Medicare for All – The Bernie Sanders and Elizabeth Warren Health Care Plans(healthpolicyandmarket.blogspot.com)
healthpolicyandmarket.blogspot.com
Medicare for All – The Bernie Sanders and Elizabeth Warren Health Care Plans
http://healthpolicyandmarket.blogspot.com/2019/10/medicare-for-allthe-bernie-sanders-and.html
4 comments
I agree that short term providers will likely take in less money with a "Medicare for all" solution, but I think the problem presented by this blog post is overstated/misrepresented:
1) The "Over 65" demographic visits the hospital more than other demographics so comparing raw number of people is an apples to oranges comparison (65+ somewhere between 3-10x more likely to utilize an inpatient stay, https://www.hcup-us.ahrq.gov/reports/statbriefs/sb235-Inpati...)
2) Roughly half of all administrative costs in US hospitals are associated with billing. Administrative costs are lower in single payer systems because hospitals don't need to bargain and coordinate billing with multiple parties. Doctors will still be needed by hospitals, but hospital workers/sales people/VPs who bargain with insurance companies will be less necessary. This is a significant percentage of hospital expenditures [https://www.americanprogress.org/issues/healthcare/reports/2...] Administrative staff seem much more likely to see paycuts or staffing cuts rather than necessary staff like doctors/nurse.
The reason candidates feel a need to propose anything related to health care is that the costs are too high. Anybody expecting lower costs without cutting, you know, costs isn't engaging reality.
So yes, any serious proposal to address the cost of health care in America will include cuts to the costs of health care in America, which includes hospitals, doctors, and so on. This seems blindingly obvious.
The linked blog post seems to want the current system to be preserved as-is, with no cuts to anything. Which is a viewpoint, but not a very popular one.
So yes, any serious proposal to address the cost of health care in America will include cuts to the costs of health care in America, which includes hospitals, doctors, and so on. This seems blindingly obvious.
The linked blog post seems to want the current system to be preserved as-is, with no cuts to anything. Which is a viewpoint, but not a very popular one.
I think the enlightening thing is that higher costs have been driven by government funded programs. I have to pay taxes for Medicare directly and there is a hidden tax in the form of higher healthcare costs in the private market.
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Yes. The plan is to cut payments to providers. This includes doctors. I'm sorry.
Healthcare has become a huge portion of our economy, in fact the largest at 18%. Doctors account for about 750k jobs in the US, compared to 16 million in the segment total: they account for only 4.5% of healthcare jobs.
Healthcare is also the fastest growing employment sector.
There are huge inefficiencies in the US healthcare system. We pay more to provide equivalent service as other first world countries.
However, switching to a single-payer system with a snap of one's fingers will not solve those inefficiencies, and will create massive upheaval in just about every Americans life, and our economy in general.
The article is pointing out that if the government sets prices at which all companies decide they cannot profitably render services, 20% of our economy and 16 million jobs just vanished. No candidate has addressed this issue.
Healthcare is also the fastest growing employment sector.
There are huge inefficiencies in the US healthcare system. We pay more to provide equivalent service as other first world countries.
However, switching to a single-payer system with a snap of one's fingers will not solve those inefficiencies, and will create massive upheaval in just about every Americans life, and our economy in general.
The article is pointing out that if the government sets prices at which all companies decide they cannot profitably render services, 20% of our economy and 16 million jobs just vanished. No candidate has addressed this issue.
I find it hard to believe that someone who has spent a large chunk of their life in the field of medicine is going to choose unemployment over continuing to practice with less remuneration.
If the jobs you describe are necessary, then they will continue. If they are not, they might go away. That's how things work.
We've had a long time to find these inefficiencies you describe, and yet all they've done is multiply. Cutting rates means leaving less room for inefficiencies, and is the most certain precursor to eliminating them that I know of.
If the jobs you describe are necessary, then they will continue. If they are not, they might go away. That's how things work.
We've had a long time to find these inefficiencies you describe, and yet all they've done is multiply. Cutting rates means leaving less room for inefficiencies, and is the most certain precursor to eliminating them that I know of.
