Now would be a good time for Republicans to learn a lesson Democrats have yet to learn: Managed care doesn’t cut costs.
We have three basic alternatives in how we finance health care: (1) continuation of the ACA with changes as needed; (2) repeal of the ACA and replacement by a GOP “plan”; and (3) enactment of a single-payer Medicare for All system of national health insurance (NHI). But you would never know that from the debate, which lacks details of the first two options and remains silent on the third.
I am once again worried that the lay public sees this endorsement and assumes that the AMA represents the majority of American physicians, including me. It does not.
Gap policies call into question whether or not they are worth it. They are just another way to evade the ACA’s requirements and another grab for profits in a failing health insurance industry.
The majority of Americans believe that everyone should have the health care that they need when they need it, and that we need a financing system that will pay for it. Others believe that they should take care of their own health care needs and not be required to pay into a risk pool that covers the health care of others. So should the health insurance system provide comprehensive coverage for all, or should it allow individuals to purchase coverage for only those benefits they perceive they might need?
In early 2015, I posted two comments here stating it will be impossible for anyone to explain the results of CMS’s “patient-centered medical home” (PCMH) experiments.
I am not a doctor. Nor was I trained in establishment health policy ideology by a graduate school of economics or health policy. I state that I am not a doctor not because I hold the condescending view of doctors held by CMS and those who enacted MACRA, but because I want to make it clear I cannot be accused of having the bias that CMS and other MACRA proponents allege that doctors have.
No poll has ever posed these questions: “Do you support or oppose a health insurance system in which everyone would be covered by a program like Medicare? Would your opinion change if you knew such a system would: Lower total spending on health care; restore patient choice of doctor; give doctors more control over medical decision-making?”
About half of Americans would prefer a single government health plan for everyone, according to this poll. However, when offered several choices, more would prefer to build on the current system (36%) than would prefer to establish a single government plan (24%). Also, followup questions show that the opinions of a single government plan are quite malleable, depending whether the query has a positive or negative slant.
Slavitt has put himself in a box. He has admitted that Obama’s and Congress’s decision to force doctors to use the clumsy electronic health records (EHRs) sold by the American computer industry was bad policy, but he has no idea how to fix that problem. All he can do is talk like Donald Trump – he’ll come up with “something better.”
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