In a conversation about value-based care and cost containment at the 2019 ForbesHealth Summit, 3 health executives agreed the policy Medicare-For-All jeopardizes the ability to provide healthcare for everyone
Panelists, Michael Dowling, President & Chief Executive Officer, Northwell Health, Laurie H. Glimcher, M.D., President & Chief Executive Officer, Dana-Farber Cancer Institute and Farzad Mostashari, Founder and CEO of Aledade described the financial gymnastics and negotiations needed to ensure privately and publicly-insured patients have equal access to care, particularly when up to 64% of revenues from public payers are non-negotiable.
Thus, Medicare-for-All would require uncomfortable tradeoffs society is not ready to address. The panelists also agreed scientific advancements have made us ‘victims of our success’ by extending life expectancy by up to 35 years and highlighted as the population ages it requires more costly medical interventions. In this scenario, how do we slow the growth of these costs of care and do no harm?
Furthermore, improving outcomes and long-term cost containment requires a focus on prevention and mechanisms to pay for these interventions. It is widely accepted across the health system that early disease detection can save both money and lives. However, the reimbursement structures are misaligned with a focus on prevention and as Mostashari noted, “No one is getting paid $20,000 for preventing a stroke,” which means Medicare-for-All makes a focus on prevention even less likely.
Mostashari went on to say, “It’s great to spend money on care when you need it but it’s best not to need it.” It’s a great sentiment but will require a solution that prioritizes prevention over illness while providing equal access to quality care. According to these experts, that solution won’t be Medicare-for-All.
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