A near-universal health-care plan that wouldn't break the bank

[applegrove]

https://www.washingtonpost.com/opinions/a-near-universal-health-care-plan-that-wouldnt-break-the-bank/2018/05/13/3c37e456-5544-11e8-abd8-265bd07a9859_story.html?noredirect=on&utm_term=.43eae4028786

The Editorial Board at the Washington Post

"SNIP.........


SINCE THE day Obamacare passed, as Republicans have sought to sabotage it, Democrats have hoped for more. Their hopes have taken them ever closer to pushing a radical upending of the health-care system, exemplified in Vermont independent Sen. Bernie Sanders’s plan for a European-style single-payer program, which a growing list of prospective Democratic presidential candidates has endorsed. But there are options that are neither as cruel as the GOP’s miserly repeal-and-replace nor as disruptive as the more sweeping left-wing proposals. In other words, they are compassionate and realistic.

Economists at the Urban Institute, an independent research group, released on Sunday a proposal that would get the nation to near-universal health-care coverage and relieve many of the financial burdens some people face under the current system — and cost the federal treasury far less than more radical plans. It would leave in place Medicare and the employer-based health-care system, whereby most Americans get their insurance. But it would create a new health-care marketplace for most everyone else — those on Medicaid and the Children’s Health Insurance Program, which are government initiatives for low-income people, and those buying insurance on their own in the individual market.

As under Obamacare, insurance companies could not deny people essential care. But the federal subsidies helping people buy coverage would be more generous, pegged to the “gold” tier of plans in the current system. The subsidies would scale with income; some people would get free coverage; even at the high end, no one would pay more than 8.5 percent of their income in premiums for a gold plan. People could take this money and buy into a new, government-run plan, or they could purchase coverage from private insurers. Crucially, doctors, hospitals and other providers would be barred from charging private insurers in the new market more than they charge Medicare, which could lower costs dramatically in areas of the country served by only a few providers whose market power allows them to set high rates.

Because many people would pay premiums and other forms of cost-sharing, they would have some skin in the game. Between this and the fact that employer insurance would continue , the cost to the government would be about $98 billion in the first year — a lot, to be sure, but far less than a switch to single-payer. Insurers would be protected from catastrophic costs through permanent reinsurance and risk-adjustment programs, mechanisms that stabilized the system in Obamacare’s early years. Given the size of the new market, more insurers and most providers would probably participate.

.........SNIP"

[BigmanPigman]

1. The GOP would never consider anything that would help the average American,

only themselves and their rich pals. They are going after Medicare, Medicaid and Social Security while they still have control of the House and Senate. Their goal is to make people bankrupt and to make the sick die in record time.

[mcar]

2. $98 billion is chump change

Rescind the Dotard tax cuts and we'd be fine and dandy.

[Freddie]

3. I like this, and the "Medicare For Everyone" idea

Much as I think health coverage should not be tied to employment, too many people are happy with their employer plans. If (eventually) employers are allowed to offer these plans too, single-payer could be phased in gradually.

[Hoyt]

4. It is a low investment start toward a Public Option or even Medicare-for-All.

Not so sure providers would jump for it, but it’s time to start rationalizing the system no matter who objects or whines.

You’d still need a mandate, and something to keep employers from dumping or gutting their plans.

Also not sure insurers would trust government after virtual wounding/repeal of Obamacare and promises.

In any event, we have to do something or we’ll shortly be worse off than before Obamacare.

[Yupster]

5. The hitch I see is the part about

doctors can't charge anyone more than medicare pays.

Many doctors are not taking on medicare patients because they feel the compensation for them loses money for them or at best doesn't make them enough to go through the trouble of being doctors.

If doctors were paid the same for all their patients as they are for their medicare patients, I think we'd quickly see a doctor shortage much worse than today.

[applegrove]

6. Do you know how many really bright people try to get in to medical school

and don't quite make it the competition is so fearce? Many of them would be happy to work for $200,000 a year like they do in canada. Walk by any hospital in canada and you'll see jags and beamers parked there all the time. They do fine.