قالب وردپرس درنا توس
Home https://server7.kproxy.com/servlet/redirect.srv/sruj/smyrwpoii/p2/ US https://server7.kproxy.com/servlet/redirect.srv/sruj/smyrwpoii/p2/ What Medicare for All means, political and practical

What Medicare for All means, political and practical



Medicare, which has been in place since 1965, is a government health insurance program that covers all Americans aged 65 and over and is funded by taxpayers. Part of our social security wages are directed to Medicare to cover most services such as hospital stay and physician visits.

Medicare people may also choose to receive additional coverage from Medicare-approved private insurers to cover other services such as dentistry, vision and prescription drugs.

Medicare for All supporters want to expand this program to cover more than Americans aged 65 and over. Some, like Vermont Senator Bernard Sanders, insist that Medicare cover all citizens and legal residents, while others such as Michigan senator Debbie Stabenu insist on lowering the age requirement and allowing people between the ages of 55 and 65 to buy.

Many of those who insist on Medicare for All believe that health is a human right, and many supporters believe that increasing spending in the US healthcare system can help attract more people into the Medicare system.

It is worth noting that Medicare is quite popular as it now stands. In a December Gallup study of Americans who are insured publicly through Medicare or Medicaid (the government's health program that includes people with limited income), 79% say they are satisfied with the quality of their healthcare and believe they have good to excellent health coverage.

Where did this idea begin and why does it gain weight?

The concept of a government-funded healthcare system is not new. Efforts to provide some kind of universal health coverage in the United States date back to 1

904 when the Socialist Party approved the idea.

In 1912 Republican President Theodore Roosevelt ran for a third term as a candidate for a progressive party; its platform included a "single national health service". Although he lost, the concept of a single payer system will continue to sneak into a political debate. Some of the strongest resistances of a nationalized health care system come from physicians who feared it would hamper their profits. Teddy's cousin, President Franklin Roosevelt, will try to pass in 1935 as part of the Social Security Act a universal national health insurance program as part of the New Course. President Harry Truman continued to insist on this during his stay. According to the Kaiser Family Foundation, the fear of socialism and the panic of the South Democrats that the nationalized health care system would require desegregation ultimately hinders healthcare efforts.
He returned to his renown when Sanders included him as part of his presidential platform for 2016. He did not win, but the idea started with a number of Democrats. In fact, it also has some support from the Republicans. According to a recent study by the Kaiser Family Foundation, 40% of Republicans support the idea of ​​federal health insurance.
  Opponents Unite to Cancel Medicare for All

And in recent months, Medicare for All was a call for Democrats. This was heard by people who are now freshman in New York, Alexandria Occasio-Cortez, and California's Harley Ruda, who beat 15-nation Republican President Dana Roberbacher. And it was not a campaign platform limited to the shores. Texas Democrat Sylvia Garcia won his first term, promising to fight for Medicare for All.

What the program will do

Our healthcare system can best be described as a hybrid. About half of the money comes from the private sector: people who have private insurance through their employers or self-insured. The other half is from the public sector: federal, state and local authorities who pay at Medicare and Medicaid.

If the country accepts Sanders' proposal, people who are currently receiving insurance from their employers will move to the government system. Sanders' plan will cover basic healthcare services as Medicare now and will include teeth and vision coverage without need. The only potential for pockets in the pocket will be for some prescription drugs and for some eligible treatments.

If states want to fund additional benefits for their residents, on Sanders' proposal, they could, but they will have to do so without federal help.

As well as increasing access to healthcare, Medicare supporters for All say that switching to this system would lead to increased efficiency to reduce healthcare costs. The American health system now costs almost twice as much as other high-income countries pay per capita.

According to the Sanders plan, can I keep my doctor

While your doctor has been – Licensed and certified Medicare provider, your visit will be covered. But if your doctor decides not to participate in Medicare, you will either have to pay from your pocket or contact a doctor.

What would not cover the program?

With Sanders' comprehensive program, the only things you will probably have to pay for are selective and cosmetic procedures. But the devil is in the details and many of these details still have to be invented.

For example, Medicare has signed a contract and has approved some private insurers to provide additional coverage. Will the Medicare for All system be a differentiated system with additional insurance similar to the current or private insurance industry will disappear completely? It depends on which proposal needs to be approved.

  Sanders faces voters in CNN City Hall before trips to Brooklyn and Chicago Also, keep in mind that Medicare pays doctors and hospitals less than private service insurers and not all hospital systems or doctors accept Medicare. The American Hospital Association found that private health plans pay hospitals around 45% more than treatment costs while Medicare and Medicaid pay about 12% less than costs, and the difference of 57 percentage points If we move into Medicare for All , all hospitals and doctors agree with this salary cut? Will they organize themselves to demand more? These are the questions with which the architects of an extended system have to fight.
If Sanders for Medicare for All becomes a law, it will not happen overnight. It would develop for four years.

