Everybody’s talking about “Medicare for All.”
Bernie Sanders and other leading national Democrats have embraced, in varying degrees, the proposed single-payer national health insurance system—new South Orange County Congresswoman Katie Porter ran and won election last November while backing the idea.
But despite the talk, most industry watchers don’t expect it to happen anytime soon.
On the other hand, something’s gotta give because people are fed up with the status quo.
Those were among the takeaways for some 150 employer and insurance reps attending Fountain Valley-based MemorialCare Health System’s annual conference on March 8 at the Westin South Coast Plaza in Costa Mesa.
MemorialCare Chief Executive Barry Arbuckle—who oversees five area hospitals that bring in close to $3 billion in revenue—and University of California-Berkeley health economist James Robinson said some sort of government takeover of the healthcare system is unrealistic, at least for the foreseeable future.
However, they said the popular anger fueling the idea is real.
The proposal largely serves as “a vote of no confidence, a wake-up call that we can’t just continue down this path of higher deductibles and more people falling off the bandwagon,” Robinson said.
The catch, he said, is that “everybody loves Medicare for All until someone adds up the tax implications.”
Other Options
The duo were pressed at the event to come up with a more likely scenario than Medicare for All.
“I think that where we’re gonna go in California and then in the United States if the Democrats take the White House in a couple of years, is completing the ACA [Affordable Care Act, or Obamacare], filling in the remaining holes,” Robinson said.
That’s a plan—incremental moves to shore up the ACA—which has been tacitly endorsed by House Speaker Nancy Pelosi.
How to do it? “Things that don’t require a big in-your-face tax increase,” Robinson said. Not through Medicare expansion, but Medicaid: “There’s still a lot of running room for that. I think we added 4 million people to Medi-Cal because of Obamacare, that’s more people that live in most states.”
He also suggested expansion of the California Care model of government-subsidized insurance for individuals.
Rather than Medicare for All, Arbuckle said we could see Medicare for “more,” through a lowering of the eligibility age to something like 55. This is “the exact opposite of what many of us have talked about for years,” which is a plan to gradually raise the Medicare eligibility age.
The prior aim to increase the eligibility age was because “people are living longer, working longer.” But now, Arbuckle said, “I think it’s just a frustration where people are wanting to push off their healthcare expenses to somebody else.”
Is the healthcare system headed for a collapse? Robinson said no.
“One of the favorite lines of economists is, ‘Unsustainable trends shall not be sustained’ … but I’m not sure that’s true in healthcare. This is just going on and on,” Robinson said with a smile and to nervous laughter from the audience.
“I’m generally optimistic, I think we will find a way,” Arbuckle said.
Cost Cutting
Arbuckle also discussed his group’s efforts to hold down medical costs.
One example: Duexis, an arthritis medication made by Chicago-based, Ireland-registered Horizon Pharma PLC.
He called it “shameful” that Duexis, “a combination of two old drugs, the generic equivalents of Motrin and Pepcid,” costs about $1,500 a month when the two generics prescribed separately cost no more than $40.
He said MemorialCare nurses and doctors worked with pharmacists on “lower-cost alternatives that are just as effective” as Duexis and cut prescription costs by nearly $500,000 in one year.
