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Medicare Expansion in Democratic Candidate Debates Misses Point

Posted by Thomas Edwards on August 9, 2019 9:50 AM EDT
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Interesting "Other Views" op-ed piece by the former publisher of The Daily Press casts a conservative light......

...on the issue of Medicare for All topic that was heavily bantered about in the Democratic Presidential candidates debates a week or so ago.

Former publisher, Digby Solomon, who is a frequent contributor to op-ed pieces in The Virginian-Pilot, wrote an interesting opinion titled "Medicare's expansion will come with a cost".  It was published in the Other Views column on the editorial page in this past Wednesday's edition of The Virginian-Pilot.

Characteristically, the opinion again focused on the supply side, with a nod to the impact on healthcare system demand due to prices being lowered dramatically if a "Medicare for All" model were adopted or put into effect as all the Democratic candidates proposed.  Mr. Solomon argues the point that the impact in increased demand and volume into the American healthcare system would be untenable, citing common examples from the Canadian and UK healthcare systems' responses which have been to ration healthcare and to impose stiffer limits and judgments on allowable healthcare based on the concept of a system of gateway entities determining allowable care under the "moniker to ration called "limited clinical value".  

He further cites the impact in long wait times, citing:  "The strain on resources has led to increased wait times even for critical illnesses:  Nearly a quarter of cancer patients have to wait more than the recommended two months to begin treatment".  This argument, of course, has been cited many times by the opposing Republican or conservative perspective.  

Fear and uncertainty often drive lack of action.  

Make no mistake, I'm not in disagreement or in support of Digby Solomon's point of view.  Nor would I make the mistake of challenging him in a side debate.  In fact, I very much think his perspective is right.  Just as I suggest that the liberal view of a more centralized system may also we worth considering.  A "death panel" threat conjures up all sorts of images, most of which nobody wants to consider.

The point in my blog today isn't to case dispersions on Mr. Solomon's argument or to support the liberal view either.  What I do suggest, which we as a blogging trio has suggested on other occasions in this space, is that solving for improving the cost/quality/value dimension of the American healthcare system still ignores that fact that the American population is increasingly becoming more unhealthy.  And interestingly, many of the chronic illnesses that can be reduced are amongst the portion of the American population that benefits from government-sponsored or subsidized health insurance through Medicare, TriCare, Medicaid, etc.  

Until we build policies, programs and efforts tied to driving population health improvements that reduce demand on the American health care system, the problem will not be reduced.  Why can we as a people not see that rewarding healthy behavior, reductions in health care system claims and reinvesting the savings into more research is a better focus for the future?

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