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Friday, August 2, 2013

PNHP — ‘Medicare for All’ Would Cover Everyone, Save Billions in First Year: New Study

Physicians for a National Health Program

FOR IMMEDIATE RELEASE


Economist says Canadian-style, single-payer health plan would reap huge savings from reduced paperwork and from negotiated drug prices, enough to pay for quality coverage for all – at less cost to families and businesses

WASHINGTON - July 31 - Upgrading the nation’s Medicare program and expanding it to cover people of all ages would yield more than a half-trillion dollars in efficiency savings in its first year of operation, enough to pay for high-quality, comprehensive health benefits for all residents of the United States at a lower cost to most individuals, families and businesses.

That’s the chief finding of a new fiscal study by Gerald Friedman, a professor of economics at the University of Massachusetts, Amherst. There would even be money left over to help pay down the national debt, he said.

Friedman says his analysis shows that a nonprofit single-payer system based on the principles of the Expanded and Improved Medicare for All Act, H.R. 676, introduced by Rep. John Conyers Jr., D-Mich., and co-sponsored by 45 other lawmakers, would save an estimated $592 billion in 2014. That would be more than enough to cover all 44 million people the government estimates will be uninsured in that year and to upgrade benefits for everyone else.

“No other plan can achieve this magnitude of savings on health care,” Friedman said.

His findings were released this morning at a congressional briefing in the Cannon House Office Building hosted by Public Citizen and Physicians for a National Health Program, to be followed by a 1 p.m. news conference with Rep. Conyers. Sen. Bernie Sanders, I-Vt., and others in observance of Medicare’s 48th anniversary at the House Triangle near the Capitol steps. A copy of Friedman’s full report, with tables and charts, is available here.

Friedman said the savings would come from slashing the administrative waste associated with today’s private health insurance industry ($476 billion) and using the new, public system’s bargaining muscle to negotiate pharmaceutical drug prices down to European levels ($116 billion).

“These savings would be more than enough to fund $343 billion in improvements to our health system, including the achievement of truly universal coverage, improved benefits, and the elimination of premiums, co-payments and deductibles, which are major barriers to people seeking care,” he said.

Friedman said the savings would also fund $51 billion in transition costs such as retraining displaced workers from the insurance industry and phasing out investor-owned, for-profit delivery systems.
Over the next decade, the system’s savings from reduced health inflation (“bending the cost curve”), thanks to cost-control methods such as negotiated fees, lump-sum payments to hospitals, and capital planning, would amount to an estimated $1.8 trillion.

“Paradoxically, by expanding Medicare to everyone we’d end up saving billions of dollars annually,” he said. “We’d be safeguarding Medicare’s fiscal integrity while enhancing the nation’s health for the long term.”
Friedman said the plan would be funded by maintaining current federal revenues for health care and imposing new, modest tax increases on very high income earners. It would also be funded by a small increase in payroll taxes on employers, who would no longer pay health insurance premiums, and a new, very small tax on stock and bond transactions.
“Such a financing scheme would vastly simplify how the nation pays for care, restore free choice of physician, guarantee all necessary medical care, improve patient health and, because it would be financed by a program of progressive taxation, result in 95 percent of all U.S. households saving money,” Friedman said.

Friedman’s findings are consistent with other research showing large savings from a single-payer plan. Single-payer fiscal studies by other economists, such as Kenneth E. Thorpe (2005), have arrived at similar conclusions, as have studiesconducted by the Congressional Budget Office and the General Accountability Office in the early 1990s. Other studies have documented the administrative efficiency and other benefits of Canada’s single-payer system in comparison with the current U.S. system.

Friedman’s research was commissioned by Physicians for a National Health Program, a nonprofit research and educational organization of more than 18,000 doctors nationwide, which wanted to find out how much a single-payer system would cost today and how it could be financed.

“Funding H.R. 676:  The Expanded and Improved Medicare for All Act – How we can afford a national single-payer health plan in 2014,” by Gerald Friedman, Ph.D., Department of Economics, University of Massachusetts, Amherst.

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Physicians for a National Health Program is a single issue organization advocating a universal, comprehensive single-payer national health program. PNHP has more than 15,000 members and chapters across the United States.

10 comments:

  1. > Friedman said the plan would be funded by maintaining current federal revenues for health care and imposing new, modest tax increases on very high income earners. It would also be funded by a small increase in payroll taxes on employers, who would no longer pay health insurance premiums, and a new, very small tax on stock and bond transactions.

    When will we start penalizing policy makers and their academic supporters for false advertising? It is already the case that Obamacare, with it's own taxes, is not going to bend any curves. Now they want the private sector to spend just a tiny bit more? No thanks.

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  2. marris,

    I still have some work to do on so-called 'Obamacare', but for now looks like both it and this hypo presented by Moe and Larry, er.., I mean Sanders and Conyers here, will increase the 'leading' flow of NFA which imo is different than the non-govt doing this 'by itself' via the intra-non-govt sector flows of today's insurance schemas...

    It is different imo even though the sectoral balances work out the same ex-post...

    So a program could be "tax neutral" and imo, it would result in a better economy as the govt sector would INCREASE the leading flow of $NFA...

