[Correspondence] The effect of Medicare for All on rural hospitals

Alison Galvani and colleagues1 robustly modelled the effect of the Medicare for All Act on US national health expenditures and outcomes. Spending on hospital care and physician or clinical services accounts for 53% of total spending. Their model assumes that Medicare rates are uniformly 22% lower than are private-payer rates and that, by switching all fees to Medicare rates, overall reimbursements will be 6% lower for hospitals and 7% lower for physicians.

[Correspondence] The Global Kidney Exchange programme – Authors’ reply

Marta López-Fraga and Beatriz Domínguez-Gil make their point about our Health Policy on the ethics of the Global Kidney Exchange (GKE) programme1 by asking us to imagine that Alyson, an Ohio farmer, is willing to donate a kidney to her daughter but unable to afford the surgery. Medicare pays for kidney transplantation surgery in the USA, even for people younger than 65 years, so there is no way in which GKE could prevent Alyson's daughter from receiving a kidney from her mother. Kidney transp...

[Correspondence] Rebuilding the broken health contract in Chile

Many Chileans think that their country has lost its way. Massive protests highlight the need for a political reform to prioritise universal health care. The uncritical worship of the most extreme version of the free market by the Pinochet dictatorship led to the dismantling of the social contract and privatisation of the social security system. A system of personal retirement accounts was mandatory for new workers whereas the current workforce could opt out from the existing government-manage...