Category Archives: 2020 Election Issues

Can Washington deliver on drug costs amid impeachment probe?

Posted on by • Posted in 2020 Election Issues, Health Insurance Coverage Adequacy, Health Insurance Industry, Health Policy, High Deductible Health Plans, High Drug Prices, High Premiums, High Prices, Medicare, Out of Pocket Expenses • Leave a comment

https://apnews.com/1c5c5dc43950421a9ab4ff7edb9fe678?omnicid=CFC1688174&mid=henrykotula@yahoo.com

Major legislation to reduce prescription drug costs for millions of people may get sidelined now that House Democrats have begun an impeachment inquiry of President Donald Trump. Proposals had been moving in Congress, but there are more ways for the process to break down than to succeed. Still, nobody says they’re giving up.

Some questions and answers about the legislation and its uncertain prospects:

 

Q: Why, now, is there a big push to lower drug prices?

A: Some would say it’s overdue. Drug prices emerged as the public’s top health care concern near the end of the Obama administration as people with health insurance got increasingly worried about their costs.

In the 2016 campaign, Trump and Democrat Hillary Clinton called for authorizing Medicare to negotiate prices. But after Trump won the White House, his focus shifted to the failed Republican drive to repeal the Affordable Care Act. A year went by before the administration reengaged on prescription drugs .

Now, facing the 2020 election, Trump and lawmakers of both parties in Congress have little to show for all their rhetoric about high drug prices. For there to be a deal , enough Democrats and Republicans have to decide they’re better off delivering results instead of election-year talking points.

 

Q: What are the major plans on the table?

A: On the political left is House Speaker Nancy Pelosi’s plan authorizing Medicare to negotiate prices for the costliest drugs. In the middle is bipartisan legislation from Sens. Chuck Grassley, R-Iowa, and Ron Wyden, D-Ore., to restrain drug price increases. The wild card is Trump. He doesn’t share the traditional Republican aversion to government as price negotiator and keeps complaining that it’s unfair for Americans to pay more than patients in other countries.

There’s significant overlap among the major approaches.

Trump, the Senate bill, and Pelosi would all limit what Medicare enrollees pay annually in prescription copays. That would be a major change benefiting more than 1 million seniors with high costs.

Pelosi and the Senate bill would require drugmakers to pay rebates if they raise their prices to Medicare beyond the inflation rate. Long-available medicines like insulin have seen steep price hikes.

Pelosi and the administration would use lower international prices to determine what Medicare pays for at least some drugs. Pelosi is echoing Trump’s complaint that prices are unfair for Americans.

“If they wanted to do a deal, it’s sitting right there in front of them,” said John Rother, president of the National Coalition on Health Care, an umbrella group representing a cross-section of organizations.

 

Q: How would any of these plans reduce what I pay for prescription drugs?

A: Under Pelosi’s bill, private purchasers such as health insurers and employer-sponsored plans would be able to get the same price that Medicare negotiates. Medicare would focus on the costliest medications for individual patients and the health care system as whole.

People on Medicare could be the biggest winners. There’s consensus that seniors should get an annual limit on out-of-pocket costs for medications — $2,000 in the Pelosi bill or $3,100 in the Senate bill. Older people are the main consumers of prescription medicines.

 

Q: What would “Medicare for All” do about drug prices?

A: Under Medicare for All, the government would negotiate prices for prescription drugs.

Whether or not they support Medicare for All, Democratic presidential candidates are calling for Medicare to negotiate prices.

 

Q: Why are drug prices so much higher in the U.S. than in other countries?

A: It’s not the case for all drugs. U.S. generics are affordable for the most part.

The biggest concern is over cutting-edge brand-name drugs that can effectively manage life-changing diseases, or even cure them. Drugs with a $100,000 cost are not unusual any more. In other countries, governments take a leading role in setting prices.

In the U.S., some government programs such as Medicaid and the veterans’ health system get special discounts. But insurers and pharmacy benefit managers negotiate on behalf of Medicare and private health plans. Federal law protects the makers of a new drug from generic competition, which gives the manufacturer a lot of leverage.

