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It is not clear whether hospitals would be able to adapt to significantly lower payments.
"This would force health systems to adopt a very serious diet," said Stuart Altman, professor of health policy at Brandeis University. "I have no idea what would happen. No one else either.
But developers should not expect to save as much money as they hoped they would reduce hospitalization payments. Some hospitals could replace their missing revenues by charging more for the same care or by ordering more tests and billable procedures, said Dr. Stephen Klasko, General Manager of Jefferson Health. "You will be surprised," he says.
While the Medicare for-all bill introduced by Rep. Pramila Jayapal, Democrat of Washington, and the Sanders bill advocated a government-run insurance program, Jayapal's proposal would replace existing Medicare payments with a new one. new system of regional budgets.
"We have to change not only who pays the bill, but also how we pay for it," said Dr. Gaffney, who advised Ms. Jayapal on her proposal.
Hospitals would be able to make substantial savings by reducing administrative costs, which is a byproduct of a system that runs several insurance companies, said Dr. Gaffney. Under the Jayapal bill, hospitals would no longer be paid above their costs and the money for new equipment and other investments would come from a separate fund.
But the Sanders bill, backed by some Democratic presidential candidates, including Senators Kirsten Gillibrand of New York, Cory Booker of New Jersey, Elizabeth Warren of Massachusetts and Kamala Harris of California, no. not consider a brand new payment system, but an extension of the payment system. existing health insurance program. Payments would be largely based on what Medicare currently pays to hospitals.
Some Democrats have also proposed more progressive plans. Some would like to expand Medicare to cover people over 50, while others would not abolish private health insurance, including those that now offer Medicare.
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