Exit polls from the 2018 blue wave suggest that Democrats won in large part because voters were worried after months of Republican attacks on our health care system. Now that Democrats have won control of the House, it’s time for them to demonstrate that they are prepared to be both leaders in undoing the damage done by Congressional Republicans and the Trump administration and in reforming our health care system to guarantee health care coverage for all.
Representative Pramila Jayapal (WA-07) has introduced the Medicare for All Act, which will not only ensure universal coverage—it will improve the quality of coverage, while allowing the US to better control the cost of care.
The United States spends more, per person, on health care than any other country in the world. Despite that, we have worse population health outcomes than many other high-income countries—and these outcomes vary greatly based on a person’s race, gender, income, and location.
The Medicare for All Act takes on both of these problems—the high cost of services and the high cost of administering our fragmented health care system—at their roots. Let’s take each of them separately.
Tackling the high cost of services. The cost of many services and pharmaceuticals is higher in the United States than in other high-income countries. This is due to a multitude of factors, many of which the Medicare for All Act would change in key ways:
It would set a budget to pay providers for the care they are expected to provide. That means providers will receive compensation from the government based on the amount they spent in previous years, which would help keep cost inflation low.
It would remove the issue of opaque pricing for medical services from the equation altogether by setting clear cost levels for procedures and other care. People with different types of insurance would no longer be charged different prices.
Finally, it would reverse the tide of explosive growth in the cost of pharmaceuticals by allowing Medicare to issue competitive licenses that would break patent monopolies for critical medications (like insulin) and allow generic production of those medications if a pharmaceutical company refuses to negotiate a reasonable price.
Bringing down high administrative costs. According to a 2014 study, administrative costs account for over 25% of all hospital costs in the US—a figure that is very high relative to other countries. The Medicare for All Act would reduce these costs and redirect them toward the provision of care by making some important changes:
It would shift us from a multi-payer system that has an overwhelming number of insurers, providers, and other variables to a single-payer system that would only have one payer—the federal government. By one estimate, this change alone could save our country $350 billion every year.
And, by creating greater certainty for providers, like doctors and hospitals, about the revenue they will have each year and by lowering their incentive to maximize profits, the Medicare for All Act would result in providers spending less on things like overhead and marketing.
There are several health care proposals from Democrats that would seek to build on the Affordable Care Act, expand Medicare or Medicaid, or some combination of those things.
Rep. Jayapal’s Medicare for All Act stands out because it provides comprehensive coverage with no premiums, co-pays, or deductibles. This bill would guarantee that every person living in the United States has access to health care services