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Watch LIVE as PNHP president Dr. @awgaffney joins John E. McDonough and @AnyaRWallack for a #SinglePayer discussion, moderated by @goldbergcarey. via @commonhealth
Anya Rader Wallack identifies as a supporter of #SinglePayer. She says challenges exist around politics (powerful industries are opposed) and taxes (where once hidden costs are made explicit), but has hope and is encouraged by the growing enthusiasm around #MedicareForAll.
"We have 29 million people uninsured. We need to bring that to zero, and the best way to cover everybody is to have a plan the covers everybody." - Dr. @awgaffney
There are grave injustices in U.S. health care, including the growing problem of underinsurance. The only way to address these problems is to embrace #SinglePayer #MedicareForAll says Dr. @awgaffney.
First-dollar coverage might seem utopian to American patients, but it is possible. Canadians, for example, do not pay copays or deductibles for hospitalization. The only thing cost-sharing accomplishes is to deter patients from seeking care. - Dr. @awgaffney
John E. McDonough of @HarvardChanSPH suggests everyone watch Dr. @awgaffney's appearance on @FoxBusiness. We agree! Video here: video.foxbusiness.com/v/600907927700…
How would we transition to #SinglePayer #MedicareForAll? Dr. @awgaffney says the successful implementation of Medicare in the 1960s should give us hope that we can sign up every American for coverage.
Job retraining and income support would be necessary for administrative insurance company workers who might lose jobs through no faulty of their own, says @AnyaRWallack. We agree, and current #MedicareForAll legislation includes funds for these programs.
How do we finance #SinglePayer? Dr. @awgaffney points to an economic analysis by @PERIatUMass (source here: bit.ly/2E6AhCw) and adds that #MedicareForAll would *reduce* total national health spending in the long run.
Dr. @awgaffney pushes back against critics who urge caution on #SinglePayer. "The best way to get to where you want to go is to hold out a very clear vision. We're not going to get there if we don't fight for it."
One constituency that could help pass #SinglePayer is the business community, which loses huge $$$ to health insurance companies, says @AnyaRWallack. This has already begun with @BizHealthPol demanding real change.
Dr. @awgaffney points to changing opinion on the part of medical providers, with doctors and nurses open to a system that allows them to treat patients and shed administrative responsibilities. (Of course, @NationalNurses is a "fierce supporter" of #MedicareForAll.)
John McDonough recalls virulent opposition to the ACA in 2009, and wonders what would be different this time. Dr. @awgaffney counters that, if industry will fight tooth and nail against incremental reform, why not go for fundamental reform that will actually fix our problems?
"#SinglePayer is one important thing to do as a nation, but we need to do a lot more" to improve population health. - Dr. @awgaffney
Issues of state competitiveness and federal waivers make it much more difficult to achieve #SinglePayer at the state level says @AnyaRWallack. Although activists can push for state bills to help further the movement and advance the conversation.
Dr. @awgaffney says those who support "universal coverage" but not #SinglePayer should consider the astronomical costs and inevitable trade-offs of covering everyone through a fragmented, multi-payer system.
"The insurance companies love Medicare Advantage and the drug companies love Medicare Advantage" says John McDonough who floats the idea of "Medicare Advantage for All." Um...NO-NO-NO-NO-NO.
Dr. @awgaffney points to the myriad problems of Medicare Advantage, such as rampant upcoding and higher costs than traditional Medicare (and profits for do-nothing private insurers).
After John McDonough critiques fee-for-service, Dr. @awgaffney reminds him that #MedicareForAll would fund hospitals through global budgets, which would help control long-term costs.
"You're not going to have a health care system without hospitals, doctors, or nurses. You could absolutely have a health care system without private health insurance companies." - Dr. @awgaffney
Is the "public option" a worthwhile policy? @AnyaRWallack worries about private insurance companies gaming the system and "dumping" costly or high-risk patients onto the public plan.
"Medicare, in many ways, is a mess" because there are holes in coverage and privatization has taken a toll, says Dr. @awgaffney. We advocate *improved* #MedicareForAll that would expand benefits and eliminate cost-sharing.
The status quo is a "godawful mess" says @AnyaRWallack. She wonders what "special political sauce" will help improve matters. We suspect the growing movement for #SinglePayer will have its say in pushing for fundamental change.
Dr. @awgaffney finds reasons for optimism because "right now, #SinglePayer is closer to the center of the political discussion than it has been since the early 1970s."
Dr. @awgaffney also points to the remarkable growth of PNHP's student arm, @snahp_national. "Medical students across the country are organizing for #SinglePayer."
And we're done! To learn more about our #SinglePayer proposal, visit pnhp.org/nhi. To learn more about current #MedicareForAll legislation in the U.S. House, visit pnhp.org/housebill.
