Why O'Malley's health care plan is the best of the three

[Recursion]

https://martinomalley.com/policy/health-care/

1. Encourage states to adopt global budgeting (also called "All Payer&quot for hospitals, which is the only proposal in the field right now that has been demonstrated to address the main driver of health care spending: hospital costs.

2. Streamline Medicare by combining A, B, D, and supplemental coverage into an optional "Medicare Essential" program. This will lower costs while providing higher benefits to recipients by eliminating duplication of administrative work.

3. Promote and fund comprehensive primary care centers (think Kaiser or Mayo or many FQHCs). These are not the cost sinks that hospitals have turned in to, and can provide 90% of the care hospitals provide.

4. Force hospitals and doctors to provide one single, transparent rate for all procedures regardless of the financing stream (FQHCs do this now) and negotiate those rates down for all Americans

5. Point the FTC's antitrust division at hospital mergers

6. Allow immigrants to enroll in Medicaid

7. Require states to offer prenatal and family planning care to everyone

8. Take the HCF that funds FQHCs out of discretionary spending and into mandatory spending, and require behavioral and oral health parity in the spending

9. Expand the NHSC to triple its rolls (the NHSC pays back student loans for physicians, nurses, and other health professionals who work in community health centers)

10. Mandate release of all clinical trial data

And lots, lots more.

This is light years ahead, frankly, of either Clinton's or Sanders's plans.

O'Malley's plan does not simply focus, like theirs do, on health care financing. Health care financing isn't the primary problem: provider costs are. Advocates of single payer or simple ACA tightening both say that, given time, their preferred policies will eventually lead through indirect means to lower provider costs. Governor O'Malley's plan is the only plan that directly addresses provider costs, by requiring a single, transparent price for any service, drug, or device. (NB if it works like it does in Maryland, there can be adjustments for local costs of living.)



Here is where our health care spending is currently going. "Overhead" includes administrative costs and profit for insurance companies, Medicare, etc. "Stuff" includes devices and drugs. The big Pac Man, eating the entire expenditure, is services. And what are those services?



Hospitals and physicians.

That's where our money is going. That's why we pay twice as high a percentage of our GDP as the rest of the world. Governor O'Malley's plan is the only one of the three that directly addresses that. This idea has been tested and proven in Maryland, and it can work throughout the country.

Yet another reason I and about twenty other people are proud to support him.

[JDPriestly]

1. This has some good ideas, but we need to take the profit out of health insurance first.,

Single-payer is the key.

This system of controlling hospital costs will not work unless we have universal coverage. At this time, the hospitals absorb the cost for expensive treatment for the uninsured and pass it on.

We have to insure everyone. Single payer, universal insurance is the first step. Then other reforms that are needed can follow.

[Recursion]

2. Why? Why do you care *that* much about 4% of spending?

About 4% of spending is private insurance overhead (including profit) and about 2% of spending is public insurance overhead. Sure, I'd like 4% cheaper health care, but it's absurd to look at that pie chart and conclude that the "overhead" sliver is the problem.

This system of controlling hospital costs will not work unless we have universal coverage.

But it has worked, in Maryland. It's the only state in which hospital prices have gone down, and there's still not universal coverage even there.

We have to insure everyone. Single payer, universal insurance is the first step.

Only if your goal is to lock-in forever marked-up provider costs. Do single payer before you lower prices, and every single attempt to lower them later will be attacked as "cutting Medicare". This isn't just hypothetical; look at the actual history of the "doctor fix". Doctors are overcharging Medicare by 15% and have been for decades, and everybody agrees that is true, but we can't cut that because anyone who tries is attacked as "cutting billions from Medicare".

[JDPriestly]

3. Doctors are overcharging Medicare? Do you have a link for that?

A few doctors may, but I doubt that the percentage of our doctors who are dishonest is that high?

Medical care for the elderly is very, very expensive. Being very sick is often just a part of aging and then dying.

There is Medicare fraud, but I don't think it is as prevalent as some want to believe. I think most doctors are extremely honest. Insurance companies???? They are not in it because they want to help people. That's my experience anyway. Doctors are. My doctor is.

I do think that Kaiser-style healthcare delivery is a good idea. But many people don't like it.

Hospitals cover the costs of residencies and training of doctors. That is one of the reasons that their costs and expenses are high.

[Recursion]

5. Seriously? Google "the doctor fix"

http://khn.org/news/faq-could-congress-be-ready-to-fix-medicare-pay-for-doctors-2/

We are politically incapable of lowering costs through Medicare. We have to do it directly.

[Fumesucker]

4. People like single payer because picking insurance coverage is a nightmare guessing game

It's a nightmare thanks to the incredibly complex verbiage and plethora of different choices and it's a guessing game because very few of us know for sure what our medical prognosis is likely to be.

I'm on Medicare these days so it's not so much of an issue for me now but picking out the coverage I wanted used to be a horrendous experience. I'm expert at what I'm expert at and I didn't have the time or extra attention to devote to becoming an expert at both insurance and medical jargon.

My family once had the verdict of an entire substantial medical insurance court case boil down to a single word, "and" versus "or", in a lengthy contract written in dense legalese. The details are absolutely critical.

A huge percentage of the American public is functionally illiterate, they don't have the capacity to read or understand these contracts.