Rx

4. Prices skyrocket and the government raises taxes to compensate.

My 35-years in health care management and related fields say that you are wrong. In order for prices to skyrocket, you would need to have a measurable decrease in supply or similar increase in demand. I leave the 161-million people who have employer supplied health insurance alone. No change in supply or demand. Other insured people and those who self insure are left alone. People on Medicaid will have their coverage changed from a federal/state program to a federal program. That will decrease the cost of dual processing for a single patient. People who opt in to Medicaid and can pay, would be charged a premium to cover their costs. Those with less income would pay less, on a means tested basis. These people currently get their care either on Medicaid and pay nothing, or in ERs when they are critically ill, and usually pay nothing. Medicare currently gives hospitals grants to cover uninsured.

When all people are covered by some sort of plan, most of federal/state/local costs would be focused on the federal program. By funneling patients into primary care, costs actually come down. This was proven when the VA changed eligibility requirements for Vets without service connected disabilities. Vets could not get outpatient care, exclusively. However, if they got really ill, like in a diabetic coma, they could be admitted to a VA Hospital, where the costs of one admission were more than decades of ambulatory, maintenance care. By eliminating tens of thousands of unnecessary hospital admissions every year, VA increased the number of Vets treated with no increase in budget. Increased demand for low cost, low intensity care offset by decreased demand in high cost/high intensity care. The private sector example is not exactly the same, but suprisingly similar. We are paying for expensive care for critically ill people because we are unwilling to pay for primary care for all who do not currently have it available.

The biggest change to the system would be the paying for and control of prescribed drugs from a central formulary. A central formulary would be able to reduce the costs that drug companies incur by meeting the requirements of dozens of third parties. A surtax on Private Health Insurance,and taxes on supplements would fund most of this. We would avoid another Opioid crisis by better control. We would also decrease costs of "evergreening," and other schemes.

Any time the government attempts to regulate prices, those prices go up (from the suppliers), and the government pays more than an individual paid previously. Taxes go up.

And you confirm my statement in your last paragraph - a surtax on private health insurance, and taxes on supplements.

There will either be an excess supply (unlikely), or an excess demand (very likely).

The only people dumb enough to try this are the Democrats. They didn't learn the lesson with Obamacare - my premiums quadrupled, and it became more economical to pay the IRS penalty. An MRI exam that cost $100 before Obamacare, now bills at $10,000.....because when the government pays the bill - it's free money...and the health care providers figured that out quickly.

I just double checked, and an MRI in my hometown costs $823. They actually cost about $1,800 in 1985, when they were first available. If you ever got one for $100, it was a miracle akin to walking on water. It is difficult to have a sensible conversation, when you exaggerate so much. The GSA negotiates prices for government equipment, for the VA and gets it for less than the private sector pays because of the volume of the orders. That includes drugs. So, you are wrong. GSA could negotiate lower drug costs. But, since people will still get their prescriptions filled at their local pharmacy, they would be marked up by those outlets. Almost all patients will continue to get care from their current provider, with payment coming from their current insurer. I would presume that the Medicaid system would contract with private companies that provide services through private practice groups. That is how most Medicaid treatment is provided today, through the private sector. The only thing the public sector would do is collecy premiums and fees and pay provider groups.

The surtax on private health insurance would be in the amount that their actuaries currently allot to pay for prescription drugs. The insurance companies would collect premiums and pass along the amount they are currently doling out. Because they would not be on the hook for cost controls to keep down these expenses, insurance companies might like such an arrangement. Since the Feds would be a single point for payment of pharmacy costs, drug companies would have lower marketing and related costs. Taxing supplements would be like the fees placed on cigarettes and alcohol. These items are not necessary and are purchased by people with disposable income. But, it would not rise to the level of skyrocketing.

As far as supply and demand are concerned, I have decades of experience monitoring both. I will put that up against your partisan driven fantasies. But, any time you want to have a serious debate, do a little real research. You might find my proposal is good for the private sector and patients at the same time. The government is more or less a facilitator and monitor of these services.

Shall I send you a copy of my statement when I received an MRI last year? $10k

Maybe VA prices aren't representative of the prices the rest of us pay....because the gov is footing the bill.

Of course, when I said "I'm a cash patient" they dropped it to $1000. People I know who work in medical billing tell me that they jack the prices way up because the insurance companies will refuse to pay, and negotiate down. The higher they start, the higher they end in the resulting negotiations.

https://www.forbes.com/sites/theapothecary/2017/03/22/yes-it-was-the-affordable-care-act-that-increased-premiums/#72f5c2311d25

https://www.wsj.com/articles/trump-proposes-forcing-hospitals-to-disclose-discount-rates-negotiated-with-insurers-11564431303

So, even though you knew that people really don't pay $10,000 for an MRI you said they did. So much for your credibility. Go back to posting echo chamber babblings. At least I know not to take that stuff seriously.

By the way, the rule requiring hospitals to post prices, the Trump Administration instituted this week, should eliminate the scenario you suggested. I knew that. And, we knew that "junk insurance policies," that would have to bring up their standards would cost more. They were like those life insurance policies for 80-year olds. They pretend to be insurance, but are just a scam to remove your money from your wallet.