Assessing Health Policies Flashcards
Bernie Sanders’ version of ‘Medicare for all’
Would expand Medicare eligibility to all Americans and change the program to cover more services and eliminate most deductibles and copays. Since this would cover basically everything and everyone, the private insurance market would largely disappear - and doing away with private insurance is largely part of the plan.
Single payer healthcare
General term for a government financed system in which everyone is insured through a government program funded by taxes.
Note that this does not necessarily mean that government is administrating itself, just paying (like the Canada model).
Socialized medicine
Socialized medicine is a single payer system in which the government also administrates health care, unlike the Canadian system.
The VA system is an example of socialized medicine.
‘Public option’ system
Effectively expanding access to Medicare without eliminating private insurance. This way everyone has a ‘public option’ for health insurance, but may also have private options.
Alternatively a new public system could be set up, leaving Medicaid in place as is.
Medicare for America bill
Bill in Congress right now which seeks to change our healthcare system. Proposes a federal public program that would replace current Medicare/Medicaid/individual market insurance plans, but would be opt-out. Would be free below 200% FPL with graduate premium increases.
Enrollment would begin in 2023 and be for lifetime, but individuals could still opt out for private insurance. Newborns automatically enrolled starting 2023.
No annual or lifetime limits, with step therapy and prior authorization made illegal in public plans.
Universal coverage
Effectively equivalent to a ‘right to healthcare.’ Whatever the details of the system, this just implies that everyone within the country has healthcare of some kind no matter what, even for those in poverty who cannot afford to contribute.
The key difference between Medicare for America and Medicare for all
In Medicare for America, people get to keep their employer-sponsored insurance plans.
Seema Verma’s predictions on the public option
Verma argues that the public option will inflate an already existing problem: physicians charging private insurance more because public insurance underpays them. When this happens, private insurance will have a harder and harder time staying afloat, and eventually it will no longer be viable, leaving us on the single payer system.
This comes with all the potential disadvantages of the single payer system, such as innovation stagnation and delays (requiring an act of Congress to change adopt new treatments and improve the standard of care).
