“Perhaps you caught the recent two-page spread in the New York Times (August 13) in which health policy experts weighed in on what they thought should be part of the Democrats’ Medicare for All. Ignoring the fact that this speculation will only become relevant if the Democrats capture the presidency and a filibuster-proof majority in the Senate, (we can dream, can’t we?), what might you learn from reading this?
One thing you will not learn is what it will take for MFA to lower medical spending, which was not discussed at all. The primary driver of lower spending forecasts in these plans is to reduce prices paid for medical goods and services. Whether insurance administrative costs would be lowered (and insurance firm workers and hospital reimbursement specialists would be laid off) is up in the air in this discussion, since such savings depend on how many different insurance plans will be offered. Providing more choice of plans to buyers costs money, and the experts differed on whether they thought choice was good or bad for consumers.
Read more in The Philadelphia Inquirer.
Conspicuous by its absence was the observation that lowering spending on the currently well insured by enough to pay for expansion of coverage to those who lack such generosity will require lowering payments to hospitals, health systems, and drug companies. That, in turn, means lower wages or providing less employment for doctors, nurses, scientists, other health workers, and stockholders who made the mistake of buying medical stocks. Great if you are a consumer, but not so great if you have a medical person in your family or pharmaceutical stocks in your portfolio.
The experts apparently agreed with Senator Kamela Harris that “one disadvantage [of the job-based insurance 167 million of us currently have] is that it can cause some people to stay in jobs they don’t want.” One key assumption here is that the coverage you would get under Harris’ MFA would be as good as the coverage you get where you now work, something yet to be determined. Another economic assumption is that your money wages and the amount you pay explicitly for health insurance would be unaffected—which is almost surely not the case.”