A survey earlier this year by the Kaiser Family Foundation and the Washington Post found that 51 percent of Americans would support a national health plan while 43 percent opposed it.
Susan Jaffe, writing in The Lancet on Sept. 1 of this year, said that leading health-care providers, drug makers and insurance groups may have also noticed this movement for a single-payer-run system, and have formed a Partnership for America’s Healthcare Future.
This partnership is aimed at preserving Medicare and Medicaid and strengthening employer-sponsored health insurance among other things. I have spoken to a physician who is very aware of what is happening and I asked him directly how does a single-payer system affect physicians. His answer was that the doctors he meets from other countries where this single-payer is in effect seem to be working with no serious problems for the providers, but we are talking about different culture and government structures in place.
Hundreds of millions of Americans “have affordable coverage they value and they get the care they need when they need it – from the best doctors and hospitals in the world,” said Kristin Grow, vice president for communications at America’s Health Insurance Plans, a trade group representing health insurance companies.
Grow said, “We need to improve what is working and fix what is not so that every American has affordable coverage, access to high-quality care, and control over their health care choices… Solutions will come from both private and public sectors.”
Now that the elections are over and we can actually direct our attention to a subject that came up in the last presidential election, Medicare for All. This is a national healthcare plan. Seema Verma, the Medicare and Medicaid administrator, a Trump appointee, slammed the plan, Sen. Bernie Sanders’ idea currently, saying it would turn into a “Medicare for None.”
Sanders is saying that Verma is trying to “throw” millions of people off their health insurance during the Trump administration’s “failed” effort to repeal the Affordable Care Act. Seema, in turn, denounced what she called the “drumbeat” for government-run socialized healthcare.” She said, “You are giving the government complete control over decisions pertaining to your care, or whether you receive care at all.”
Sanders said that “Medicare is, by far, the most cost-effective, efficient and popular healthcare program in America.” He added that “Medicare has worked extremely well for our nation’s seniors and will work equally well for all Americans.”
The Sanders proposal would add benefits for Medicare beneficiaries, coverage for eyeglasses, most dental care, and hearing aids. It would also eliminate deductibles and co-payments that Medicare and private insurance plans currently require.
The Universal Medicare Program or UMP provider payments would be based on a fee-based schedule developed using methodology modeled after the current Medicare program. The Federal Government would negotiate prices directly with drug manufacturers, medical assistance equipment and supplies.
Now comes the difficult part. The money the federal government spends on the various health programs incorporated under the UMP would be generated by raising the income tax paid by Americans who earn more that $250,000 and also from a payroll tax similar to what employers contribute to subsidize employee health expenses.
But when researchers at the Urban Institute examined a similar Medicare for All proposal Sanders offered during his 2016 campaign, they concluded that the plan would cause a net increase in health-care spending of $6.6 trillion over a decade, assuming there would be significant cuts in provider payments.
“People will get free healthcare, their health will improve, and there are a lot of good things about it,” said John Holahan, a senior fellow at the Urban Institute. I think it would be a monumental undertaking to make it work.
Variations of federal legislation have been introduced in some 14 state legislatures. In New York, the assembly passed it but was not able to get it through the Senate. California is also divided.
Either way, the states need permission from the federal government, the CMS, to implement a single-payer plan. A Trump official has already said no on a waiver request.
Bertram Drachtman
Great Neck
