THE CHIEF EXECUTIVE of Harvard Pilgrim Health Care doesn’t want the government to take over the entire health insurance business – at least until after he retires –  but he sees some advantages to the movement seeking an expansion of Medicare so that government-backed insurance covers everyone.

For one, Harvard Pilgrim CEO Michael Carson thinks Medicare for All – a rallying cry among many Democrats – is part of an important discussion to have. For another, Carson said, the best plan is a middle way that involves more collaboration between the government and private insurers.

Carson shared his thoughts about potential changes big and small to the health care marketplace with Paul Hattis, an associate professor at the Tufts University Medical School, and John McDonough of the Harvard Chan School of Public Health, during the “Health or Consequences” Codcast.

McDonough asked Carson about California Sen. Kamala Harris’s endorsement of a system to eliminate private health insurance.

“Let’s wait until I retire,” Carson joked.

In seriousness, Carson said he thinks a combination of approaches is likely the best path forward.

“At the end of the day, it’s a joint solution. I don’t think it’s a single-payer, government programs, no-private-health-insurance organization solution. I think it’s a combination,” Carson said.

Carson, who was profiled recently by the Boston Globe, is a former soccer player and US Air Force veteran who grew up outside of Frankfurt. Part of Carson’s reticence about a completely government-run health insurance system appears to stem from his upbringing. Carson recalled that his mother, when they were living in Germany, would receive a limited number of certificates to see the doctor.

“Going to a program like that is going to mean changes in how we access health care, because if we just think it’s free health care and access is unlimited, those costs are going to spiral really out of control,” Carson said.

Under Carson, who took over at Harvard Pilgrim last year, the company is looking to expand its business with government programs and the insurer could possibly re-enter the state’s Medicaid program, MassHealth, he said.

Carson also discussed the proposed merger between Harvard Pilgrim and Partners HealthCare, which fell apart last year. Noting Harvard Pilgrim’s joint-venture relationships with three hospital systems in New Hampshire and some risk-sharing deals with providers in Massachusetts, Carson said the discussions with Partners stemmed from consideration about how best to serve the insurer’s members.

“There were lots of benefits that could have come from that,” Carson said of the now-scuttled merger idea. “It’s not easy just to slam a provider and a health insurance company together,” Carson said. “It didn’t come together at the time.”

Carson also reported that, after some “tough financial years” between 2014 and 2016, when insurers were adjusting to the Affordable Care Act, Harvard Pilgrim has had two good financial years in 2017 and 2018, owing both to overall market conditions and also to tighter cost management at Harvard Pilgrim.