Pharmaceutical companies say high initial prices are justified to recoup the costs of research and development.

However, a major case study — the 2015 Senate investigation of costly breakthrough drugs for hepatitis C infection — found that drugmaker Gilead Sciences priced the medication to maximize profits, not to foster access.

 

Q: What’s the outlook for drug pricing legislation?

A: Impeachment could suck the air out of the room.

“It is extremely difficult to get things done in that type of environment, and certainly for a president who is largely incapable of compartmentalizing,” said longtime Democratic health care adviser Chris Jennings. “Having said that, the work of policymakers in power must include being responsive to here-and-now domestic problems.”

Trump has pointedly refrained from criticizing Pelosi’s bill even as other Republicans called it “socialist.”

Pelosi’s legislation had its first committee consideration last week, and the leading Democrat on that committee promoted it using Trump-like rhetoric that it’s unfair for Americans to pay more. The bill will get a floor vote, and it could gain political momentum if a pending budget analysis finds big savings.

Democrats would be hard-pressed to drop their demand for Medicare negotiations. But could Trump agree to a more limited form of negotiations than what’s now in Pelosi’s bill? Could he sell that to Senate Republicans?

“It boils down to the crude political calculus of whether in the end this will help my side,” said health economist Joe Antos of the business-oriented American Enterprise Institute. “Will Democrats be able to stomach Donald Trump taking credit for all of this? On the Trump side, it is going to be more of a legacy issue for him.”

 

 

 

 

Americans need more convincing on Medicare for All, poll says

Posted on by • Posted in 2020 Election Issues, ACA, Health Policy, Medicare, Medicare for All • Leave a comment

https://www.pbs.org/newshour/health/americans-need-more-convincing-on-medicare-for-all-poll-says?omnicid=CFC1688174&mid=henrykotula@yahoo.com

Americans need to know more before they can make up their minds about proposed overhauls to the nation’s health care system, according to a survey released Thursday.

When asked if they wanted to wipe out private health insurance for a so-called Medicare for All public insurance program, 40 percent of U.S. adults between the ages of 19 to 64 said they did not know enough to offer an opinion.

A few Democratic presidential candidates have put forward their proposed health care plans, including Medicare for All. Sen. Bernie Sanders, I-Vt. and Sen. Elizabeth Warren, D-Mass. have advocated for Medicare for All models that replace private insurance with a national health insurance plan. And Sen. Kamala Harris, D-Calif., released a health care proposal that covered 330 million Americans under one government health care plan. According to the candidates, these plans would make health care affordable for more Americans. It could help reduce the number of uninsured Americans, which currently amounted to 27.5 million people nationwide in 2018, according to the Census Bureau, marking a rise of 1.9 million people over the previous year.

According to a July 22 poll from the PBS NewsHour, NPR and Marist, 70 percent of U.S. adults said they supported Medicare for All proposals as long as they maintain an option to keep private health insurance. A system like this has been proposed by Pete Buttigieg. By comparison, when asked in a separate question, only 41 percent of survey respondents said they wanted to scrap private health insurance for a government-run plan.

In this latest poll from the Commonwealth Fund, another 32 percent of Americans said they opposed the idea, while 27 percent of Americans favored such a plan, according to the survey results published by the Commonwealth Fund, which researches health policy. The survey polled 4,914 U.S. adults ages 19 to 64 from March 19 to June 9.

“People are confused about what this might mean for them, and what it might mean for the health system and what it might mean in terms of trade-offs,” said Sara Collins, vice president of Health Care Coverage and Access at the Commonwealth Fund, during a call with reporters Wednesday.

Americans are largely satisfied with their health insurance, but lacked confidence that their health care coverage could protect them financially if they fell seriously ill and required medical care.

“These satisfaction rates reflect the fact that most people don’t use their insurance a ton,” said Sabrina Corlette, a research professor and co-founder of the Center on Health Insurance Reforms at Georgetown University. “It’s sporadic interactions.”

