How Might It Work
According to the Kaiser Family Foundation , a non-profit organization that studies insurance and opinions regarding insurance, there are several proposals for how such a Medicare for All program would work. They include:
- Medicare for All single health program: This program type would establish a single insurance program for all U.S. residents. The plan might result in higher taxes for some but lower costs for healthcare. This is a comprehensive plan where every person would have the same health plan, although they could potentially get supplemental coverage through an employer.
- Medicare for All nationalized health program: This national healthcare plan would be an alternative to private insurance plans. A person could choose to participate in the public healthcare plan or keep their private insurance plan. This would be similar to the option of Medicare for most individuals older than age 65, but persons of all ages could purchase the Medicare-like insurance. Ideally, this plan would be more affordable to people in the U.S. and create competition in the healthcare marketplace that could drive down costs.
Other proposals include lowering the age when people could qualify for Medicare or increasing the qualifying income for Medicaid, a government-sponsored insurance program for those with lower incomes.
The Upshot: M4a Creates A Small Amount Of Manageable Churn But Increases The Overall Demand For Labor And Boosts Job Quality
The job challenge relating to a fundamental health reform is managing a relatively small increase in job churn during an initial phase-in period. Most Medicare for All plans explicitly recognize and account for the costs of providing these workers the elements of a just transition. As noted previously, this sort of just transition is far easier when health care is universally provided.
Besides this challenge, the effect of fundamental reform like M4A on the labor market would be nearly uniformly positive. The effect of a fundamental reform like M4A on aggregate demand is almost certainly positive and will therefore boost the demand for labor. The number of jobs spurred by increased demand for new health care spending will certainly be larger than the number displaced by realizing efficiencies in the health insurance and billing administration sectors.
Finally, the introduction of fundamental health reform like M4Aparticularly reform that substantially delinks health care provision from specific jobswould greatly aid how the labor market functions for typical working Americans. Take-home cash pay would increase, job quality would improve, labor market transitions could be eased for employers and made less damaging to workers, and a greater range of job opportunities could be considered by workers. The increased flexibility to leave jobs should lead to more productive matches between workers and employers, and small businesses and self-employment could increase.
Canada: Public Funding Private Care
The single-payer health care system in Canada is probably closer to Medicare for All than any other national system. Under this system, the government provides health insurance coverage, but most of the actual care comes from private doctors and hospitals.
As in Britain, patients pay nothing at the time they receive care they simply show their national insurance cards. That creates much less paperwork for both patients and providers.
However, Canadas single-payer system doesnt cover all forms of health care. Many Canadians receive private insurance through their jobs to help cover the costs of dental care, vision care, and prescription drugs. All in all, the government pays for about 70% of Canadians health care costs, according to The New York Times. The total cost of the system is similar to Britains about 10% of GDP.
To keep costs down, Canada puts hospitals on strict budgets and limits the number of specialists who can receive training. Both these rules can result in long wait times for care. A 2019 report from Health Quality Ontario on the provinces health care system says that emergency room patients wait an average of 9.7 hours to be admitted to the hospital. Also, 30% of patients said they had to wait either somewhat too long or much too long for an appointment with their primary care doctor.
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The Basics Of Medicare For All
What to know about Bernie Sanderss health care plan.
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Its possible youve tuned out when the Democrats running for president have tussled over Medicare for all. But now that Bernie Sanders, who introduced the Medicare for All Act in the Senate, is ascending in the nominating contest, its a good time to take a closer look at what it would mean for the health system, your health insurance and finances, and the federal budget.
Heres our quick primer, with some suggestions for further reading.
Medicare Prescription Drug Coverage
Medicare drug coverage helps pay for prescription drugs you need. To get Medicare drug coverage, you must join a Medicare-approved plan that offers drug coverage .
Each plan can vary in cost and specific drugs covered, but must give at least a standard level of coverage set by Medicare. Medicare drug coverage includes generic and brand-name drugs. Plans can vary the list of prescription drugs they cover and how they place drugs into different “tiers” on their formularies.
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Would You Have To Change Your Current Health Insurance
Yes. People who get their coverage from Medicare would see the smallest change. They would keep getting insurance called Medicare from the government, only with new benefits and fewer fees. People with nearly any other type of insurance would have to switch to the government plan.
But, as Mr. Sanders often points out, people who lose their private insurance would, in almost all cases, get more generous government insurance instead. Nearly every doctor and hospital in the country would probably accept the new Medicare insurance, so changing your insurance would probably not mean changing doctors, as it often means now when you change your private insurer.