In the first year, Medicare will grow, with the eligible age dropping to 55, and all children aged 18 and younger will be added to the rolls. Over the next two years, the age will drop to 45 and then to 35. By the fourth year she will really become "Medicare for All".

How will you get paid for this?

This is where the tire comes to the road and one of the reasons why it's so controversial.

The graph below illustrates the federal Medicare & Medicaid Services Centers for Healthcare Expenditure from 2017 to 2026

several figures that need to be taken into account when thinking about health care costs.

1. National Health Care Costs: This is the yellow line in the chart. It represents how much we as a country spend on things like drugs, visits to doctors and hospital care; including all sources of funding, both public and private. In 2017, the cost of health care was 3.5 trillion. Over the decade from 2017 to 2026, the cost is expected to be $ 45 trillion.

2. Federal Health Care Costs: This purple line represents the federal government's share in national healthcare spending, which includes Medicare and Medicaid. Much of this comes from taxes. In 2017 federal health spending was $ 974 billion. In 2017 to 2026, federal health spending is expected to be $ 13 trillion.

3. Total State Expenditure: This is the green line, federal spending on health plus what states and municipalities pay. It represents about half of the total national healthcare expenditure; the other half comes from the private sector. In 2017, total government spending was $ 1.56 trillion. Over the decade from 2017 to 2026, total government spending is expected to be $ 21 trillion. Sanders Analysis for Medicare for All:

Sanders' analysis is based on the Medicare & Medicaid Centers for 2016. Cost estimates for health services. CNN uses Sanders' assumptions and applies the same savings ratios to the most recent forecasts in this Sanders data analysis.

1. National Costs for Health: Using Sanders' assumptions under Medicare for All, national health spending for 2017 would be only about $ 3.2 trillion. For the decade from 2017 to 2026, Sanders' total national healthcare spending would be nearly $ 39 trillion.

Keep in mind that Medicare & Medicaid Services Centers predict that national healthcare expenditure under our current system is about $ 45 trillion from 2017 to 2026 $ 6 trillion over the decade.

Sanders believes that these savings will largely be the result of reduced administrative costs, reduced payments to doctors, and lower prices of medicinal products prescribed by the single payer system.

2. Government spending: Sanders makes no difference between federal and state spending in his analysis. All his costs are considered federal or public, as under the Medicare for All plan, the federal government is largely the only payer.

Sanders's analysis assumes that if Medicare for All was introduced in 2017 this year, federal spending would be about $ 2 trillion, and total public or federal spending would be about $ 27 trillion for the decade 2017-26 . But Sanders once again thinks that the total national healthcare spending under Medicare for All would have reached $ 3.2 trillion in 2017 and about $ 39 trillion in the decade, meaning Sanders will need another $ 12 trillion to $ 14 trillion dollar to cover national health spending for a decade.

To pay for his plan, Sanders has called for a new income tax of 2.2% for all Americans and 6.2% for employers. It will also increase taxes on the rich. But, he says, people will save money because they will no longer have to pay contributions, monthly bonuses, or self-payments. A family of four, earning $ 50,000, will save more than $ 5,800 each year, he said. Sanders says that although everyone will pay more taxes, they will compensate for this by paying less healthcare premiums.

Some experts believe that Sanders' picture is too pink, overestimating how much savings would be the result of a single payer system. Critics fear that he has underestimated the price of more people using health care. Now there are about 28.5 million uninsured Americans, and it should not be surprising that securing insurance for many more people will be expensive.

A recent Pew Research Center survey found that 6 out of 10 Americans believe the federal government's responsibility is to make sure that all Americans have health coverage. according to Sanders' plan, national healthcare spending will increase by more than $ 6 trillion compared to what we are supposed to spend by 2026. He also predicts that national health spending will be closer to $ 51 trillion instead of Sanders' $ 41 trillion forecast. That means an additional $ 32 trillion for new federal spending, according to the Urban Institute.
  Victory over Amy Klobucher can give progressive democrats a chance for real change

Other experts, including Kenneth Thorpe, chair of Health Policy and Governance at the Emory University School of Public Health, are also opposed to Sanders' ratings. Regardless of how spending will be reduced, everyone will be affected, Thorpe said, and Sanders' tax increases can not cover an increase of $ 32 trillion.

Sanders hikes to reach the required $ 32 trillion. And it will affect everyone. Sales tax is a regressive tax, which means it will affect the poor more than the rich.

Thorpe knows this not only because he is an economist and has analyzed Sanders' plan for 2016, but because he was elected by the Vermont Legislature in 2005 to potential greenhouse gas bill projects in the state of the Green Mountain.

"There will be winners and losers," he explained. And who can pay more can surprise you.

According to Thorpe, someone who is already Medicare or Medicaid, who pays very little, if he rewards the rewards at all, is likely to start paying more taxes and possibly not seeing relief or compensating for the premiums. The reason is that what they pay with taxes is potentially higher than their current premiums.

Owners of small businesses can be in a similar boat. If they have less than 50 employees, they are currently not paying bonuses for their employees. But they will pay more in taxes on wages and see no relief or offset the premiums.

