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08/05/2019 David Gurvis, DPM
National Health Insurance? Medicare for all? Not-So-Fast (Sev Hrywnak, DPM, MD)
While neither solidly pro nor against “Medicare for all”, I would ask Dr. Hrywnak to back up some of his statements. A few pro and cons as I see them, in no particular order. While true that Medicare as it is now handles the older population from the young healthy 70 year old to the chronically ill 65 year old, that would change as it would then include the young and healthy as well as the older and ill and everyone in between. As always, the young or the healthy would fund the ill. As to taxes, yes, they would go up and in many cases (I have seen no real figures here and would like to) that would increase the yearly tax burden on many but would be offset by the lack of insurance premiums which can, in many cases be onerous. Also, there would be no pre-existing conditions (something the Republicans are threatening to trash with their efforts to wipe the ACA entirely out of existence) and that would save the medical recipient money. Another off set would be copayments and co-insurance payments which would no longer exist. Business would pay less for employee benefits but what would they do with it? Better employee pay? History says no. Better CEO compensation is more like it. There would probably be rationing. That exists now however and is pretty much financially based and would change to government bureaucratically based rationing ( not automatically good or bad). I am not sure the above factors can even be quantitated into a net increase or decrease in out of pocket expenses for the average American. I assume my payments in the office would go down. And I would be subject to even more regulation? On the other hand, I could call and schedule an MRI without an hour of precertification efforts. But, in particular, I would like the source of your statement that when budgetary shenanigans are factored back in, the administrative burden of Medicare is twice that of private insurance. That figure is more disturbing than other known problems so I would like to further investigate that.
David Gurvis, DPM, Avon, IL
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