Eighty-five percent of working-age Americans said they were satisfied with their health insurance. That included private health insurance, Medicaid, and coverage purchased on the individual marketplace established under the Affordable Care Act. Another 14 percent said they were dissatisfied with their current health insurance.

In contrast, 61 percent of U.S. adults age 16 to 64 said they were confident that they would be able to afford the cost of care if they became seriously ill, while 38 percent of Americans said they were not confident.

These survey results come as Democratic presidential candidates promote their health care plans going into the 2020 election. Meanwhile, Republicans in Congress and the Trump administration have promised to replace the Affordable Care Act, known as Obamacare, with “something better,” although it is unclear what that would be. To date, they have eliminated some policies put into place under Obamacare, including dismantling the individual mandate.

Health care will be one of the most important issues among voters going into the next presidential election. Health care costs for Americans are the highest among industrialized nations. Meanwhile, life expectancy has dropped nationwide in recent years, in part due to the rise in drug overdose deaths, many of which are tied to the opioid crisis. Among developed nations the OECD ranked for infant mortality, the U.S. was among the bottom 11, after Russia.

This survey suggests that all the campaigns have their work cut out for them if they want to ramp up public awareness of proposals on the table to fix health care, Corlette said. She said the public needs more education and discussion about possible solutions aimed at problems in the U.S. health care system.

“It strikes me as a really good opportunity for people on both sides of the debate,” Corlette said. “There’s clearly a lot of people who have just not made up their mind.”

But she said the lack of confidence in how much protection health coverage affords people tugs at the reality that “the system doesn’t work really well for people who are very sick.”

New analysis from the Kaiser Family Foundation supports that notion. Annual family premiums for employer-based health insurance rose 5 percent to $20,576 on average, faster than wage growth, which increased by 3.4 percent, according to the study, published in Health Affairs. And since 2009, those premiums jumped 54 percent.

Health insurance costs and coverage only provide part of the picture of what troubles Americans, said Thomas Miller, a resident fellow with the conservative American Enterprise Institute.

Policymakers need to think about more than tinkering with “incremental expansions of coverage on the margins beyond where we already are,” Miller said. “It’s important to remember that people need most of all economic growth, job security and reasons to be optimistic about managing their lives.”

 

 

 

Is Gun Violence a Public Health Issue?

Posted on by • Posted in 2020 Election Issues, Centers for Disease Control & Prevention (CDC), Gun Violence, Health Policy, Public Good, Public Health, Public Safety • 1 Comment

https://mailchi.mp/burroughshealthcare/february-8-1687741?e=7d3f834d2f

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The United States population is 327 million and there are 393 million guns in this country. The issue of guns and gun control remains one of the nation’s most divisive.

As the Los Angeles Times explains in a recent editorial, “to truly address gun violence, we need to view it through a public health lens — one that reframes the issue as a preventable disease that can be cured with the help of all community members.”

The American Public Health Association (APHA) shared recently that the U.S. has the dubious distinction of “outpacing” any other country with a gun violence burden. Highly publicized statistics vary from source to source, but they do bear repeating, beginning with the fact that:

  • 82 percent of all firearm deaths in nearly two dozen populous, high-income countries—

including Australia, France, Italy, Spain and the United Kingdom — occur in the U.S.

  • 91 percent of children ages 0-14 killed by firearms in this group of nations were from the U.S.

The Gun Violence Archive stays up to date on this year’s sobering victim numbers, already standing at:

Total incidents:         36,390
Deaths:                       9,578
Injuries:                       19,102
Mass shooting:               268

Ways but No Will

Having dedicated himself to the science of gun violence, health policy professor David Hemenway, Ph.D., of the Harvard T. H. Chan School of Public Health says we’re all watching too much media where “guns are the solution to so many problems. The good guy with the gun is the big hero.”

In real life, guns are not solutions to problems. The myth is imposed early and continues to be perpetuated. Children are exposed to 90 percent of movies, 68 percent of video games and 60 percent of shows that include violence, Common Sense Media said six years ago. Current numbers are surely much higher.

Dr. Hemenway also balks at the old “we’ll be able to protect ourselves when that intruder comes into our space” argument. It takes lots of training, repetition and practicing, over and over, to do the right thing right, he says, and most don’t have time or resources to get that — right.

