Consider a business with two customers

The first customer pays in about two months after getting bill, questions or rejects a quarter of the charges, and, depending on who you ask, pays substantially less than your other customer.

The second customer pays within a month, questions about 5% or 6% of the charges, and pays a premium.

That’s the dynamic in Massachusetts between the state Medicaid program (the first customer) and private payers (Blue Cross, Harvard, Tufts, Fallon).

The contrast gives one pause as we debate the merits of ‘public plan’ competing against private plans under some form of national healthcare.