What Medicare For All Means
As the name suggests, Medicare for All expands on the original Medicare program thats been around since 1965. This program, which provides guaranteed health insurance to older Americans, is consistently popular with voters. A 2015 survey by the Kaiser Family Foundation found that 75% of Americans covered by Medicare said the program was working well for most seniors.
When Medicare was first introduced, it was designed in a way that allowed the program to expand to cover more people. However, the only time that happened was in 1972, when the program was broadened to cover people with disabilities. For the next 45 years, the number of people covered remained mostly unchanged.
Then, in 2017, Sen. Bernie Sanders of Vermont proposed expanding the program on a massive scale to cover virtually everyone in the country. Under his plan, an all-inclusive Medicare would replace the existing Medicare and Medicaid programs, as well as all private health insurance. Its essentially the latest spin on a single-payer health care system, in which the government uses tax money to provide health insurance for everyone.
Would Medicare For All Lower Health Care Costs
The answer depends on who is analyzing the plan.
It would lower costs for people who are struggling to pay for their health care premiums and services.
In 2019, around a quarter of Americans said they had problems paying their medical bills. One-third of insured adults said it was challenging to pay for their health insurance, and about a third said they didnât take their medicine as prescribed because of the cost, says the Kaiser Family Foundation.
For people with employer-sponsored coverage in 2019, employees contributed an average $6,015 toward a premium for family coverage, and individuals contributed $1,242 for their premium, according to a Kaiser Family Foundation survey. The average deductible was $1,655, the survey says.
For people who didnât have employer-sponsored insurance and bought individual plans, the average cost of a premium was $5,280 a year in 2018 , and for family coverage, it was $14,016, according to ehealthinsurance.com. Deductibles averaged $4,578 for individuals and $8,803 for families in 2018, the publication says.
Medicare for All would eliminate these premiums and out-of-pocket costs.
It can be âthoughtfully designed to reduce total costs for a vast majority of American families,â Berwick says. âPeople will get more for their moneyâ in terms of access to more health benefits and better quality of care, he says.
âThe fact is, the more health services that are covered, the more it costs,â says Blahous.
How Would This Be Paid For
National health care spending: Federal health care spending:Total government spending:Sanders’ Medicare for All plan analysissuggest1. National health care spending: Sanders’ assumptionsGovernment spending: options, 28.5 million 6 in 10estimatedDefeating Amy Klobuchar could give progressive Democrats a chance for real changeanalyzed
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Will Quality Of Care Go Down
The rhetorical response to single-payer health insurance is that its government-controlled healthcare. Its then used to argue that the government would be making important decisions about the care you get and dont get, and who you see, Weil said.
But Medicare for All could actually give you more choice than private insurance.
With Medicare, you can go to any doctor, Weil said. I have private insurance and have a lot more restrictions as to who I see.
Jayapal Introduces Medicare For All Act Of 2021 Alongside More Than Half Of House Democratic Caucus After Millions Lose Health Care During A Pandemic
Legislation guarantees health care to everyone as a human right by providing comprehensive benefits including primary care, vision, dental, prescription drugs, mental health, long-term services and supports, reproductive health care, and more with no copays, private insurance premiums, deductibles, or other cost-sharing
WASHINGTON Today, U.S. Representatives Pramila Jayapal and Debbie Dingell introduced the Medicare for All Act of 2021, transformative legislation that would guarantee health care to everyone in America as a human right at a moment in which nearly 100 million people are uninsured or underinsured during a pandemic. Endorsed by 300 local, state, and national organizations and co-sponsored by more than half of the House Democratic Caucus including 14 committee chairs and key leadership Members, the landmark bill provides comprehensive benefits to all with no copays, private insurance premiums, deductibles, or other cost-sharing.
The Medicare for All Act of 2021 is also endorsed by 300 local, state, and national organizations that represent nurses, doctors, business owners, unions, and racial justice organizations. This includes Physicians for a National Health Program, Public Citizen, National Nurses United, Center for Popular Democracy, Peoples Action, Social Security Works, Labor Campaign for Single Payer, SEIU, and hundreds more.
For a full list of endorsing organizations, .
To view the text of the legislation, .
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The Fight That Will Mobilize The Nation
Democrats request, which the president agrees with, states that Medicare should have the power to negotiate with pharmaceutical companies and maintain the savings that would be achieved by such price negotiations up to $450 billion over a decade to pay for the improvements and expansions to Medicare. Sen. Bernie Sanders and 16 other Democratic senators write that their demands present an historic opportunity to make the most significant expansion of Medicare since it was signed into law.
