end of health insurance companies by 2020. We might have been a bit optimistic—or provocative. But it is certain they will end. Insurance companies will largely cease to be the middle man—taking premiums, paying providers, saying no to consumers, and making a profit—that we blame. Whether we will come to love them is another matter. That depends on how well they actually care for patients.