As the election nears, voters are starting to focus on the pocketbook. Kaiser Health News interviewed Robert Blendon, a Harvard University professor of health policy, who suggests that the cost of medical care and prescription drugs are of greater concern than the sweeping changes the leading Democratic candidates are stumping. In fact, 58% of Democrats felt that the issues they are more concerned with, like surprise billing, are the issues should lead the debate.
And just in time for the Republicans, a new study by the Commonwealth Fund which projects that one single-payer approach will cost the U.S. an additional $2.8 trillion in 2020 and $34 trillion over 10 years. Under this proposal, every American would become insured including undocumented immigrants and include not only traditional medical care but also long-term care, dental and vision and out-of-pocket costs to consumers would be about $720 billion in 2020. A more modest version, which excludes illegal aliens, would reduce consumer costs by $209.5 billion and increase costs to taxpayers by $1.5 trillion in 2020 and $17.6 trillion over 10 years. But that leaves 10.8 million people in America with no coverage.
The study also looked at a more gradual plan which builds off ACA with a public option. This decreases out-of-pocket spending by $22.6 billion but increases taxpayer costs by $122.1 billion in 2020 and $1.5 trillion over 10 years.
However, a big assumption under this study is that providers would be paid based upon the current Medicare reimbursement rates. I actually laughed out loud at that one since it is commonly known that private-payer insurance significantly supplements underpayments by Medicare and Medicaid – so there would be a lot of protesting by healthcare professionals.
How much is a trillion dollars? A lot of money. The current U.S. government debt is over $22 trillion. So, Democratic voters are getting lukewarm about sweeping change, Republicans are against it. I expect that the leading candidates are going to shift their rhetoric to gradual change; something I have been advocating on this blog for years.