Episode 7: Medicare For All
Stacey and Jake are joined by Stephanie Kang, M.S. (DrPH 2020)
After listening to Episode 7: Medicare For All, we hope listeners have a better understanding of what the goals and objectives of Medicare For All are and how the passage of Medicare For All would impact healthcare workers and Americans. Stephanie discusses other efforts at healthcare reform, their merits, and whether they solve system problems. She also reflects on Medicare For All as a movement - as a tool that leaders like Senator Sanders are using to build momentum toward monumental healthcare reform. Jake, Stacey, and Stephanie also reflect on how complex and difficult the current system is for Americans.
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A summary of Episode 7: Medicare For All and additional learnings can be found down below.
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Thank you for joining us!​
Our Guest
Stephanie Kang
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Stephanie Kang, M.S. is a Doctorate of Public Health Student at the Harvard T.H. Chan School of Public Health
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Stephanie was a Health Care Fellow the Congressional Progressive Caucus Center. She worked with Congresswoman Pramila Jayapal (WA-07) on the House version of Medicare For All.
Stephanie received B.S. in Neuroscience and an M.S. in Global Health from Northeastern University and Northwestern University, respectively. Since then, she has worked in public health, specifically in East Africa, performing drug discovery research for neurodegenerative diseases, and coordinating clinical research and quality improvement programs in hospital settings. Prior to starting her doctoral program, she was the Program Director for two non-profits: one an innovative education program at Harvard Medical School for underserved Boston youth and the other, a global health organization implementing community-based health projects in rural Haiti.
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To learn more about Stephanie Kang.
Summary
Stephanie brought energy and passion to Medicare For All - having worked directly with Congresswoman Pramila Jayapal (WA-07), we learned that Medicare For All references two similar legislative bills, one in the House by Rep. Jayapal and one in the Senate by Sen. Bernie Sanders.
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Stephanie explains that Medicare For All accomplishes three objectives: 1) increasing coverage of health insurance to all Americans, 2) increasing the number of services covered by current Medicare to include Dental, Vision, Mental Health, Long-Term Care, and more, and 3) contains costs by leveraging buying power for drugs, medical devices, and personal protective equipment and by consolidating administrative function. Accomplishing these three objectives reduces system waste, creates a fairer and more equitable system, and shifts the healthcare system toward prevention.
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When comparing Medicare For All and other health reform efforts, Stephanie, walks us through how reform efforts meet or do not meet the three objectives that Medicare For All seeks to accomplish.
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Public Option (Medicare Buy-In)
This reform provides Americans with a public insurance plan option and would likely include a mandate that certain (new/added) services are covered. The Public Option may expand coverage by making insurance premiums more affordable but this is not a guarantee, and it may include expanded services being covered. The Public Option allows for private insurance companies to cherry-pick healthy patients (lower costs), allowing for sicker patients (higher cost) to choose the public option, of which tax dollars are spent on.
Expand Services? No, unless explicit
Expand Coverage? Very little
Lower cost? No
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Lowering the Medicare Age
This will expand coverage to Americans near 65 years old but does not expand services. Services such as Dental, Vision, Mental Health and Long-Term care are not currently covered by Medicare and would not be covered by lowering the Medicare age unless explicitly passed by Congress. Due to Medicare's inability to leverage buying power and negotiate drug prices, this option would ultimately increase healthcare system costs rather than reduce them.
Expand Services? No, unless explicit
Expand Coverage? Yes
Lower cost? No
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Fixing the Affordable Care Act
This option builds upon the Affordable Care Act that was passed in 2010. It first reestablishes parts of the Act that were dismantled and second, identifies coverage and affordability gaps and attempts to solve them.
Expand Services? No, unless explicit
Expand Coverage? Yes
Lower cost? No
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If passed and implemented, Medicare For All would consolidate insurance companies and reduce the number of people needed for administrative roles. As Bill Hsiao discusses, standard payment procedures would be established and one centralized clinical and patient record would significantly rude waste. Moreover, both the House and the Senate versions of Medicare For All include funding to support the transition of workers for up to 5 years. So individuals who might lose their job, are retirement eligible or need support finding or training for a new role will be funded for up to 5 years.
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While we did not get into the specifics of funding Medicare For All. Stephanie did provide us with the idea that funding is available and exists; however it is currently being spent with private insurers and being wasted through administration (non-medical expenses). Stephanie also references the Yale study that found that "transitioning the U.S. to a single-payer health care system would actually save an estimated $450 billion each year, with the average American family seeing about $2,400 in annual savings. The research, which was published in the medical journal The Lancet, also found that Medicare for all would prevent about 68,000 unnecessary deaths per year."
Lastly, Stephanie discusses that major legislation aside from Medicare For All may need to be passed for the U.S. to move toward a Single Payer System. She also raises an important question to reflect on - What is the purpose of Medicare For All (current piece of legislation)? Is it meant to build public energy and be a tool to promote progressive healthcare legislation that expands coverage and services and reduces cost, or is it a do or die policy?