Although the United States is an international mega-power, it as much to learn, Dr. Hemenway says, noting that “every other country has shown us the way to vastly reduce our problems.” That means if other countries can get control of gun reasonability — as New Zealand did in a hurry following its first mass shooting — we can, too.

Repeated surveys of Americans say they favor universal background checks. As recent history has shown, whether or not that will come to fruition still remains unanswered.

Prevent Rather Than Repair

The idea of “community” as it relates to “public” means motivating responsible gun owners, says Dr. Hemenway, citing his colleague Cathy Barber, M.P.A., at T.H. Chan’s Means Matter campaign. She collaborates on a number of pertinent issues with gun owners, advocates and trainers, as well as gun shop owners.

Dr. Hemenway’s must-do list includes licensing of gun owners and all that entails, including strong background checks, and only allowing firearm sales to a licensed owner. He also recommends a federal agency to oversee the massive gun issue — a heretofore novel and yet seemingly sound idea.

The medical community has taken its stand on the public health effects of gun violence after frequently describing for the rest of us in riveting detail what it’s like to treat victims of shootings. Formally, members have established the nonprofit American Foundation for Firearm Injury Reduction in medicine (AFFIRM), with more than 40,000 healthcare colleagues.

The group seeks to inform medical protocols for their peers on the frontlines of gun violence, and to engage other first responders and stakeholders, as well as to educate and inform the public. They say they’d rather prevent than repair, and they worry about a culture of indifference and acceptance — of normalization that leads to divisiveness in this nation.

Meeting of the Minds Needed

It’s tough to solve a problem if stakeholders can’t come together to share ideas and solutions, the kind of proactive collaboration that provided results and conclusions around seat belts and smoking.

So why doesn’t the federal government jump headlong into gun violence research, specifically the Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH)? The Dickey Amendment came to fruition in the early 1990s when gun violence did become a public health issue.

The National Rifle Association (NRA) said then that the CDC was biased against guns, and attracted Congressional support that basically eliminated any funding “to advocate or promote gun control”: That meant no studies related to firearms, and in 2011, the amendment reached to the NIH. After the Sandy Hook school shooting, President Obama told the CDC that the Dickey Amendment shouldn’t completely ignore funding for gun violence research, but Congress stopped it nonetheless. Currently, the amendment isn’t really in effect but there’s still no funding.

To that end, early this year, Rep. Carolyn Maloney (D-NY) introduced H.R. 674 and Sen. Edward Markey (D-MA) introduced S.184, the Gun Violence Prevention Research Act of 2019, which was referred to the Subcommittee on Health, where it’s been languishing. It would provide CDC funding to study gun violence for the next five fiscal years.

Random Attacks Are Few
 
If the United States is unable to tackle more research into gun violence, that hasn’t stopped smaller, independent studies, like one from the state of Utah. It published a report in 2018 with the T.H. Chan School, looking at suicide and firearm injury. It was supported by both parties, and by gun rights champions.

The results showed that 87 percent of those who died by suicide could have passed a background check and that Utahns with mental health or drinking issues weren’t properly storing or locking up guns. The most surprising fact: Those random attacks that people are warned about as reasons to carry guns occurred only three or four times a year.

So with all we know and all that’s yet to be known if more scientific research is conducted, the following have been suggested as remedies to the gun violence epidemic. The solutions run the gamut from more basic to creative:

  • Universal background checks
  • An assault weapons ban, along with a ban on high-capacity magazines
  • Mandatory license needed to buy a gun
  • Mandatory gun registration
  • Mandatory training for owners
  • Waiting periods for firearm purchase
  • More taxes on gun manufacturers
  • Safe and secure gun storage
  • No sales to anyone on a terrorist watch list
  • No sales to anyone convicted of a felony
  • Red-flag law: Families can ask a judge to temporarily prohibit an individual from possessing a firearm if those parties believe that individual might commit violence.