Really? Democrats can make this a truly historic opportunity by doing everything they can to instead pass the Medicare for All Act of 2021, which would establish a national health insurance program for all U.S. residents from birth or residency cover all medically necessary services including inpatient, outpatient, prescription drugs, mental health and substance use services, reproductive health care, gender-affirming care, dental, vision, hearing, physical therapy and long-term care eliminate all premiums, deductibles, co-pays and co-insurance abolish obscene profit-making from our health care system reduce classism and racism by eliminating a means-tested program for the poor save over 68,000 lives every year eradicate medical bankruptcy and save $458 billion every year.
Passing H.R.1976, the Medicare for All Act of 2021, is the kind of history-making this country needs from Democrats right now. The pandemic is still here, and we cannot delay any longer.
What Medicare For All Could Mean For Your Health Care
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Medicare for All is a proposed single-payer health care system that would cover Americans of all ages. Various tax-funded plans under the Medicare for All banner have been introduced in Congress since 2003, and the concept was championed by candidates Bernie Sanders and Elizabeth Warren during the 2020 Democratic presidential campaign.
While a 2021 Medicare for All bill has been proposed in the House of Representatives and awaits committee review, most of the health care conversation today focuses on expanding Medicare benefits for current recipients as offered in President Joe Bidens Build Back Better package.
While those changes fall short of universal eligibility, they might pave the way for more significant reform in the future, some experts and advocates say.
Joe Biden did not run on Medicare for All, but in a lot of ways, the question is, What lays the groundwork for the establishment of a national health insurance program? says Dr. Abdul El-Sayed, former executive director of the Detroit Health Department and co-author of Medicare for All: A Citizens Guide.
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Congressional Budget Office: Medicare For All Would Reduce Healthcare Costs
On December 10, 2020, the Congressional Budget Office released a new estimate of the cost of Medicare for All, finding that overall health costs would decline between $42 and $743 billion per year. The CBO found that administrative costs under Medicare for All would not only be vastly lower than the costs of our current chaotic system of private insurance, they would be even lower than Medicares current administrative costs of two percent. Read more »
Employment Effects Of Fundamental Health Reform: Gains In Health Care Losses In Insurance And Billingwith Likely Economywide Net Job Gains From Rising Economic Demand
Like all positive productivity gains, Medicare for All would be more likely to increase the total number of jobs in the U.S. economy, even as health reform leads to the redeployment of workers from some sectors and into others.
Despite the many labor market benefits of fundamental health reform like M4A, many critics have claimed that such reform would lead to a loss of jobs. This claim is misleading. One small grain of truth to it is that the universal provision of health insurance would allow people who would strongly prefer not to work , but who have remained in their current jobs in order to retain health insurance, to be free to quit. This type of voluntary reduction in labor supply following a health reform would be strongly welfare-improving. For example, the ACA was clearly associated with a large increase in parents with young children transitioning to part-time work . To the degree this occurred because these parents no longer needed to work full time to obtain ESI, and they preferred spending more time with their children for reasons of worklife balance, it should be seen as a clear win for the policy.
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Would This System Make The United States Like Other Western Countries
Not exactly. Nearly every peer country has universal health insurance coverage. But Mr. Sanders proposes a plan with the government providing insurance to everyone directly, and with people responsible for almost no out-of-pocket costs. It comes the closest to the Canadian system, also called Medicare. But in Canada, Medicare does not cover prescription drugs or dental care, for example. In most European countries, there is a mix of private and public sources of insurance.
Regions With Hybrid Single
Healthcare in Australia is provided by both private and government institutions. Medicare is the publicly funded universal health care venture in Australia. It was instituted in 1984 and coexists with a private health system. Medicare is funded partly by a 2% income tax levy , but mostly out of general revenue. An additional levy of 1% is imposed on high-income earners without private health insurance.
As well as Medicare, there is a separate Pharmaceutical Benefits Scheme that considerably subsidises a range of prescription medications. The Minister for Health administers national health policy, elements of which are overseen by individual states.
Building upon less structured foundations, in 1963 the existence of a single-payer healthcare system in Spain was established by the Spanish government. The system was sustained by contributions from workers, and covered them and their dependants.
The universality of the system was established later in 1986. At the same time, management of public healthcare was delegated to the different autonomous communities in the country. While previously this was not the case, in 1997 it was established that public authorities can delegate management of publicly funded healthcare to private companies.
In 2000, the Spanish healthcare system was rated by the World Health Organization as the 7th best in the world.
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