Question

you are wirking for a U.s senator who is very concerned about rising health care costs. to adress this problem, she and her colleagues are proposing a single national fee schedule that would apply to all providers and suppliers. what do you tell her about the dustainability of this approach to reduce overall costs and trends?

Answer 1

The new Medicare-For-All program would cover all medically necessary services, with defined categories of benefits to be covered, as well as dental and vision services — a broader definition of benefits than is currently covered by Medicare or by the ACA essential health benefits. Under the Ellison bill, the new public plan would also cover long-term services and supports (LTSS), whereas under the Sanders bill, Medicaid would continue to provide LTSS. The Sanders bill would have the public plan cover all reproductive health services, including abortion, and would repeal the Hyde Amendment. Under both bills, there would be no premium or cost-sharing requirements, other than limited cost sharing (up to $200 per year) on prescription drugs to encourage the use of generics under the Sanders bill. The Sanders bill would establish a beneficiary ombudsman program to help consumers with complaints, grievances, and requests for information, and to track and identify for the Secretary of Health and Human Services issues and problems in payment or coverage policies.