I support physician leadership, even when considering a one-party payor system. The broadest division among one-party payor system advocates is how the delivery of care is organized.
The Democrats have revealed their “Medicare for All” proposal. According to the Wall Street Journal. Here are the salient features. Under the Medicare for All Act of 2019, the federal government would pay for the following:
- Health coverage for all Americans to include items such as premiums, copays and deductibles (see the 2019 Realities for the Basics of Healthcare below)
- Expansion of Medicare to younger Americans essentially replacing both Medicaid (low income/disabled) and Employer paid (workers) health care coverage
- The current for-profit healthcare insurance model would be reduced to supplying supplemental coverage only (this will not go unnoticed by the FORTH PARTY decision makers whose job it is to maintain profit or the current THIRD-PARTY PAYORS)
- Benefits seem to be along the line of current ACA coverage and also include prescription drug coverage, long-term care, and full mental health coverage (including addiction)
- The VA and Indian health Service would continue but there was no discussion of the Tricare Program.
I have always supported the private delivery of healthcare, augmenting whatever system is in place. Under this proposal, it seems that hospital and other FIRST PARTY providers of healthcare appear to be ticketed for lower reimbursement.
No one system escapes criticism. It appears that there is good, bad, and ugly to be found in any system you choose. For sure there would be winners and losers.  Health plans which are the major element in our currently dysfunctional for-profit healthcare insurance model might go the way of the endangered species. The pharmaceutical industry will definitely be reigned in. Providers have mixed opinions, and in my mind, they should play a key role moving forward. I will visit that issue a little later in this discussion.
The payment plan? I will discuss dollars and sense in the next blog.
Please keep an eye out for my soon to be published book: Earthquake: How America’s Ever-changing Healthcare System Victimizes Americans
- Armour, Stephanie and Kristina Peterson, “House Democrats Reveal Plan for Medicare for All,” Wall Street Journal Politics/Health Policy, 26 Feb. 2019, wsj.com/articles/house-democrats-reveal-plan-for-medicare-for-all-11551219200
- Thorlby, Ruth and Sandeepa Arora, “The English Health Care System,” The Commonwealth Fund, International health Care Systems Profiles, international.commonwealthfund.org/countries/england/