MEDICARE-FOR-ALL: PROPOSALS POLITICS AND TRADEOFFS

摘要

Discussants: P. Neuman¹, R. Frank², K. Pollitz³,1. Kaiser Family Foundation, Washington, District of Columbia, United States, 2. Harvard Medical School, Boston, Massachusetts, United StatesThere is growing national interest in expanding Medicare as a strategy to stabilize and expand health insurance coverage and lower costs. Whether “Medicare for All,” or a “Medicare Buy-in” for people under 65, the proposals share the belief that Medicare is a system that we can build on for a broader population of beneficiaries. These ideas will become more prominent as elections pose the question of what’s next following the Affordable Care Act. This symposium offers several perspectives on these various proposals. John Rother, chair and moderator, reviews the history of the idea that Medicare should be the building block for a broader health-care insurance system. Tricia Neuman provides an overview of leading proposals, highlights key differences, and discusses the potential implications for the Medicare program and its beneficiaries. She reviews public opinion polling data on the various proposals, including positions held by the major political parties. Karen Pollitz discusses the implications of these proposals for the individual health insurance market, employer-based markets, and government programs such as Medicaid and the VA. Richard Frank addresses the broader economic implications of these proposals, including differences in administrative costs of Medicare vs. the private insurance system and the potential effects on health care organizations. The panel discussion that follows addresses trade-offs, including the likely opposition of acute-care providers and physicians’ organizations as well as current Medicare beneficiaries. There will be opportunity for questions and comments from the floor.