Those conclusions are taking the available detail of the current proposals to conclusion.
I seriously doubt that any proposal would pass that results in such a conclusion. The point the article is making is that the proposals need to consider the facts that result in that conclusion (ie, current Medicare/aid rates cannot support the current industy), and need to offer proposals to counter act such a conclusion. Any proposal that doesn't is not a proposal, but a platitude.
I seriously doubt that any proposal would pass that results in such a conclusion. The point the article is making is that the proposals need to consider the facts that result in that conclusion (ie, current Medicare/aid rates cannot support the current industy), and need to offer proposals to counter act such a conclusion. Any proposal that doesn't is not a proposal, but a platitude.
Supporting the current industry is not the goal. The current industry is failing too many people.
Proposing too many details before a candidate is even elected would be foolish. Any particular detail can be distracting from the overall goal.
Proposing too many details before a candidate is even elected would be foolish. Any particular detail can be distracting from the overall goal.
First I just want to point out that I really do not think healthcare should be a jobs program. Second, turning medicare on for all will NOT destroy the entire industry, we would not lose 16 million jobs from a 20% cut in healthcare pricing. Healthcare insurance providers would definitely be in for some hurt. Bloated administrations would be out. 20$ ibuprofen would be out. The market would start to function as a market should.
I'm not saying it should be a jobs program. I was pointing out that the impact would be far greater than doctors.
I think the point that you are missing in the article is that for any company offering medical services, Medicare/aid is subsidized by other revenue. That is, from the companies perspective, it is offered at a loss. If that subsidization goes away, the company can no longer afford to offer that service. The economic impact of such an event would be massive, and a serious proposal requires far more detail than hand-waving.
I think the point that you are missing in the article is that for any company offering medical services, Medicare/aid is subsidized by other revenue. That is, from the companies perspective, it is offered at a loss. If that subsidization goes away, the company can no longer afford to offer that service. The economic impact of such an event would be massive, and a serious proposal requires far more detail than hand-waving.
That may be the plan but the fact that the leading proponents of this policy assiduously avoid addressing this is more governing by mass cognitive dissonance, and that's not credible. It's simply evidence that these people are afraid of goring the necessary oxen.
Of course its not highly mentioned, because its politics and its probably an unpopular consequence of the expansion. When Trump glorified his tax cuts, he didn't exactly shout from the rooftops that the majority of those cuts would be for the wealthy and for corporations, because that too would have been unpopular. Nobody wants to see doctors being paid less, they just want a decrease in healthcare costs. I think proponents of this plan do not to want admit that lower doctor pay would be a consequence because that would be admitting a downside, which opponents would undoubtedly latch on to (again, its politics), and with the rise of populism this could be a real threat to the success of the plan to expand the healthcare.
If the plan can't survive pointing out the various giant elephants in the room then it's not much of a plan. You have to do better than "lets hope everyone is happy to join us in pretending this problem doesn't exist."
Further, of all the oxen that need to be gored provider compensation is not the most scary. Who is going to believe these people are capable of addressing the really tough aspects of US healthcare when they can't deal with even that? When the only defense is "don't talk about it"?
When faced with such cowardice I conclude that what we'll actually get is more cop-outs; anyone with a non-subsistence level income will take another huge bath, the backhand rationing that is huge deductibles will continue and we'll still have a big cohort of people that get no healthcare.
Further, of all the oxen that need to be gored provider compensation is not the most scary. Who is going to believe these people are capable of addressing the really tough aspects of US healthcare when they can't deal with even that? When the only defense is "don't talk about it"?
When faced with such cowardice I conclude that what we'll actually get is more cop-outs; anyone with a non-subsistence level income will take another huge bath, the backhand rationing that is huge deductibles will continue and we'll still have a big cohort of people that get no healthcare.
Yup, that's fine. Those doctors have nowhere else to go, every other country has public healthcare, where their salaries are much less inflated. The over-payment of doctors in the US has caused huge healthcare brain drains in other developed countries. Attacking doctor salary is a huge step forward.