Also mentioned as possible solutions:

  • The federal government could buy the domestic handgun manufacturing industry.
  • It could ban the import of all handguns.
  • It could offer cash buybacks for all handguns in circulation.
  • A person buying a gun would have to enlist for military reserve service.

Scientific American sees it this way, opining that we just don’t know enough about gun violence perpetrators and we should.

Did they get firearms legally, or how did they get them?

Are our current laws being used to disarm dangerous people?

What do we do about the proliferation of underground gun markets?

How can we better evaluate violence prevention policies and programs, as in “Do they work?”
 
As the editorial board notes, research doesn’t infringe on Second Amendment rights, but it does support those other, unalienable rights we are all due, thanks to the Declaration of Independence. Don’t forget “Life, Liberty and the pursuit of Happiness.”

Paying for healthcare shouldn’t bankrupt families

Posted on by • Posted in 2020 Election Issues, ACA, Bad Debt Expense, Bankruptcy, Essential Health Benefits, Health Insurance Coverage Adequacy, Health Policy, High Deductible Health Plans, High Premiums, High Prices, Out of Pocket Expenses, Out-of-Network, Preexisting Conditions, Short Term Health Insurance, Surprise Bills • Leave a comment

https://www.modernhealthcare.com/opinion-editorial/paying-healthcare-shouldnt-bankrupt-families?utm_source=modern-healthcare-daily-finance&utm_medium=email&utm_campaign=20190923&utm_content=article4-readmore

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Healthcare costs in the U.S. are too high. Americans struggle to afford basic needs like prescription drugs and too often face crushing surprise bills after undergoing necessary medical procedures. Seniors in particular feel the weight of health expenses when they discover that the Medicare benefits they earned don’t always provide sufficient coverage.

While the Affordable Care Act instituted protections for Americans with pre-existing conditions, guaranteed essential health benefits and made some progress in lowering patients’ costs, those advancements are under attack in the courts and through regulatory actions. I chair the House Ways and Means Committee, which has jurisdiction over a great deal of our nation’s healthcare system, including Medicare. Under Democratic leadership, we are fighting to bring down healthcare costs and preserve critical existing health protections.

Our committee hit the ground running this year. The first hearing I convened as chairman focused on protecting Americans with pre-existing conditions. Nearly 130 million Americans have a pre-existing condition—anything from asthma to cancer to diabetes. Thanks to the ACA, insurance companies can no longer refuse to cover these individuals. The hearing shed light on the importance of this safeguard and the ways it provides Americans with greater peace of mind and financial security.

We also highlighted the immense pain families will endure if 18 Republican state attorneys general succeed in their case to repeal the law.

House Democrats, along with Democratic state attorneys general, jumped into this court battle and continue to defend the millions of Americans with health conditions from discrimination and financial ruin.

We also took concrete steps to increase transparency and lower drug prices. Ways and Means advanced legislation that sheds light across the healthcare supply chain—from pharmaceutical manufacturers to pharmacy benefit managers—to help reduce costs for families. More can be done. In the coming months, the committee will consider legislation to improve the Medicare Part D program, establishing an out-of-pocket cap on expenses for beneficiaries. This would lower costs for seniors and save taxpayers money.

Part D reform is just one way to improve Medicare for beneficiaries. Many seniors aren’t aware that Medicare does not cover routine vision, hearing or dental exams. I will work to change that. Helping seniors access the glasses, hearing aids or dental care they need will save them money on the front end. This coverage will also prevent the trauma and expense of falls or other related health problems that could arise down the road as a result of inadequate services.

Some of the most jarring and devastating medical costs Americans encounter are surprise medical bills. Ways and Means plans to tackle this problem too. We are crafting legislation now that will help patients avoid the huge expenses that follow inadvertently being treated by out-of-network providers.

Healthcare is a necessity and it’s a human right. Paying for it shouldn’t bankrupt families. We can lower patient costs without stifling medical innovation or throwing hospitals into turmoil. It’s possible to achieve commonsense solutions that strengthen our nation’s healthcare system while reducing the burden on consumers.

