by Sarah Gantz, Updated: February
21, 2020
Medicare for All is one of the most talked-about policy
proposals of the 2020 Democratic primary — but could it ever happen?
According to Paul Starr,
a Pulitzer Prize-winning health economist who worked on the failed Bill Clinton
health-care plan in the 1990s, the answer is: not any time soon. For one thing,
extending the program for older and disabled Americans to everyone would
consume so much of the federal government’s resources, it would require massive
tax increases and turn the government into “a health insurance company with
armed forces,” the Princeton economist said Friday at a health care cost
conference held by the University of Pennsylvania’s Leonard Davis Institute.
What’s more, he noted,
putting everyone on government health care would completely dismantle the
highly profitable insurance industry while lowering payments to the medical
industry — both of which hold huge political sway.
Rather than proposing to
dismantle a big chunk of the American economy all at once, he said, it would be
smarter for the next president to find smaller yet still meaningful reforms
that have a chance of getting through Congress. “Midlife Medicare,” in which
the eligibility age would gradually go lower than the current 65, would help
millions of Americans without “destabilizing the rest of the system," he
said.
There’s good reason why
the concept of Medicare for All has captured the public’s attention, Starr
said. The rising cost of health care and the threat President Donald
Trump and Republicans pose to the Affordable Care Act have made health care top of mind for voters. Candidates know they must come up with
a plan to address consumer anxiety about health care cost and coverage if they
want to win votes.
The biggest and boldest
of these plans is Medicare for All, proposed by Democratic front-runner Bernie Sanders. Not only would the Sanders plan put everyone
on Medicare, it also would cover dental care, vision, and other services not
currently covered by traditional Medicare.
During the most recent
Democratic debate, Sanders pointed to a study in the medical journal Lancet
that found a Medicare for All plan like his could save billions of dollars a
year.
The analysis estimated
the plan would result in a health care system that costs about $3 trillion a
year, compared with current health care spending of $3.5 trillion, according to
the Washington Post, which dug into the details of the new report. Other organizations have pegged a
higher cost, ranging from $3.8 trillion to $4.2 trillion a year. But that
assumes the health industry plays along, which is not likely even if a Democrat
wins the White House.
The government would need
to raise an additional $773 billion to pay for the plan, the Lancet analysis
estimated. The study suggested that taxing employers and individuals, who would
no longer be paying for private health insurance plans, could largely cover
that cost, according to the Post.
Much of the savings in
Medicare for All would come from the program’s ability to regulate the amount
it pays providers and hospitals — which are staffed and built based on today’s
huge price tags. Salaries, construction plans, and debt payments all would take
big hits.
Starr thinks lawmakers
should focus on smaller reforms that could make a more immediate difference for
people burdened by health care costs. In addition to incrementally lowering the
Medicare eligibility age, he also said bipartisan agreement should be possible
on surprise hospital bills, which have bankrupted people who have
insurance but unknowingly used an out-of-network provider.
“It’s not radical, but
another big failure does not equal success,” he said, quipping that if he could
go back in time, he would have advised Clinton not to aim so high with his
plan. "If we can get real, we can get moving.”
No comments:
Post a Comment