There’s a reason any mention of cost is notably absent from the recent CBO report on single-payer health care proposals. That’s because Democrats specifically asked for a report without cost estimates. They’re aware that the American public is unlikely to get behind their plan to outlaw private health insurance and launch a government takeover of the U.S. health care system. According to Emory University health economist Kenneth Thorpe, more than 70% of working Americans who have private insurance would wind up paying more for health care under a version of “Medicare-for-all” very similar to the one Sanders has introduced in the Senate.
|One solution to most instances of surprise billing is to simply eliminate the possibility of being treated by an out-of-network emergency, ancillary, or similar clinician at an in-network facility. There are multiple ways to accomplish this, but one approach—sometimes called “network matching” or an “in-network guarantee”—would require these facility-based clinicians to contract with every health plan that the facility at which they practice accepts or, alternatively, choose to secure payment from the hospital rather than insurers. That requirement can be imposed either directly or, alternatively, indirectly by making joining an insurer’s network the only way clinicians can secure payment.
The Georgia Public Policy Foundation has long advocated for market-oriented solutions to Georgia’s health care challenges. The Foundation has released a report analyzing the cost and potential impact of two Section 1332 State Innovation Waivers the governor could consider:
- A reinsurance program that would apply to all large insurers in the state and “reimburse accumulated claim costs that exceed a set threshold within a given year.”
- A Georgia primary care access option, which would require large insurers to offer at least one plan that includes a direct primary care model.
Just as choice and competition make products and services less expensive in the rest of the economy, they can do so in health care. We must substantially expand Americans’ freedom to choose their own health insurance—both in public and private programs. We should gradually convert the Medicaid program from its current single-payer form into one in which enrollees receive tax credits to buy private insurance. And we should strengthen Medicare Advantage, the market-based form of Medicare whose consumer-driven structure has incentivized insurers to offer broader benefits, lower out-of-pocket costs, and better health outcomes than traditional Medicare does.
Health care advances have delivered great benefits to society, bringing material improvements in average life spans and quality of life. Yet these improvements have come at a cost—an ever-expanding portion of the US GDP is being consumed by healthcare expenses. Could technology be part of the solution by enabling delivery of healthcare advances while improving affordability? We have reviewed the evidence, done the math, and identified technology-enabled use cases that could create between $350 billion and $410 billion in annual value by 2025 (out of the $5.34 trillion in healthcare spending projected for that year).
|California lawmakers are headed for a showdown over how many illegal immigrants should qualify for government-subsidized health care. Democratic Gov. Gavin Newsom has proposed allowing unauthorized immigrants under age 26 to enroll in Medi-Cal, the state’s Medicaid program. Some members of the legislature, which is dominated by Democrats, have proposed that low-income people of all ages should be eligible, regardless of their immigration status. Both would be first-in-the-nation expansions and represent another step by California to enact economic and social policies in defiance of the Trump administration, including more financial support for those in the country illegally.
Would expanding Medicaid in Alabama bankrupt the already cash-strapped state budget and further sink our country into unsustainable levels of national debt? “When you expand Medicaid, the administrative costs and the cost of expansion will eventually swamp the state,” warned U.S. Rep. Gary Palmer (R-AL). “It has in other states. Illinois is about to go bankrupt.” States that expanded Medicaid have signed up more than twice as many “able-bodied adults” than expected and per-person costs have exceeded original estimates by a whopping 76%, according to a 2018 report by the Foundation for Government Accountability. This led to cost overruns of 157%, the report showed, with Medicaid now accounting for one of every three state budget dollars.
|For generations, the prices that hospitals charge patients with private insurance have been shrouded in secrecy. An explosive new study has unlocked some of those secrets. It finds that employers and their insurers are failing to control hospital costs, increasing calls for transparency into insurer-hospital agreements. The analysis, by Chapin White and Christopher Whaley of the RAND Corporation, finds that hospitals are charging the privately insured 2.4 times what they charge Medicare patients, on average. The authors were able to access the actual contracted prices used by employers representing four million workers.
The Medicare for All plan embraced by leading 2020 Democrats appears more lavish than what other advanced countries offer, compounding the cost but also potentially broadening its popular appeal. The plan from Vermont Sen. Bernie Sanders would charge no premiums, copays or deductibles, allowing only limited cost-sharing for some prescription drugs. It would cover long-term care, dental, vision, hearing coverage and much more. But while other countries do guarantee coverage for all (but with often significant restrictions in access to actual care), the promised benefits vary significantly—and none are as comprehensive. [Supporters of the plan might want to read this scathing review of a book, “The Socialist Manifesto,” that chronicles the disasters that have ensued from this utopian political philosophy.]
- New federal costs under M4A would be unprecedentedly large
- We do not know how or whether the federal government could successfully finance its additional spending under M4A
- The projected additional costs of M4A’s coverage expansion would exceed the potential savings from eliminating private health insurance administration
- Current M4A proposals would sharply cut payments to health providers while increasing health service demand, most likely causing supply shortages, and disrupting Americans’ timely access to health care, and
- The costs of M4A would be borne most directly by health providers and those most in need of health services.