Although neither of the major party campaigners for U.S. President in November support a “Medicare for All” style single-payer health insurance program, this issue surfaced during the Democratic primary debates as one option for extending coverage to the uninsured and abbreviating health care administrative expenditures. Our recent Georgetown Health Policy Journal Club discussed two editorials in the October 1 issue of American Family Physician that offered contrasting answers to the question: “Would Medicare for All Be the Most Beneficial Health Care System for Family Physicians and Patients? “
In “Yes: Improved Medicare for All Would Rescue an American Health Care System in Crisis, ” Dr. Ed Weisbart argued that the COVID-1 9 pandemic exposed the shortcomings in an employer-based health insurance system with an patchwork populace assurance safety net. He pointed out that 93% of U.S. primary health care physicians acquired Medicare, and Medicare enrollment has been associated with improvements in age-specific mortality relative to peer nations. In addition, Dr. Weisbart suggested that implementing an expanded edition of Medicare with more comprehensive coverage for the entire population would lead to large administrative cost savings, shorten documentation responsibility, and potentially increase primary care physician satisfaction by eliminating the moral injury associated with being unable to help patients who cannot afford care.
In “No: Medicare for All Would Cause Chaos and Fail to Control Health Care Costs, ” Dr. Richard Young countered that “expansion of Medicare … would not address the deeper troubles in our health care system.” At current pay charges, implementation of Medicare for All could stimulate substantial financial difficulties for hospices. Absent new legislation to allow the Middle for Medicare and Medicaid Work( CMS) to negotiate dope premiums and consider overheads in coverage findings, he pointed out, expanding Medicare would further increase the previously floundering U.S. health care bill. Dr. Young argued that regardless of their financing mechanisms, other countries with universal coverage have lower costs principally because their citizens are willing to sacrifice – whether that entails practising within strict budget restrictions( e.g ., fewer cancer screenings, more conservative prescribing of statins) or slumping to cover some beneficial but very expensive therapies. Ultimately, he observed that
many of the things that forestall attending physician about the current[ U.S. health care] system originated with Medicare: the devaluation of primary care services; the relative overpayment for expert care; the inability to bill for helping cases with more than two or three concerns in one stay; the requirement for face-to-face assistances( before the coronavirus infection 2019 exceptions went into effect ); the refusal to pay family physicians for clinic and hospital work on the same day; and the lack of motivations for full-scope family medicine.A 2019 RAND study estimated that total national state spendings under a Medicare for All plan would increase by only 1.8%, from $3.82 to $3.89 trillion annually. Nonetheless, the federal government’s direct share of health care spending would rise by 220%, from $1.1 to $3.5 trillion, an increase that would have represented more than half of 2019 federal spendings and outstripped the $ 2 trillion plus CARES Act fiscal relief pack surpassed earlier this year.We also addressed little ambitious( and, maybe, more politically appetizing) proposals for extending coverage that build on the framework of the Affordable Care Act, such as adding a publicly administered insurance option to increase competition( and lower payment expenses) in the district state marketplaces. Former Vice President Biden has expressed support for “Medicare for More, ” extending Medicare eligibility to persons age 60 to 64 and possibly allowing younger adults without economical policy alternatives to “buy in” to the program. The upcoming Presidential and Congressional polls will clearly play a critical role in determining if our country moves in that guidance .** This berth firstly appeared on The Health Policy Exchange.
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