 

Insurers to deliver whopping $1.3B in ACA consumer rebates

Posted on by • Posted in 2020 Election Issues, ACA, Health Insurance Industry, Health Policy, High Premiums, Market Uncertainty, Medical Loss Ratio (MLR), Uncertainty • Leave a comment

https://www.healthcaredive.com/news/insurers-to-deliver-whopping-13b-in-aca-consumer-rebates/562689/

Dive Brief:

  • Health insurers are expected to issue at least $1.3 billion worth of rebates to customers in the coming weeks, hitting a new record, according to an analysis from the Kaiser Family Foundation.
  • The record amount reflect just how profitable payers were over the past few years, largely fueled by insurers in the individual market, according to KFF. Companies in the individual market are expected to return about $743 million to customers, more than that of insurers in the small and large markets combined.
  • The average rebate per customer in the individual market is about $270. There are about 2.7 million customers in the individual market.

Dive Insight:

The Affordable Care Act sets limits on insurer profits, and in an effort to protect consumers, the law requires plans spend a majority of premium dollars on actual care, or claims for their patients.

Each year, if insurers do not meet that threshold, also known as the medical loss ratio, they issue rebates to customers. The rebates in 2019 take into account performance for the trailing three years.

“Insurers in 2018 were highly profitable and arguably overpriced, which is why rebates are so large despite being averaged across less favorable years (2016 and 2017),” KFF said.

Insurers in the individual market are fueling this whopping rebate return, according to KFF.

Even though exchange insurers struggled in 2016, previous data show that profit margins spiked in the first quarter of 2018. Many attribute the spike to insurers drastically raising premiums amid the uncertainty around policy plans from the Trump administration. Experts have said insurers raised prices and overcorrected in preparing for the potentially turbulent year.

Lingering overhead at the time was the threat of ACA repeal and the loss of cost sharing subsidy payments.

St. Louis-based Centene is expected to dish out the most in rebates, totaling nearly $217 million, followed by Virginia-based Optima Health, owned by Sentara Healthcare, which is set to return nearly $99 million.

 

 

Rate of uninsured people increases for first time since ACA rolled out

Posted on by • Posted in 2020 Election Issues, ACA, Health Insurance Coverage Adequacy, Health Insurance Industry, Health Plan, Health Policy, High Deductible Health Plans, High Drug Prices, High Premiums, High Prices, Medicaid, Medicaid Expansion, Out of Pocket Expenses, Short Term Health Insurance, Skinny Health Plans, Underinsured, Uninsured • Leave a comment

https://www.axios.com/uninsured-rate-increases-first-time-since-obamacare-ec6dbd6d-fffc-446d-be4c-02bed0d3ea3e.html

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Roughly 27.5 million people, or 8.5% of the U.S. population, had no health insurance at some point in 2018, according to new figures from the Census Bureau.

Why it matters: Last year’s uninsured rate increased from 7.9% in 2017 — the first time the uninsured rate has gone up since the Affordable Care Act has been in effect.

Between the lines: The uninsured population does not include the “underinsured,” or people who have medical coverage but face prohibitively high deductibles and out-of-pocket costs.

  • The figure also does not include people who have short-term plans, association plans and religious-based sharing ministries — policies the Trump administration has promoted, but that have holes in coverage that could leave people on the hook for high costs.

The intrigue: The type of coverage that witnessed the largest decline in 2018 was Medicaid, which fell 0.7 percentage points.

  • 4 states where the uninsured rate had a statistically significant increase were Alabama, Idaho, Tennessee and Texas, all of which have not fully expanded Medicaid under the ACA.

The bottom line: The uninsured rate is still markedly lower before the ACA became law, but it’s an odd paradox to see more people lose health coverage even though the economy created more jobs.

 

 

Health care dominates 2019 ad spending

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https://www.axios.com/health-care-dominates-2019-ad-spending-417f0487-b46b-432d-9849-41cbdb7d83c1.html

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More than half of all issue advertising this year has been on health care, and that spending will only increase as the 2020 campaign gets closer.

Between the lines: Most of the top health care spenders are focused on issues like surprise medical bills and drug prices — many of which would cut into the health care industry’s profits.

