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KHN’s ‘What The Health?’: Deciphering The Democrats’ Health Debate

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Twenty Democratic candidates for president debated health care at length over two nights in Detroit this week. But countless 30-second charges and countercharges from “Medicare for All” backers and those who want a more gradual approach to universal coverage may have left the audience more confused than ever about the best way to make the health system better and more affordable.

Meanwhile, the Trump administration sought to counterprogram against the debates, unveiling plans to allow states to potentially purchase cheaper prescription drugs from Canada and requiring hospitals to make public the prices they negotiate with insurers.

This week’s panelists are Julie Rovner from Kaiser Health News, Alice Ollstein of Politico, Kimberly Leonard of the Washington Examiner and Caitlin Owens of Axios.

Among the takeaways from this week’s podcast:

  • The Democratic presidential debate format has been good at exposing the differences among candidates on their plans to get more Americans health care. But there was little mention of other important health issues, including how they would protect the Affordable Care Act’s requirement that insurers cover people with medical problems, lower drug prices or handle state requests to implement work requirements for Medicaid enrollees.
  • Debaters were quick to talk about problems they see stemming from the way insurers and drugmakers operate, but they did not touch on another major player in setting health care costs: hospitals.
  • Sen. Kamala Harris of California, a leading Democratic presidential candidate, unveiled her plan for a Medicare for All health system this week and endorsed the use of private Medicare Advantage plans. But Sen. Bernie Sanders (I-Vt.), another contender and the original author of a Medicare for All plan, complained that Medicare has been a lucrative part of the business for those private insurers and that they should not be included in Democratic efforts to set up a single-payer Medicare system.
  • Harris’ plan was also criticized by more moderate Democrats because it would require everyone with employer-provided insurance to change to either Medicare or a Medicare Advantage plan.
  • Recent announcements by the Trump administration on new health care policies, such as the option for states to explore importing drugs from Canada or forcing hospitals to post the prices they have negotiated with insurers, appear to be an effort to give the president a stronger health portfolio as he goes into the 2020 campaign.

Plus, for extra credit, the panelists recommend their favorite health policy stories of the week they think you should read too:

Julie Rovner: The Washington Post’s “Driven to the end: Olympic cyclist Kelly Catlin could do it all. Until it all became too much,” by Kent Babb.

Alice Ollstein: The New York Times’ “Need Extra Time on Tests? It Helps to Have Cash,” by Dana Goldstein and Jugal K. Patel.

Kimberly Leonard: The San Francisco Chronicle’s “One Day, One City, No Relief: 24 hours inside San Francisco’s crisis,” by Kevin Fagan and Chronicle Staff.

Caitlin Owens: Bloomberg News’ “Drugmakers’ Alleged Price-Fixing Pushed a Needed Pill Out of Reach,” by Ben Elgin.

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