Mayor Pete Buttigieg jumped into the Democratic presidential primary's most contentious issue with the release of his "Medicare for All Who Want It" outline. A particularly bold part of his health plan tackles a key issue largely avoided by the other candidates.
Buttigieg comes down firmly on former Vice President Joe Biden's side with a plan that closely resembles the one the front-runner released in July. Buttigieg's proposal would retain the private insurance market, create a public health insurance option with limited auto-enrollment, and boost subsidies for lower-income Americans.
One crucial difference--and not just with Biden's plan--is that Buttigieg's proposal explicitly calls out hospital and provider prices as a critical driver of health-care costs. His plan would cap out-of-network provider charges at double what Medicare would pay for the same service.
Out-of-control prices are an inevitable consequence of America's confusing mash-up of private employer coverage, public plans and individual insurance options. Fragmentation reduces negotiating power and makes it extremely difficult to bargain effectively with providers, especially as hospitals consolidate.
In addition to already inflated pricing and spending, there are countless individual examples of abusive pricing and behavior from providers.
Provider prices came up only a few times across five Democratic debates in which health care received sustained airtime. It's a touchy subject considering the large number of people employed by health providers and their relative popularity among voters.
Buttigieg's willingness to openly address the issue is a refreshing step forward in the health policy debate and boosts the appeal of his plan. His proposal would retain many of the current system's flaws, even with the addition of a public option. But the cap has the chance to improve matters substantially. On top of cutting outlier prices, it would bolster negotiating leverage for the public option and private plans by making it less lucrative for providers to refuse to join insurance networks. It could bring the cost of insurance and care down and expand access in a less disruptive manner.
The cost of such a plan and voter concerns about eliminating private coverage means it's not guaranteed to pass even if Democrats take back the White House and Senate. In that light, it's refreshing to have a more moderate alternative that at least acknowledges and attempts to tackle one of the health system's biggest issues.
Editorial on 09/23/2019