Tuesday, July 31, 2018

Medicare for All would cost $32 Trillion over 10 years...LESS than what we're paying now. Pt 2

Note: This is part 2 of Medicare for All (M4A). See part 1 here. 

Medicare for All (M4A), or universal health care, is the one major driving force in the upcoming elections for Democrats. Modern Healthcare (subscription): 
In the House, progressive Washington Democrat Pramila Jayapal founded a Medicare for All caucus to try to hammer out a comprehensive, streamlined platform over the next conference. More than 60 House Democrats have joined Jayapal's group.
I thought the analysis below added a few more interesting points. It’s extremely important to note that none of the arguments presented by this report even mentioned the elephant in the room; saving lives. Odd?

Co-pays and Deductibles: I also believe an income-based office visit fee would help bring down the cost further (not "skin in the game"), somewhere in the range of $1 to $30. The report suggests...
“It would likely lead to a huge spike in overall healthcare utilization because it bans any co-pays or deductibles.”
With that said, check out the list of possibilities:
Libertarian think tank Mercatus Center of George Mason University senior research strategist Charles Blahous alleged that the Medicare for All plan backed by Sen. Bernie Sanders would put the brunt of the proposal's costs on provider pay cuts
1. Reduce provider payments by $384 billion in the first year, and by nearly $660 billion in 2030.

2. The plan could save the United States more than $2 trillion over 10 years in national healthcare spending ... Increase the federal government's costs to nearly $33 trillion above current levels. 
3. “To the extent that the cost of M4A is financed by new payroll taxes, premium collections, or other revenue increases, the net effect on the federal budget deficit would be substantially less."

4. The healthcare system would save billions every year on drug spending … allows the HHS secretary to negotiate prescription drug prices with the manufacturers. 
5. The paper acknowledged that phasing out employer-sponsored health care would translate into a huge increase in taxable wages, as it would free individuals, families, and employers from hefty healthcare spending. States would also no longer have to fund Medicaid, consistently their largest budget item.

6. Benedic Ippolito, a health economist with the right-leaning American Enterprise Institute says (that) while the U.S. health care system does need to grapple with the "right price to pay for health care," how it will impact provider behavior—investments in equipment and buildings, patient access and health outcomes.

7. Blahous cited the CMS' Office of the Actuary's projections that current payments would lead to negative operating margins for nearly half of hospitals by 2040. By 2019, over 80% of hospitals will lose money treating Medicare patients. A dramatic structural change to reimbursement structure could shutter many provider doors. 
The Republicans continue to push health care plans the will cost more money with none of the savings upsides. Anyone think high deductible HSA’s makes sense?
The latest House Republican push to leverage health savings accounts to cut spending on superfluous services … runs counter to (the report) … passed a packet of bills originally projected to cost more than $90 billion to expand use of HSAs. HHS Secretary Alex Azar praised HSAs as a way to lower unnecessary spending, saying that from his own behavior when he had an HSA he was much more cautious about the number and manner of services on which he was willing to spend a limited number of dollars.
That’s called self-rationing, where Americans delay or don’t get the treatments they need, costing them their health, lives, and money.  
But Ippolito said the new paper highlights that single-payer proponents will need to acknowledge the political fight on their hands. "In my time of listening to these single-payer proposals, a lot of emphasis is on administrative savings—they appeal to that because they don't rile up constituencies," he said. "But going after provider payment rates means taking on one of the most well-organized constituencies in domestic policy.”