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The term “Medicare for all” has gained a unique prominence in the current public discourse, but whether it’s a feasible path for healthcare in this country, or oversimplified election-year hype is up for debate.
Many of the Democratic candidates positioning themselves for the 2020 presidential run have embraced the idea, but what does “Medicare for all” actually mean? The term itself has no uniform definition, with supporters espousing a variety of conceptual models all designed to improve access to healthcare for all Americans.
In its most radical conception, a “Medicare for all” plan would dismantle our current system of employer sponsored benefits in favor of single payer plan where the federal government distribute payments to providers based on a pre-determined rate schedule. Insurance companies currently serving as the intermediaries between patients and healthcare providers would be eliminated. We would apparently all depend on the government for a one-size-fits-all health plan.
There are, of course, some hurdles laid out in front of this idea. For starters, there’s a widely held belief that switching to government-sponsored healthcare would drastically reduce the quality of care we currently enjoy as Americans. In addition, a recent Gallup survey found that 83 percent of health plan participants rate their plan as excellent or good. With half of the population covered by employer plans it remains to be seen if people would happily switch to a new government plan.
Another difficulty with any iteration of a “Medicare for all” single-payer plan are questions about cost. Currently, overall healthcare spending in the US is a mix of government programs – like the Veterans Administration system, Medicare and Medicaid – and private systems – like the aforementioned employer-sponsored plans and privately purchased plans like those bought through the ACA private exchanges. Even as many candidates are promoting the idea, details that address how we will shift costs to a government-administered single-payer system and disburse the estimated $33 trillion 10-year cost of this program have yet to be laid out in a way that is understandable to skeptics.
Other Medicare-for-All plans propose incremental changes designed to effect universal access to coverage by allowing people under 65 without access to coverage to buy into Medicare. Some proposals look to reduce the Medicare availability age to 55, and others attempt to reduce copayments and prescription drug costs.
The healthcare economy in the United States represents almost 20 percent of our gross domestic product. Entrenched interests that participate in that spending, including hospitals, physicians, pharmaceutical companies and medical device manufacturers have all come out against the single payer model. It will take more than the campaigning of idealists to uproot the current healthcare paradigm.
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