Yesterday, as reported by Dr. Adam Gaffney, President of the Physicians for a National Health Program (PNHP), Rep. Pramila Jayapal (D-Wash.) and more than 100 co-sponsors in the House of Representatives, introduced the Medicare for All Act of 2019.
In keeping with earlier posts on the subject, and to further convince not only the skeptics, but the opponents of Medicare for All, here is what is in the act, according to Dr. Gaffney’s letter:
What’s in the Medicare for All Act?
- Covers all medically necessary care, including hospitalization and doctor visits; dental, vision, and hearing care; mental health services; reproductive care, including abortion; long-term care services and supports; ambulatory services; and prescription drugs.
- Covers all U.S. residents. Coverage is portable and lifelong.
- Provides free choice of doctor or hospital.
- Eliminates all patient cost-sharing such as co-pays, premiums, and deductibles.
Budgeting and Efficiency
- Pays institutions such as hospitals and nursing homes via lump sum global operating budgets to provide covered items and services.
- Funds capital expenditures such as expansions and renovations with a separate budget.
- Pays individual providers on a fee-for-service basis that does not include “value-based” payment adjustments. Providers cannot use fees for profit, marketing, or bonuses.
- Establishes a national drug formulary that promotes the use of generics. HHS will negotiate prices for drugs, supplies, and equipment on an annual basis.
- Allows the override of drug patents when drug firms demand extortionate prices (a key recommendation from PNHP’s 2018 Pharma Proposal).
- Provides regional funding for rural and urban areas that are medically underserved.
- Preserves the benefits provided by the Dept. of Veteran Affairs and the Indian Health Service.
- Overrides the Hyde Amendment that bans federal funding of abortion.
Transition to Medicare for All
- Implements Medicare for All over a two-year transition period.
- In the first year, current Medicare enrollees can utilize expanded benefits such as dental and vision care. After year one, the plan automatically enrolls everyone ages 0-18 and 55 and older, and also offers a Medicare Transition buy-in plan through the Federal and State exchanges during this time.
- Allocates one percent of budget for the first five years to assistance for workers displaced by the elimination of private health insurance.
There are other similar legislation already introduced, especially the one introduced by Sen. Bernie Sanders, as well as several faux Medicare for All plans that are really Medicare for Some.
Sen. Sanders’ bill calls for a four-year transition period, so the difference is not that important. What is important is that both bills will transform healthcare as we know it and finally get this nation to do what other nations already are doing.
As reported today by Dr. Don McCanne, the legislation was written with the help of a broad swath of lobbyists and special interest groups, if perhaps not the kind associated with typical health policy legislation on Capitol Hill.
Among these groups, as written in The Intercept yesterday by Ryan Grim (not making that up, folks), are the following: nurses, doctors, disability rights activists, and advocates for the elderly, as well as public interest organizations such as Public Citizen and the Center for Popular Democracy.
According to Mr. Grim (don’t laugh, that’s really his name), along with Consortium for Citizens with Disabilities, the main groups involved in drafting the legislation were National Nurses United, a major nurses union that has long been on the forefront of the fight for single payer; Physicians for a National Health Program; the Center for Popular Democracy, which organizes poor and marginalized communities; Public Citizen; and Social Security Works, which represents more than a million progressive seniors who support expanding the Medicare coverage they have to the rest of the population.
Mr. Grim called these groups “special interests” and said that the insurance and pharmaceutical industries had no part in the drafting of this legislation, to which Dr. McCanne gave an affirmative comment, because they are “when that interest is for the all of the people and their health, but we need to keep out the “usual suspects.”
It is sad that some choose to call those organizations who fight for people as “special interests”, yet, have no problem when those interests are insurance companies, pharmaceutical companies, large hospital systems, Wall Street, investors, and shareholders in the medical-industrial complex.
Eventually, we will get there. Unfortunately, many of us may not live to see it, or be able to take advantage of it for only a short time before the opposition party repeals it, or we pass on.