Where it stands: The biggest spender by far is a dark-money group called Doctor Patient Unity.

  • It has shelled out more than $26 million on ads opposing Congress’ plan to address surprise medical bills. Doctors and hospitals staunchly oppose the leading proposal because it would cost them money.
  • AARP and the Partnership for Safe Medicines, an industry group, are on opposite sides of the intense battle over drug prices, which will heat up further this fall.

Health care was a winning issue for Democrats in 2018, but they’re not spending much on health care messaging right now.

  • One of the top 5 health spenders is One Nation, which is running anti-Medicare for All ads.
  • There aren’t any pro-Medicare for All groups in the top 5, nor are there any groups running ads explicitly on the benefits of the ACA.

Yes, but: Democrats will almost certainly spend more time and money on health care deeper into the 2020 cycle.

  • Health care was still a huge issue in yesterday’s special election for North Carolina’s 9th district — likely a sign of things to come.
  • “Fast forward to fall of 2020, and you will once again see…campaigns litigated on pre-existing conditions, health care costs and drug costs, because Republicans have only made the problem worse for themselves since 2018,” Democratic strategist Jesse Ferguson said.

 

 

Medicare-for-All Opponents Push Ads Around Democratic Debate

Posted on by • Posted in 2020 Election Issues, Health Policy, Medicare, Medicare for All, Politics, Single Payer Health System, Single Payer Healthcare System, Universal Healthcare System • Leave a comment

https://www.wsj.com/livecoverage/campaign-wire-election-2020/card/1568297160?utm_source=The+Fiscal+Times&utm_campaign=b9ecdac8d9-EMAIL_CAMPAIGN_2019_09_12_08_14&utm_medium=email&utm_term=0_714147a9cf-b9ecdac8d9-390702969

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An industry group opposed to Medicare for All will launch a slate of new television and digital ads around the Democratic presidential debate on Thursday as part of a seven-figure campaign aimed at eroding support for a federal health-care system.

Ads will also run on Facebook, Twitter, and Snapchat, according to the Partnership for America’s Health Care Future, whose membership includes drug makers, insurers, and others in the health-care industry. The organization said it will take over YouTube’s homepage following the debate.

The ad blitz show industry groups view Medicare for All as a serious threat in a 2020 election. Sens. Bernie Sanders of Vermont and Elizabeth Warren of Massachusetts, who are among the front-runners for the Democratic presidential nomination, back replacing the U.S. health system with a government program that would cover everyone.

The ads say Medicare for All, as well as options that let people buy into a program like Medicare, would lead to higher taxes, worse health care, and amount to government control.

Backers of Medicare for All say the proposal would lower overall U.S. health-care spending, expand coverage nationwide, and free people from costly premiums and deductibles. They say the current system lets insurers and others in the industry make unseemly profits.

The campaign, which is also opposed to buy-in options such as the proposal backed by former Vice President Joe Biden, also launched ads around the previous Democratic presidential debates.

 

Biden, Sanders, Warren clash over Medicare for All in Houston

Posted on by • Posted in 2020 Election Issues, ACA, Health Insurance Coverage Adequacy, Health Policy, High Deductible Health Plans, High Drug Prices, High Premiums, High Prices, Medicare, Medicare for All, Out of Pocket Expenses, Politics, Preexisting Conditions, Uncertainty, Underinsured, Uninsured, Universal Healthcare System, Value-Based Healthcare, Vote • Leave a comment

Biden, Sanders, Warren clash over Medicare for All in Houston

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The battle over health care that has dominated the Democratic race for the White House took center stage in Houston, where for the first time the top three candidates tangled over whether the nation is ready for sweeping reforms.

Former Vice President Joe Biden went back and forth at the opening of Thursday’s debate with the two progressives who are his leading challengers atop the polls, Sens. Bernie Sanders (I-Vt.) and Elizabeth Warren (D-Mass.).

Arguing that the “Medicare for All” proposal championed by Sanders would cost people their insurance, Biden called out the Vermont senator as a socialist and said his proposals would be too costly.

