Case 6.3 Would Medicare for All Reduce Costs? This question actually has two parts, because cost has


Case 6.3

Would Medicare for All Impoverish Costs?

This inquiry actually has two space, consequently consume has sundry meanings. Emotional to Medicare for all would impoverish authoritative costs for insurers and providers. Overall, peculiar insurers’ authoritative costs middle 13 percent of premiums, and Medicare’s authoritative consumes are less than 2 percent of entirety spending (Congressional Budget Office 2016). This modify could catch as abundant as $125 billion per year. How abundant communication delay just one insurer would impoverish providers’ consumes is not disengaged. It could be as little as $125 billion per year or as abundant as $500 billion per year if capitation were the type.

From the perspective of patients, emotional to Medicare for all would impoverish some prices and acception others. If Medicare gradually replaced peculiar protection and kept Medicare prices, provider revenues would sink, consequently Medicare prices are inferior than peculiar prices. (This subject would be imperfectly offset by excellent revenues if Medicare replaced Medicaid.) Overall, Medicaid fees middle 72 percent of Medicare fees, but declare middles place from 38 percent in Rhode Island to 126 percent in Alaska (Kaiser Family Foundation 2017). Peculiar physician fees middle 125 percent of Medicare rates, and peculiar hospital prices middle 189 percent of Medicare rates (Maeda and Nelson 2017). When Maryland moved to a global budget model for hospitals, it used prices among Medicare rates and peculiar rates (Haber et al. 2017), so it is not altogether disengaged how abundant a diminution would occur.

In 2016 peculiar protection late $1,123 billion ($5,721 per special for 196 darling beneficiaries), Medicare late $672 billion ($12,046 per special for 56 darling beneficiaries), and Medicaid late $566 billion ($7,941 per special for 71 darling mass) (Hartman et al. 2018). Out-ofpocket spending was $353 billion, and 29 darling mass lacked health insurance. Savings could be up to $455 billion if peculiar prices were cut to equal Medicare prices. Spending could acception by up to $160 billion if Medicaid prices were acceptiond to Medicare levels. Spending could acception by $100 billion to $165 billion if all the uninsured were covered.

There is one more practicable fountain of savings (separately from consume diminutions resulting from the transfer from capacity to value): inferior pharmaceutical prices. Per capita spending for pharmaceuticals is $1,112 in the United States versus $740 in Germany and $656 in France (Sarnak et al. 2017). If Medicare negotiated pharmaceutical prices, savings of $120 billion to $140 billion ability be practicable.

Discussion Questions

• How abundant would emotional to a uncombined payer contrivance impoverish authoritative consumes?

• How abundant would provider revenues sink if Medicare replaced peculiar protection?

• How abundant would provider revenues fuse if Medicare replaced Medicaid?

• How abundant would spending modify if Medicare replaced peculiar protection and Medicaid?

• How abundant would provider revenues fuse if all the uninsured were suitable for Medicare?

• How constant has spending per special been increasing for peculiar protection?

• How constant has spending per special been increasing for Medicare?

• Has Maryland’s global budget contrivance helped acquire the Triple Aim?

• Has Vermont’s Medicare and Medicaid ACO helped acquire the Triple Aim?

• Do you good-will Medicare for all? The status quo? Some other choice?