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작성자 Minna Rubinstei… 댓글 0건 조회 10회 작성일 24-11-06 09:31본문
Though it has not been made accessible on Buttigieg’s website, the marketing campaign has shared with us and several press outlets a set of recommendations that it estimates would save Medicare almost $300 billion via 2029.78 Specifically, Buttigieg would enact site-neutral funds so hospitals are paid the identical as physician clinics for comparable providers, scale back funds for put up-acute care, decrease funds to hospitals that make use of medical residents and interns (graduate medical training), and work to cut back hostile hospital occasions corresponding to hospital-acquired infections.79 Most of those policies have been proposed on a bipartisan basis to reduce the prices of traditional Medicare. Our estimate represents a starting point, earlier than proposed changes (analyzed in the following part). Methodological notice: Our low-price estimate relies on the Berwick & Johnson estimates cited by the marketing campaign, although reported figures differ as a consequence of completely different finances home windows and measurement baselines used.95 Our central estimate represents our best projections of the proposals, and our high-price estimate adjusts the prices based on the potential viability of the proposals. However, the proposals might prove unachievable or unsustainable on prime of the substantial cuts medical suppliers would already expertise underneath Medicare for All. Buttigieg has a variety of proposals to scale back different non-drug costs exterior of Medicare.
These proposals would save a mixed $2.5 trillion over a decade if implemented as proposed. We estimate these proposals would possible generate between $13.1 trillion and $15.Three trillion over a decade, with a central estimate of $14.2 trillion. We estimate these measures would obtain $2 trillion to $6.1 trillion of financial savings over a decade, with our central estimate discovering $4.7 trillion of financial savings. Our low-price estimate of $3.Four trillion in savings relies on Berwick & Johnson. Warren argues that her plan would sluggish well being care value development to the nominal charge of economic progress - reducing annual health care value development from above 5 p.c underneath current law and 4.4 p.c under our central estimate of her plan to about 3.9 % per year. 110 % of a global average value index (H.R. On prime of these packages, she would guarantee that all hospitals are paid at a mean of one hundred ten % of Medicare rates, require states to contribute to the program instead of their current Medicaid spending, and increase rural health-related investments. Warren proposes to alleviate this concern by paying hospitals at a median of a hundred and ten p.c of present Medicare rates, with greater payments for main care in addition to rural and teaching hospitals and lower funds for hospitals with increased margins and "overpaid specialists." Relative to the bottom estimate, this proposal would value about $1.2 trillion over a decade.93 Importantly, it is possible hospitals would be unable to remain solvent at payments of solely one hundred ten % of Medicare charges, that are significantly below what they at the moment cost within the personal sector.
To cut back the federal prices related to Medicare for All, Warren would require states to pay the federal government the same quantity they in any other case would have paid for Medicaid and CHIP via a "Maintenance of Effort" payment. All U.S. residents can be mechanically enrolled in Medicare for All, which would cover ordinary medical care as well as dental, imaginative and prescient, hearing, and mental well being services. In order to scale back that value differential and enhance the leverage of insurance firms attempting to carry suppliers into their networks, Buttigieg would prohibit suppliers from charging more than twice Medicare rates for out-of-network companies. On common, well being care suppliers cost significantly extra to private insurance companies than they do to Medicare, notably for out-of-network services the place insurance firms have little leverage. She would enforce this negotiation and improve the government’s leverage via a big tax penalty for non-compliance and a process for compulsory licensing and/or public manufacturing as a backstop. Based on press studies and discussions with the campaign, we perceive this coverage to imply growing the corporate tax rate from 21 p.c to 35 percent while retaining other modifications to the corporate code, including the base broadening enacted beneath the Tax Cuts and Jobs Act of 2017 (TCJA).
Specifically, she would reauthorize and enhance funding for Community Health Centers (CHCs) by 15 percent per 12 months over five years, implement a $25 billion capital fund for areas with well being worker shortages, improve residencies for rural and underserved communities, and expand academic loan repayment plans for well being workers. Senator Warren has proposed changing the present mixture of public and personal financing of health care with a Medicare for All single-payer system where the federal government finances virtually the total price of well being care and presents a brand new long-term care program. It assumes drug prices stay at current levels, supplier payments are set to Medicare ranges (significantly under cost rates supplied by non-public insurance coverage), and administrative costs total 4.5 p.c.Ninety Our low-cost estimate of $27 trillion assumes administrative costs of 2.Three % as Warren says she would set, whereas our high-price estimate of $30 trillion relies on Urban’s assumption of 6.Zero percent administrative costs. " We interpret this policy to mean that if well being care spending growth exceeds 3.9 % in a given 12 months (adjusted for timing shifts), payments to suppliers can be cut for future years.
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