Are there other places that do this?

Canada and Taiwan are often cited as examples of other places that have one payer health systems where all residents are insured. These governments pay for healthcare through taxes on their citizens. In Canada, the federal government only provides health care, and dental, visual and prescription medicines can be covered by the province or private insurers.

The UK National Health Service is also often used as an example for a single payer system. But in the English system, the government not only pays for services, but also negotiates and rents doctors and hospitals directly. This is considered a socialized or nationalized healthcare.

  CNN poll: Most believe the government should provide a national health insurance program

Canada and Taiwan, and under Medicare in the United States, the government does not own or negotiate suppliers. The British system is closer to the US Veterans Administration.

Another country that often appears as a model in the health debate is France, which has a mix of public and private insurance. Although most of France is covered by one of the three non-governmental health insurance funds funded by the government and covers between 70% and 80% of the cost, there are private additional insurers. Всички тези страни осигуряват почти универсална здравна грижа, чрез която застраховането се предоставя или упълномощава от федералното правителство.

Защо здравето е толкова скъпо на първо място?

В Съединените щати, за всеки един лекар има около 16 служители – но само шест от тези членове на персонала действително имат клинични роли, като помощници на медицински сестри или медицински асистенти.

Това е повече от $ 800,000 в разходите за труд на лекар. За разлика от страните, които имат национализирана система или система с един платец, Съединените щати имат стотици доставчици на здравно осигуряване, с различни кодове и различни ставки за еднакви процедури. Това е административно неефективно, ако една и съща подмяна на коляното може да бъде обработена и заредена по десетки начини.
Цената на болестите в начина на живот, като затлъстяването, е зашеметяваща в Съединените щати. Има оценки, че 80% от диабета, сърдечни заболявания и инсулт и 40% от случаите на рак са предотвратими. До 2050 г. се очаква, че 1 от 3 възрастни в САЩ са диабетици.
 Демократични тревоги за Medicare за всички & # 39; първата битка за първи път през 2020 г.

Ние също така прекарваме повече средства за технологии и наркотици. Фармацевтичните лекарства са особено скъпи в Съединените щати, отчасти защото най-големият потребител на лекарства, отпускани по лекарско предписание – Medicare – не може да договаря цени с производителите на лекарства. Според плана на Сандърс правителството ще дойде на масата за ценообразуване на брокерите. Пациентите в американската система за здравеопазване са склонни да имат много повече ненужни тестове и процедури, отколкото пациентите в други страни и че всичко това допринася за висока цена. Това отчасти се дължи на мотивацията на печалбата, както и на феномена, известен като "отбранителна медицина". Това е, когато лекарите и болниците са прекалено предпазливи и извършват тестове и сканира от страх да излязат от операционната зала и в съдебната зала. През 2008 г. отбранителната медицина струва на САЩ 55,6 млрд. Долара разходи за здравеопазване.

Според нестопанската Национална медицинска академия, през 2009 г. една трета от всички разходи за здравеопазване е била пълна загуба и не е направила нищо, за да накара американците да влязат в действителност. чувствам се по-добре.

Какво мислят повечето хора за Medicare for All?

Предложеното разширяване не е просто популярно сред политиците; има голяма подкрепа от техните избиратели. Проучване на семейство Кайзер от януари установи, че 56% от американците подкрепят Medicare за всички.

Обществената подкрепа зависи също и от това как се квалифицирате програмата. Напомнете на хората, че ще премахнат премиите за здравно осигуряване и ще намалят разходите за здравеопазване за повече американци, а подкрепата за програмите ще бъде 67%. Ако кажете на хората, че Medicare for All гарантира здравеопазването като право за всички американци, одобрението за програмата скача до 71%.

Но им напомнете, че може да елиминира частната застраховка и да подкрепят обръщането. Според проучването, 58% от американците биха се противопоставили на Medicare for All, ако се отърват от частната застраховка. Шестдесет процента от анкетираните заявяват, че се противопоставят на системата на един-единствен платец, когато им е казано, че ще повиши данъците за повечето американци.

Междувременно, какво мога да направя, за да намаля разходите си за здравеопазване?

Вземете контрола върху здравето си. Яжте по-добре. Упражнение

Хронични състояния като сърдечни заболявания, рак, диабет и затлъстяване са сред най-разпространените и скъпи в Съединените щати. Шест от 10 американци имат поне едно хронично заболяване; 4 от 10 имат по две или повече. Американците с пет или повече хронични заболявания съставляват 12% от населението, но представляват 41% от общите разходи за здравеопазване. Тези американци харчат 14 пъти повече в здравеопазването от тези без хронични заболявания.
Според американските центрове за контрол и превенция на заболяванията, хроничните заболявания съставляват 90% от всички разходи за здравеопазване. Тези условия са водещите фактори за нашата почти 3,5 трилиона долара в разходите за здравеопазване.

Наня Кунанг от CNN и Тами Лухби допринесоха за този доклад.


Source link