Although the United States leads the world in health care spending, it fares far worse than its peers on coverage and most dimensions of value. Cost and coverage are intertwined. Many Americans cannot afford health insurance, and even those with insurance face substantial cost-related barriers to care. Employer-sponsored insurance is less prevalent and more expensive than in the past, and in response, deductibles have grown and benefits have been cut. The long-term solvency of U.S. public insurance programs is a perennial concern. The United States spends far more on healthcare administration than peer countries. Administrative barriers divert time from patient care and frustrate patients, clinicians, and policymakers. Major changes are needed to a system that costs too much, leaves too many behind, and delivers too little.
The ACP’s detailed review of the current for-profit system—even with some of the improvements resulting from the Affordable Care Act (ACA)—found that “too many Americans are uninsured or underinsured” and that current spending is “high and unsustainable”—especially as other developed nations show their ability to achieve better or similar outcomes for less while offering universal, government-guaranteed coverage to all.
While acknowledging that a transition to Medicare for All could be “highly disruptive” to the healthcare system, the ACP said “single-payer financing approach could achieve [its] vision of a system where everyone will have coverage for and access to the care they need, at a cost they and the country can afford. It also could achieve our vision of a system where spending will have been redirected from health care administration to funding coverage, research, public health, and interventions to address social determinants of health.”
Medicare for All, the paper continued, could also “achieve other key policy objectives, including portability, lower administrative costs and complexity, lower premiums and cost sharing, lower overall health care system costs, better access to care, and better health outcomes, depending on how it is designed and implemented.”
According to an op-ed by Woolhandler and Himmelstein, also published in the Annals alongside the ACP’s new position paper, “Achieving universal coverage would be costlier under the “public choice” model the ACP co-endorses along with single payer.”
Unlike a public-private mix of coverage that the public option would represent, the pair write, a single-payer Medicare for All would allow hospitals and doctors to “save billions on billing-related costs” each year, and those savings could be re-purposed “to expand care” to millions for less cost than the status quo.
More information at the link above. The times they are a changin. Hugs
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