Medicare buy-in is seen as a moderate proposal, but it would set off a domino effect of cost shifting that would leave few people untouched. It would mean that services for more people would be covered by insurance that reimburses providers at below-cost Medicare rates, placing more pressure on providers to negotiate higher rates with private insurers to offset the loss in income. Such a shift would place upward pressure on individual market premiums. Providers would also try to limit the number of Medicare patients they see, making it more difficult for today’s seniors as well as the buy-in populations to access care.
Medicare for All’s sponsors claim it would reduce administrative costs and produce huge savings. “Private insurance companies in this country spend between 12 and 18% on administration costs,” says Sen. Bernie Sanders (I-VT). “The cost of administering the Medicare program … is 2%. We can save approximately $500 billion a year just in administration costs.”Not so fast. Glenn Kessler, a fact-checker for the Washington Post warned backers of Medicare for All to be “cautious” in relying on “the administrative cost saving” as a talking point, and PolitiFact rated Sanders’ statement as “half true” […at best.]
Surprise out-of-network billing and related patients’ costs are increasing among inpatient admissions and emergency department visits to in-network hospitals, according to a study published in JAMA Internal Medicine. Stanford University researchers found that from 2010 through 2016, 39% of 13.6 million trips to the ED at an in-network hospital by privately insured patients resulted in an out-of-network bill. That figure increased during the study period from about a third of ED visits nationwide in 2010 to 42.8% in 2016. [This shows the ineffectiveness of patchwork legislative solutions since Obamacare contained provisions to stop surprise bills when it passed in 2010.]
As advocates of free markets and members of the business community, we can debate which proposals to prevent surprise billing are more appropriate, but if we enshrine current rates with an arbitration scheme, or if we fail to advance solutions on surprise billing, we only play into the hands of single-payer advocates. It’s time to end secret pricing and save our health care market from the corrupt practice of surprise billing once and for all.
| Republicans undermine their own long-term interests by supporting elimination of the Cadillac Tax. The GOP opposes government-imposed cost controls, and supposedly favors market-driven discipline as an alternative. Most GOP members in Congress fail to understand that the Cadillac tax is a market-driven reform. Currently, federal tax law confers an open-ended benefit on employer-paid premiums, which are exempt from income and payroll taxes. The more a company spends on health benefits, the greater the tax subsidy. The result is higher-costs than would exist if the tax subsidy were limited, as the Cadillac tax does. |
Last year, the Trump rule on short-term health plans went into effect, which not only allowed plans to last 364 days, it lets people renew them for up to 36 months. “Sabotage!” the health care experts cried. They said this new rule would allow junk insurance that would rip consumers off and would force Obamacare premiums through the roof. But the results so far strongly suggest that the “experts” had it exactly wrong when they predicted doom and gloom by giving consumers more choice. States that opened their markets up to new choices and more competition are seeing smaller rate hikes than those that decided to “protect” their consumers by forcing them into government-mandated Obamacare plans.