December 28, 2019 | Updates

THE WEEKLY SCAN: Key Stories In The Debate On America’s Health Care Future

Good Friday afternoon, and welcome to the Weekly Scan.  Here are some of the key stories you may have missed in the debate on America’s health care future:

new letter from the nonpartisan Congressional Budget Office (CBO) reiterated the unaffordable costs and negative consequences American families would face under a new government-controlled health insurance system.  Key findings from the CBO include: 

  • “If coverage was nearly universal, cost sharing was very limited, and the payment rates were reduced compared with current law, the demand for medical care would probably exceed the supply of care – with increased wait times for appointments or elective surgeries, greater wait times at doctors’ offices and other medical facilities, or the need to travel greater distances to receive medical care.  Some demand for care might be unmet … Without sufficient investment over the long term, wait times could lengthen as providers’ costs rise with other costs in the economy and the population grows.”
  • “The transfer of ownership from private to public might be disruptive to the daily operation of hospitals … Such disruption might negatively impact the quality of care for patients.”
  • “If all hospitals were paid 100 percent of Medicare fee-for-service rates, some would close unprofitable departments or close entirely, and fewer new hospitals would be built in the future, reducing access to care.”
  • “Less spending on medical services could also alter manufacturers’ incentive to develop new technologies or providers’ incentive to invest in capital, which could affect patients’ choices over the longer term.”
  • “A potential treatment that a doctor deems reasonable might not be covered by a single-payer system.”
  • “Under a single-payer system that eliminated private insurance entirely … patients would not have a choice of insurer or benefits, and those standardized benefits might not meet the needs of some people.  For example, certain specialty drugs or expensive new treatments, such as gene therapy, might not be covered under a single-payer system.”
  • “If a single-payer system had little or no cost sharing, the demand for physicians’ services would tend to rise.  If payment rates were reduced, on average, the supply of care from physicians would tend to fall.  Both of those factors would contribute to a shortage of physicians in the United States.”
  • “ … [I]f there was little or no cost sharing and payment rates were substantially lower than what providers would receive under current law, CBO expects that average wait times would increase.”

Meanwhile, another new report from POLITICO found that a “[r]ecord number of rural hospitals closed in 2019.”  The report finds that “[n]ineteen rural hospitals had closed as of Dec. 22 – a new record since 17 hospitals closed in 2015 … Nationwide, 21 percent of all rural hospitals face significant financial distress are at a high risk of closing.”  Studies have shown that new government-controlled health insurance system could exacerbate this crisis.

  • study conducted by Navigant for the Partnership finds that the public option could put more than 1,000 rural U.S. hospitals in 46 states “at high risk of closure.”  These hospitals serve more than 60 million Americans, and as Kaiser Health News and NPR reporthospital closures can have “profound social, emotional and medical consequences,” while RevCycleIntelligence also reports“[p]atient access to care suffers when a rural hospital closes its doors for good, and consequently, patient outcomes can deteriorate.”
  • And experts are also growing increasingly worried about the “violent upheaval” a Medicare for All system would cause for hospitals.  “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,” The New York Times reports.



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