Daily Archives: May 13, 2019

To pay for Medicare for All, Democratic presidential candidates have focused on taxing the rich. But many of the plans they’ve put on the table would require across-the-board tax increases that would hit middle-earners as well as the wealthy, public policy analysts say. None more than Medicare For All. Raising the more than $30 trillion needed to fund Sanders’s health plan over a decade would require doubling all personal and corporate income taxes or tripling payroll taxes, which are split between employees and employers, said Marc Goldwein, a senior vice president at the non-partisan Committee for a Responsible Federal Budget.

Democrats asked CBO to lay out some parameters of how to set up single-payer, hoping to elude analysis of any one bill in Congress. The latter would carry political accountability—and a price tag. Instead CBO walks through “key design components and considerations” in a report that aims to bore and deploys the word “could” 209 times. Yet even this limited analysis is instructive about the “major undertaking” of single payer, as CBO puts it in hilarious understatement. CBO acknowledges, for example, that a transition that includes moving 160 million people from employer-sponsored coverage to single payer would be “complicated, challenging, and potentially disruptive” to health care and the economy. You don’t say.

Tennessee is charging ahead to become the first state in the nation to ask the Trump administration for Medicaid funding in a lump sum—a radical overhaul of the entitlement program that critics warn could force major cutbacks in healthcoverage for low-income people. State Republican lawmakers last week, emboldened by the Trump administration’s promise to provide states with more flexibility to run their Medicaid programs, approved legislation requiring Tennessee to submit a Medicaid block grant plan to the federal government within six months. The legislation now goes to Republican Gov. Bill Lee, who will sign the bill, a spokesperson said.

The U.S. does not have a “free market” health care system. 90 percent of Americans have health insurance, nearly all of whom have their coverage heavily subsidized by the government. Part of the misconception stems from the fact that 159 million Americans receive health insurance through their employers. Private coverage is not the same thing as market-based coverage. Thanks to long-standing distortions in the tax code, few workers have the opportunity to choose their own coverage in a transparent market where prices and benefits are easy to understand. Ultimately, the most important way to make employer-sponsored coverage more affordable is to evolve away from the group model and toward a system of consumer-driven, individually purchased health insurance.

Emergency medical care is an exception to the general principle of market exchange, whereby services are voluntarily bought and sold, with sellers competing on price. Under federal law, hospitals are required to treat patients that arrive needing emergency medical treatment, regardless of their ability to pay—but allowed to subsequently charge whatever they wish. In recent years, medical providers have increasingly exploited this arrangement by threatening exorbitant charges for out-of-network emergency care in order to force insurers to agree to generous reimbursement terms across the board. Patients have frequently been caught in the crossfire and forced to pay large “surprise bills” for emergency care by hospitals or doctors who remain out of network.

The Trump administration announced that it has finalized a new rule requiring all drug companies to include the list prices of their drugs in direct-to-consumer advertisements. If sunlight is the best disinfectant, the White House hopes that more visibility about drug prices will hold drugmakers more accountable and reduce costs for patients at the pharmacy counter.

President Trump announced Thursday his administration is working with Congress on a comprehensive legislative package to outlaw crippling surprise medical bills. The administration says it is aiming to increase transparency in health services billing. The president said that patients must be told ahead of treatment if a specialist, such as an anesthesiologist or radiologist, is out of their network. Patients should only be billed for out-of-network care if they consent to receiving treatment. “These bills have ruined people’s lives,” Trump said at the White House.