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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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