    Any policy that increases the "top line" govt number is more helpful than another policy that does not imo...

    for instance I like Warren's policy whereby he proposed to fund MSAs with $6K or so on Jan 1 and then let the non-govt 'go shopping' for healthcare... this provides a huge leading flow of NFA from govt to non-govt and imo IS NOT equivalent to govt, instead of providing positive balances of $NFA of Jan 1, perhaps providing a $6k "tax cut" ...

    Warren sometimes says 'a tax cut or a credit its the same thing depending on ones politics'.... I disagree with this.

    The math may work out the same ex post, but these are not equivalent policies by any stretch of the imagination...

    govt HAS TO 'spend first, and then... (results happen...)"

    So anything that increases the govt top line number imo is a much better policy than one that does not....

    I look at Obamacare, as far as it may increase the leading flows to the non-govt, as not only increasing access to healthcare within the population, but also being "much better for the economy" as it creates more leading $NFA flow from govt to non-govt in general...

    Obamacare may have more far reaching positive results for the economy outside of actual healthcare...

    rsp,



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  3. The US is alone in the type of healthcare system it has and it provides worse results for twice the price, doesn't insure everyone and the most prevalent cause of bankruptcy is medical, with most of those filing for bankruptcy having been insured. The US ranks low in quality of life wrt to measures of health like infant mortality in comparison with other developed nations.

    It's clear that the health care market is a special kind of market in that left to the private sector companies will cherry pick, deny coverage, impose restrictions, etc that lead to the problems that the US has. All other developed countries and many emerging ones have realized this and developed universal coverage either as a public good or a combination of public and private with private plans available for those desiring them and able to afford it.

    In addition, with other countries providing public health care, the US is at a competitive disadvantage by requiring firms to provide health insurance thereby increasing cost that are passed on in pricing.

    It seems to me that just about anything would be an improvement over the present situation. However, Obamacare is only a compromise and it too will fail wrt to other developed countries. The US will take a backseat wrt the rest of the developed world until it gets the message that the most efficient and effective system is single payer.

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  4. govt HAS TO 'spend first, and then... (results happen...)"

    So anything that increases the govt top line number imo is a much better policy than one that does not....


    Right. That's why a Medicare for all approach would be best economically. The only contraint is real resources-inflation, not funding. Inflation is controlled by tax policy under functional finance. Taxation might (or might not) need to be more to control inflation, but never for funding. For example, if govt expenditure is shifted from military to civilian, there would be no net increase in govt expenditure.

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  5. Do it! All the fascism we suffer under, especially the government-backed credit cartel, justifies quite a bit of socialism as mere justice.

    Of course, a money system that did not allow systemic theft in the first place would be nice.

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  6. This was the single payer option that Obama decided not to pursue. Instead, he gave a trillion dollar gift to the health insurance industry and ceded our entire national health care policy over to them. Thanks, Obama!

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  7. Mike,

    I was thinking it may backfire on them if the providers start to form their own networks in the states that are doing the exchanges and cut out the Insurance Industry middlemen...

    Basically have the Drs. and the Hospitals, non-profit systems organize and submit offers directly to the exchanges... (the Drs. just want to get paid after all...)

    Then what has happened here in Md as I understand it, is that the state is still proceeding with establishing the exchange even though recently Obama delayed the business requirement for another year...

    So what we could have here in Maryland is the non-profit provider networks submit offers to the exchanges that are BELOW what corporate HR depts are typically getting from the Insurers and then the HR dept are going to look at the offers providers are making to the exchange and figure out that they are getting screwed by the Insurers and the Insurers may shit their pants...

    Then the corporate HR people may get behind this as they will figure they can "save money" by just giving their employees money to go to the exchange... govt is supposed to subsidize lower income folks to in effect pay the premiums for them via CREDITS (this will increase leading $NFA flows greatly and IS VERY BULLISH for next year imo....)

    I guess we'll see but there could be some real fireworks if the offers to the exchanges are at or below what corporate HR depts are typically paying... those guys will be really pissed at the insurers if the exchanges get offers below what which the HR depts are typically paying now...

    rsp,

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  8. Mike,

    You know Obama could never get single payer. What's ge supposed to do? Be a purist and get zero progress?

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  9. I think that Obama probably got about as good a deal as he could, given all the competing interests. I said that the individual mandate was going to be a political hot potato, as did Howard Dean, who explained that it really wasn't necessary if Obama had followed the Vermont plan instead of the Massachusetts Romney plan. Obama likely thought he could get some GOP'ers on board by proposing what was basically a GOP plan initially. But this was before it was abundant clear that the GOP was determined to oppose everything Obama proposed "in order to break him," as Jim DeMint announced.

    Obama did say if that is we were starting from a clean slate, he would propose single payer, but that was not the case. Unfortunately, some deal had to be crafted and Obama did manage to squeak it through. That was a huge accomplishment and regardless of anything else ensures his legacy.

    Obama has made a lot of mistakes for a variety of reasons but I think that Obamacare will turn out to be have been one of his positive contributions in getting the ball down the field. If it had gone down, health care reform might have been set back indefinitely. Now the ball is still very much in play and we can be realistically be talking about single-payer.

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  10. To follow up on that, once we get to the principle of universal coverage and patients' rights, then private insurance becomes unprofitable and the opposition to it ceases when cherry-picking is ruled out. Private insurance only works if there is cherry-picking.

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