One-Size-Fits-All System Poses Added Risks To Rural Hospitals & Patients

WASHINGTON – When Democratic presidential candidates take the debate stage in Miami tonight, their discussion should not ignore the negative impacts that Medicare for all and other new government insurance systems would have on America’s hospitals and patients – particularly those already struggling to deliver needed care in rural areas.

As former U.S. Senator Heidi Heitkamp (D-N.D.) recently wrote in The Washington Post, “[c]hampioning a health-care policy that threatens to close rural hospitals and limit patients’ access to vital services is not a winning message” for Democratic White House hopefuls.

But, The New York Times reports that experts are growing increasingly concerned about the “violent upheaval” a Medicare for all system would cause hospitals, cautioning: “Some hospitals, especially struggling rural centers, would close virtually overnight, according to policy experts.  Others, they say, would try to offset the steep cuts by laying off hundreds of thousands of workers and abandoning lower-paying services like mental health.”

A report by POLITICO echoes this warning, noting that Medicare for all “would all but end private insurance and regulate hospitals in a vastly different way, dramatically changing operators’ business model and costing community hospitals as much as $151 billion a year, according to one estimate published in JAMA,” all while “slashing hospitals’ pay rates and putting up to 1.5 million jobs at stake … It’s a concern that’s left Medicare for All advocates walking a fine line, arguing for a dramatic reshaping of the health system while trying to avoid a brawl with their hometown health systems.”

Meanwhile, as Medicare for all “falters” in Congress, some 2020 presidential candidates are embracing so-called “moderate” fallback proposals – often branded “public option” or “Medicare buy-in.”  In reality, these proposed government insurance schemes would ultimately lead to a one-size-fits-all health care system run by Washington, and recent studies provide dire warnings about the ways they would harm providers and patients.  

One study found that “[f]or hospitals, the introduction of a public plan that reimburses providers using Medicare rates would compound financial stresses they are already facing, potentially impacting access to care and provider quality.”  Another study found that government insurance systems such as “buy-in” or “public option” could force hospitals to limit the care they provide, produce significant “layoffs” and “potentially force the closure of essential hospitals.”

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