This edition of Waiting Your Turn indicates that, overall, waiting times for medically necessary treatment have in-creased since last year. Specialist physicians surveyed report a median waiting time of 21.2 weeks between referral from a general practitioner and receipt of treatment—longer than the wait of 20.0 weeks reported in 2016. This year’s wait time—the longest ever recorded in this survey’s history—is 128% longer than in 1993, when it was just 9.3 weeks.
In a previous report, I found that Medicare’s administrative costs amounted to about $509 per primary beneficiary, and private plan administrative costs were about $453 per beneficiary. That means, in effect, that private health plans’ administrative costs were about 10 percent lower than Medicare’s. However, Medicare spends more on actual medical care (payments to hospitals, doctors, and other health care providers), so if you expressed administrative cost as a percentage of total costs (administrative plus medical), you’d get 6 percent for Medicare and 13 percent for private health plans – a result that is exactly backwards.
Republicans’ failure—so far—to repeal and replace Obamacare has breathed new life into the single-payer dream. In June, the majority of Americans told Pew that the government has the responsibility to ensure health coverage for everyone, and 33 percent say this should take the form of a single government program. The majority of Democrats, in that poll, supported single payer. A June poll from the Kaiser Family Foundation even found that a slim majority of all Americans favor single payer.
from a policy standpoint, Medicare-for-All is probably the hardest way to get there. In fact, a number of experts who tout the benefits of single-payer systems say that the Medicare-for-All proposals currently on the table may be virtually impossible to enact. The timing alone would cause serious shocks to the system. Conyers’s House bill would move almost everyone in the country into Medicare within a single year. We don’t know exactly what Bernie Sanders will propose in the Senate, but his 2013 “American Health Security Act” had a two-year transition period. Radically restructuring a sixth of the economy in such short order would be like trying to stop a cruise ship on a dime.
While the Trump administration discusses plans to repeal and replace Obamacare, California has introduced “The Healthy California Act,” which would institute socialized healthcare covering all undocumented residents of California, including illegal immigrants.
By passing Obamacare, Democrats were laying a “cornerstone” for government healthcare that they expected to build on, as co-author and former Sen. Max Baucus put it as the legislation came out of the Finance Committee he chaired. Former Sen. Tom Harkin described it as a “starter home.” Liberals settled for Obamacare but held out hope that they could incrementally expand it into something like a single-payer system. Hillary Clinton was ready, if she won the White House, to push for bigger subsidies and tighter regulations.
Even as voters in Colorado were backing Hillary Clinton for president and approving new taxes on cigarettes and soda, they soundly rejected a proposal to increase payroll taxes to fund a statewide single-payer healthcare system.With only a few precincts waiting to be reported on Wednesday morning, more than 79 percent of voters had opposed the initiative.The single-payer health care system would have provided hospitalization, access to prescription drugs, and most primary and specialty care, but it came with a hefty price tag. Amendment 69 would have increased payroll taxes by 10 percent and generated about $25 billion in annual revenue to fund ColoradoCare.