More than 100 House Democrats have endorsed Rep. Jayapal’s Medicare for All Act of 2019. Fourteen Democratic senators have co-sponsored a similar bill from Sen. Bernie Sanders (I-VT). The title is deeply misleading. It implies that the current Medicare system would be extended to all Americans. In fact, Medicare for All differs from Medicare in fundamental ways. While America needs a debate about health care, it should be based on an accurate description of the alternatives.
One feature of the political moment is that ideas that first appeared on the left (tariffs) are gaining support on the populist right. The latest example is a GOP plan in Florida to import prescription drugs from Canada, which is impractical, unsafe and unlikely to reduce prices at the pharmacy.
The Florida Legislature has been moving on a plan pushed by Republican Governor Ron DeSantis that directs the state health agency to set up a prescription drug importation program. Other states like Colorado are pondering similar schemes, and Vermont is well along in setting one up.
| Sen. Sanders calls his new bill “Medicare for All” because polls tell him that voters don’t want to abolish traditional Medicare. Voters also don’t want him to destroy the U.S. system of private medical insurance, but his plan would do that, too. The bill reads, “Any individual entitled to benefits under this Act may obtain health services from any institution, agency, or individual qualified to participate under this Act.” In other words, you are free to choose any doctor the federal government allows you to choose. But good luck finding one when payments to doctors and hospitals will be slashed to the point that many will have difficulty keeping their doors open. On at least one point, Mr. Sanders is being honest. He’s not even trying to sell the Obama whopper that patients will get to keep the plans and the doctors they like. |
Dominant hospital systems use an array of secret contract terms to protect their turf and block efforts to curb health-care costs. As part of these deals, hospitals can demand insurers include them in every plan and discourage use of less-expensive rivals. Other terms allow hospitals to mask prices from consumers, limit audits of claims, add extra fees and block efforts to exclude health-care providers based on quality or cost.
| Medicare, as President Lyndon B. Johnson put it, is a “light of hope” for elderly Americans. Medicare for All proposals threaten to extinguish it. Medicare for All would break a sacred promise and harm seniors’ access to care by forcing a system designed to support them to take on every other American. They deserve a system that helps them get well, not get in line. As for your taxes, the question isn’t whether Medicare for All would raise them, but by how many tens of trillions. And the monetary cost of Medicare for All is surpassed by its moral cost. The plan would strip coverage from more than 180 million Americans and force them into government insurance. |
Republican-led states are stepping up their efforts with the Trump administration to pursue work requirements and other changes to Medicaid, in the face of legal challenges and Democratic opposition.
Tennessee Republicans want permission to revamp Medicaid in exchange for a fixed amount from the federal government. Utah is testing whether it can get approval for a partial Medicaid expansion with capped payments from the federal government. And Kentucky lawmakers have weighed drug-testing recipients with criminal or substance-abuse histories, among other steps.
Eliminating profit from an entire sector of the national economy would be unprecedented. But the example of New York, on a smaller scale, shows why it is a recipe for dysfunction.
The Empire State’s hospital industry has been 100% nonprofit or government-owned for more than a decade. It’s a byproduct of longstanding, unusually restrictive ownership laws that squeeze for-profit general hospitals. The last one in the state closed its doors in 2008.
A report last year from the Albany-based Empire Center shows the unhappy results. The state health-care industry’s financial condition is chronically weak, with the second-worst operating margins and highest debt loads in the country. And there’s no evidence that expunging profit has reduced costs. New York’s per capita hospital spending is 18% higher than the national average.
Democratic lawmakers in Connecticut introduced legislation Thursday that would create a public option for health-care coverage, allowing individuals and small businesses to buy insurance through the state. Under the proposal, Connecticut would create multiple plans that small businesses and their employees could buy starting in July, leveraging the state’s existing purchasing power to lower costs. And in 2021 Connecticut would begin offering a new health-insurance option that any state resident would be able to join. The public insurance would offer coverage options for small businesses and individuals who don’t qualify for subsidies through the Affordable Care Act, officials said.
The Trump administration is sounding out an idea to require that hospitals, doctors and other medical providers publicly disclose the “secretly-negotiated” prices they charge insurance companies for services, a move that proponents say would expose for the first time the actual cost of care. [Some are skeptical that anyone in the health sector knows the actual cost of care.] Hospitals and insurers negotiate pricing contracts which are generally bound by confidentiality. HHS is seeking public comment on whether patients have a right to see the discounted prices in advance of obtaining care.
CNN and NBC exit polling last November showed a huge Democratic advantage on health care. But socialized medicine wasn’t on the ballot.
As for 2020, Democrats know people don’t want socialized medicine, so they have been calling it “Medicare for All” even though the prototype legislation ends Medicare along with private insurance. Consumers may be starting to figure this out.