I am a British author and neurologist from New York, and was intrigued by Galvani et al.1 While I congratulate the authors on being alone with us in asserting that Medicare-based universal plans can save money, 2,3 nevertheless this timely study has problems.
Cost estimates of Medicare-for-All by Democratic leaders assume current Medicare costs for all, and are therefore inherently ludicrous. Medicare covers older, sicker Americans, whereas any universal plan would include the young and healthy.
According to Galvani, savings of $188 billion would accrue from reduced payments to hospitals and doctors. This is misplaced and unnecessary. Medicare payments are barely 50% of those under President Clinton, after adjusting for inflation. Experienced physicians are fleeing the profession, junior physicians are struggling with student debt, and 45% of still-practicing physicians have endured burnout. In 2017, the Association of American Medical Colleges projected physician shortages of 90,000. Any plan that does not address this will worsen matters.
Last year we advanced an employer-funded, Medicare-based plan, which would reduce annual costs by $1 trillion, far more than Galvani. It would not require large tax increases, would save corporations $174 billion, would leave hospitals deficit neutral, yet would allow fair compensation for doctors.2,3 We would practically eliminate bureaucracy, and force pharmaceutical corporations to negotiate prices. The total cost would be 13% of GDP, slightly more than Switzerland.
Universal coverage, lower costs, increased competition, improved physician morale. A seamless system applicable anywhere in the world.
- Galvani AP, Parpia AS, Singer BH, Fitzpatrick MC, Improving the prognosis of health care in the USA, Lancet 2020;395:524-33.
- Eichhorn E, Hutchinson M, Why Medicare-for-All is Not Good for America. US News and World Report, Commentary, April 26th 2019.
- Healing American Healthcare: A plan to provide quality care for all, while saving $1 trillion, Edward Eichhorn and Michael Hutchinson, Book Baby, 2019