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.
President Donald Trump pledges to replace the Affordable Care Act while his Democratic opponent Joe Biden offers detailed proposals to improve it. Susan Jaffe reports from Washington, DC.
The USA stands alone as the only high-income country not to provide health care as a human right, leaving almost 80 million of its citizens without adequate insurance.1–3 In a 2020 study, we found that securing quality health care for the entire country would save 68 000 lives and 1·73 million life-years annually.4
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...
We commend the Editors for bringing to readers’ attention the “unfortunate distinction” of Canada's otherwise laudable publicly funded Medicare.1 The effects of this distinction on health, such as poor adherence, poor health outcomes, and avoidable hospital admissions, are well documented.2,3
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...
On March 3, 14 states will pick their nominees for the US presidential election. The feasability of a single payer insurance plan is a key issue. Susan Jaffe reports from Washington, DC.
The contest to secure the Democratic party nomination for President of the USA has brought health care to the forefront of public discourse, with much of the discussion dominated by the merits of Medicare for All, a comprehensive single-payer national health-care programme. The questions raised in this debate have brought a welcome focus on specific policy options for addressing the country's myriad health-care challenges. But largely missing has been the issue of social care, particularly th...
43% of US households report that at least one family member has a pre-existing medical condition, according to a survey released by Gallup on Dec 6, 2019. 49% of Americans (156 million people) receive health insurance through employers, and before the 2010 Affordable Care Act (ACA), a change of situation, such as losing or switching a job, would have allowed insurance companies to decline coverage or potentially make people uninsurable because of chronic health conditions. Although Democrats ...
Ischaemic heart disease has a multifactorial aetiology and can be prevented from developing in populations primordially, and in individuals at high risk by primary prevention. The primordial approach focuses on social determinants of health in populations: political, economic, and social factors, principally unplanned urbanisation, illiteracy, poverty, and working and living conditions. Implementation of the UN Sustainable Development Goals can lead to major improvements in cardiovascular hea...