What if there was M4A?

Medicare for all – or more accurately a nation-wide system of some kind to provide coverage to one extent or another to every American – carries with it many possible issues and consequences, especially if the goal is to lower costs.

Here is a big one.

The American healthcare system has unique financial hydraulics, a sophisticated and opaque “Game” that depends on self-insured employers to make and keep providers whole for the perceived “underfunding” by public payers like Medicaid and Medicare. Both doctors and hospitals are completely dependent on the financial margin derived from commercial insurance. RAND studies show that on average, private purchasers are paying approximately two and a half times more than Medicare rates for hospital care (even more relative to Medicare for hospital outpatient services).

SOURCE:

https://www.medpagetoday.com/opinion/second-opinions/97277?xid=nl_mpt_DHE_2022-02-21&eun=g1155390d0r&utm_source=Sailthru&utm_medium=email&utm_campaign=Daily%20Headlines%20Top%20Cat%20HeC%20%202022-02-21&utm_term=NL_Daily_DHE_dual-gmail-definition

8 comments

  1. It isn’t only the commercial insurers who are covering the financial margin for healthcare providers. It’s becoming more of burden to those who have private/employer-provided health insurance. Ever increasing premiums, deductibles and co-pays.all go to covering ‘the gap’.

    Liked by 1 person

  2. It isn’t only the commercial insurers who are covering the financial margin for healthcare providers. It’s becoming more of burden to those who have private/employer-provided health insurance. Ever increasing premiums, deductibles and co-pays.all go to covering ‘the gap’.

    Liked by 1 person

    1. Anyone outside of Medicare and Medicaid are paying rates that subsidize those programs. Most large employers are self funded, but their administrators pay the rates higher than Medicare.

      Liked by 1 person

  3. I have a question about “Medicare for All”. Does that mean Medicare, as it is now, where it’s essential to also purchase a supplemental policy and a prescription drug policy; or will it be like Medicare Advantage, which is like a HMO with a single premium?

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  4. It seems that big business is not willing to continue to be the money fountain to finance excess costs for healthcare relative to the rates Medicare and Medicaid are paying. I can’t blame them since the system is rigged against private insurance.
    The problem is that politicians promise that M4A would solve healthcare costs and it wouldn’t because the current Medicare/Medicaid doesn’t carry its weight.
    Perhaps we need to outsource a lot of expensive procedures like joint replacements to cheaper countries. Medical tourism would be cheaper even with travel costs included.

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