MACRA Implementation and the Road Ahead

Under Medicare for All proposals, it is assumed that insurance rates and copayments will be reduced to Medicare levels. Payments to Physicians will continue under Medicare rates, presumably relying on current reforms, such as MACRA, to help control the funding gap, with some kind of payroll or value added tax replacing premium payments, regulation of monopolistic hospital chains as public utilities, including negotiations to control both hospital and drug prices. Monopoly and monopsony power already control costs to increase profit to shareholders. Negotiation will aim to reduce these profit margins. Please see our attachment which excepts previous comments from last year on Medicare Advantage, including a more detailed exploration of Medicare for All.



 Attachment One – Hearing on the Medicare Advantage Program, Tuesday, May 8, 2018