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Top industry leaders see baby steps

Healthcare  |  August 16, 2019 6:00am  |  By Joel Lee

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The July Democratic Presidential debates once again pulled the nation’s attention to healthcare. While none of the candidates argued for the status quo, they divided into three camps – the incrementalists, the evolutionaries and the revolutionaries. 

We wanted to know how the 1,000 most influential people in the healthcare industry felt about the revolutionaries who advocate for the displacement of the employer-based health insurance system with a fully public insurance system characterized as Medicare-for-All. What we found was interesting. About half of the Presidential hopefuls are strong advocates for Medicare-for-All. Our nationwide panel of healthcare leaders were less enthused.  

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The first question we asked was about broad direction over the next five years. Would we see a shift toward greater public sector control or greater private sector control or hold about where we are today. Just over half of the respondents (51%) felt we would continue with the current balance. The other 49% felt the balance of influence and control would shift. By a 7 to 1 margin the panelists saw the shift moving toward greater public sector control and influence. On balance it appears that our panel saw a drift toward greater government influence but they seemed much more inclined to incrementalism than sweeping revolution.

We wanted the panel to identify what they felt were the most powerful criticisms of Medicare-for-All and the most important advantages that come with the plan. Two specific criticisms accounted for almost 60% of the responses. More than 36% felt the most critical flaw in the plan was its cost – saying it was unaffordable and impossible to raise taxes sufficient to cover the cost. Another 21% predicted that Medicare-for-All would come with current Medicare provider rates and found those rates would undermine the stability of the entire healthcare system. About 13% echoed a similar sentiment by noting it would create too much disruption in a volatile and important economic sector.

Proponents of Medicare-for-All would do well to understand these objections and address them clearly as proposals are fleshed out in the coming months.

The panel then turned to describing what they felt were the most important advantages of Medicare-for-All. Two choices accounted for 61% of the responses. Just over 38% saw universal healthcare coverage as the most important advantage. Dramatic cost reduction achieved by establishing a single administrative system in place of the hundreds of private health insurance plans garnered 23% of the votes. Just under 17% of the respondents saw no advantages that carried any weight, an indication of staunch opposition to fully federalizing healthcare.

We wondered what the panelists thought might be the first steps over the next three years toward a single payer system. The top response at 28% was a public option that would be implemented in at least 15 states through the Affordable Care Act Exchanges. A close second at 23% was a nationwide Medicare option for Americans between 55 and 65 years old. More than one in five respondents (21%) felt there would be absolutely no steps taken toward a single payer system. Only 11% of the sample believed an expansion of Medicaid either at a state or federal level would happen.

Medicare-for-All has generated a great deal of political discussion. Our panel of industry experts see both benefits and drawbacks. A careful analysis of their opinions and predictions suggest the nation as a whole will move toward greater public sector influence and control. As to Medicare-for-All, it seems these experts don’t see it on the immediate horizon.