At one point in the debate, Biden said of Warren and Sanders that “nobody’s yet said how much it’s gonna cost for the taxpayer.”

He also pointed to the taxes that would have to increase for middle class people to pay for Medicare for All.

“There will be deductible in your paycheck,” Biden said, referencing the chunk that taxes would take out of people’s pay.

Sanders said most Americans were getting a raw deal in terms of their present health care costs compared with countries that have systems more similar to his Medicare for All approach.

“Let us be clear, Joe, in the United States of America we are spending twice as much per capita on health care as the Canadians or any other major country on earth,” Sanders said. 

“This is America,” Biden retorted. 

“Yeah, but Americans don’t want to pay twice as much as other countries and they guarantee health care to all people,” Sanders responded. 

Health care is a top issue in the race according to polls, and Democrats believe they can win the White House if the general election against President Trump is focused on the issue.

But it is also the issue that divides the Democratic candidates the most, with Biden and other centrists proposing more modest steps, such as reforms to ObamaCare.

The battle over health care is intertwined with the debate Democrats are having over which of their candidates is best positioned to defeat President Trump, with some in the party worried that Warren and Sanders are too liberal to win a general election. Others say their bold ideas are what is needed for the party to defeat Trump.

Biden argues Medicare for All means scrapping former President Obama’s signature achievement, the Affordable Care Act, instead of building on it.

While Sanders touted that everyone would have coverage under his plan and that it would be more generous, with no premiums or deductibles, Biden countered with the cost of the proposal, which estimates put at around $32 trillion over 10 years.

In the debate’s first hour, Biden was already hitting Sanders and Warren over the cost of the plan.

“The senator says she’s for Bernie,” Biden said of Warren’s support for Sanders’s Medicare for All plan. “Well I’m for Barack.”

Warren, pressed by host George Stephanopolous on whether middle class taxes would rise from Medicare for All, did not directly answer, pivoting to argue that overall costs for the middle class would go down once the abolition of premiums and deductibles is taken into account.

“What families have to deal with is cost, total cost,” Warren said, adding: “The richest individuals and the biggest corporations are going to pay more, and middle class families are going to pay less.”

Other candidates were also in the middle of the Medicare for All exchanges.

Sen. Kamala Harris (D-Calif.), who drew flak in the early months of the campaign for seeming to change her position on health care several times, touted the plan she eventually developed, to allow some private insurance to remain under Medicare for All by allowing private companies to administer some plans in a tightly regulated way.

“I want to give credit to Bernie. Take credit, Bernie,” Harris said, while adding, “I wanted to make the plan better, which I did.”

At another point in the debate, Biden dismissed the idea that employers would raise workers’ wages if employers no longer had to provide health insurance under a Medicare for All system. 

“My friend from Vermont thinks the employer’s going to give you back what you’ve negotiated as a union all these years … they’re going to give back that money to the employee?” Biden said.

“As a matter of fact they will,” Sanders interjected.

“Let me tell you something, for a Socialist you’ve got a lot more confidence in corporate America than I do,” Biden responded. 

While all of the Democrats advocate large additional government spending to expand health insurance coverage, the debates over whether private insurance should remain as an option has proven to be a particularly fierce source of debate.

Republicans have sensed an opening on that point as well, eagerly bashing Democrats for wanting to take away employer-sponsored coverage that millions of Americans have. Sanders and Warren counter that Medicare for All coverage would be better insurance, with no deductibles at all, so people would not miss it.

“I’ve actually never met anybody who likes their health insurance company,” Warren said, noting people like their doctors, which they would be able to keep. 

Sen. Amy Klobuchar (D-Minn.), who has staked out a more moderate ground, tore into Sanders, though, over his plan’s elimination of private insurance.

“While Bernie wrote the bill, I read the bill, and on page eight of the bill it says that we will no longer have private insurance as we know it,” Klobuchar said.

“I don’t think that’s a bold idea, I think it’s a bad idea,” she added. 

Amid the division, Harris tried to strike a unifying note.

“I think this discussion is giving the American people a headache,” she said. “What they want to know is that they’re going to have health care and cost will not be a barrier to getting it.”