2017 September

Single Payer System

A Single Payer System will help “Make America Great Again”.

I am convinced healthcare in American needs to become a single payer system with an option to purchase private insurance. Why?

Many American are still slipping through the cracks of the current system because it’s so fragmented. With health insurers pulling out of the exchanges and the uncertainty of CHIP, even more Americans are likely going to slip through the cracks in 2018.

While reading Option B this weekend, I learned that 46% of Americans cannot afford to pay $400 in the event of an emergency. It’s no wonder hospitals are seeing an increase in bad debt. The average deductible in 2016 was just shy of $1500. With more Americans trying to lower their premiums, it’s reasonable to expect deductibles will continue to increase. Higher deductibles and out-of-pocket maximums means many Americans are underinsured and exposed to excessive financial risk.

Illness is a factor in more than 40% of bankruptcies and there is evidence that people with cancer are more than 2.5 times as likely to file for bankruptcy. Even relatively small unexpected expenses can have disastrous consequences: 46% of Americans are unable to pay for an emergency bill of $400. ~Option B by Sheryl Sandberg and Adam Grant

People need a certain level of support to shift into growth mindset which is essential to return America to greatness. Healthcare is an essential part of that support. As Sheryl acknowledged in Option B, paid family leave, quality healthcare and mental health coverage make the difference between people falling off and hanging on. In other words, they are essential to life.

Many leaders are acknowledging now that capitalism is not working for the vast majority of Americans. The fundamental goals of business and the welfare of Americans are misaligned.

I fully agree that the capitalist system as we know it with regards to compensation is severely out of balance when you compare the growth of executive level compensation with that of labor….The U.S. Middle Class is shrinking compared to the base of 1962 and is now about 47% of the population from about 62%… These are the kinds of trends that lead to social and political upheaval. ~ Fortune, CEO Daily

What’s clear is that we’ve tried to make universal healthcare coverage work and we’ve allowed things to get so far off track that we need to do something dramatically different. It’s time for Option B in healthcare.

We should consider a single payer system as the base of the American system. Access to healthcare should not depend on where people live or who they work for because it’s an essential service for the health and welfare of all Americans.

A single payer system is going to be expensive but to “make America great again” we need to reinvest in all people rather than just lining the pockets of the 1%. Warren Buffet one of the wealthiest people in American is onboard.

 

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About the Author: Shannon Smith is a healthcare strategist with over fifteen years of experience helping companies achieve greater success. She is also the founder and CEO of Hello Workout.

 

No Easy Answers

There are no easy answers when it comes to healthcare.

Healthcare is something everyone wants because it’s an essential service for sustaining a healthy life. However, the cost of healthcare is what makes it a difficult service to provide to all Americans. Politicians are continuing to struggle with what to do.

Changes to the ACA are still up in the air …“the president has no interest in bailing out insurance companies.”

Proposals to sure up the insurance options available on the exchanges require subsidies for low-income consumers. The GOP is willing to authorize the subsidies but there is a catch. Republicans want states to have more control over the implementation of the ACA – which essentially means health insurance available to Americans will vary state to state. Consequently, Democrats have expressed their concern for the consumer protections which were a fundamental part of the ACA.

Insurers are threatening to pull out of the exchanges if the funds for subsidies disappear. Lindsay Graham is suggesting block grants to states if all else fails which no one seems to like either because some Americans will get generous benefits and others not enough.

There is one thing they agree on:

Either way you slice it both Republicans and Democrats seems to be pointing to the complexity of the current healthcare system as a problem.

Republicans are making a case for a free market system that makes patients behave as healthcare consumers. The thought behind it is that consumers will only pay for what they need if they know the price. In theory, healthcare becomes a cash business which negates the need for the complexities of the current healthcare billing and collection industry. The problem is healthcare consumers may not have the cash for needed care.

Democrats on the other hand are making a case for a Single Payer system which will place the financial burden on the tax payer. A single payer system would provide a basic level of coverage to all Americans regardless of their ability to pay. The challenge is in defining the basic level of coverage because when someone else is paying most people think more always seems better – even if it isn’t. Bernie Sanders plan will be presented on Wednesday.

Healthcare billing and collection cost providers approximately $52 billion/year. Either strategy will put pressure on the Revenue Cycle industry providing billing and collection services because the healthcare payment processes will likely be simplified.

Bernie’s Plan

Labeled “Medicare for All” but is really “ACA Coverage for All” paid for by the tax payer. Hence a non-starter plan even though it is backed by 15 Democratic representatives.

The cost would likely exceed any cost savings even if the government “negotiates” all the prices with providers and drug companies. But let’s wait for the white paper that explains the savings and funding before we judge.