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Podcast: KHN’s ‘What The Health?’ ‘Medicare-For-All’ Debate: Who’s Going To Pay

House Democrats, led by Rep. Pramila Jayapal (D-Wash.), have formally introduced their “Medicare-for-all” legislation. The bill, which would ensure coverage for almost every medical service most people need, did not come with any suggestions for financing. But it will likely reflect the far-left end of the Democratic debate in progress.

Meanwhile, the CEOs of seven of the largest pharmaceutical companies testified before the Senate Finance Committee, where both Democrats and Republicans decried the high cost of drugs but did not specifically say what they plan to do about it.

And the Trump administration has issued final regulations intended to evict Planned Parenthood from the federal Title X family planning program. But advocates and state officials are readying lawsuits to stop the new rules.

This week’s panelists are Julie Rovner of Kaiser Health News, Margot Sanger-Katz of The New York Times, Paige Winfield Cunningham of The Washington Post and Jennifer Haberkorn of the Los Angeles Times.

Among the takeaways from this week’s podcast:

  • In addition to major changes in coverage for Americans, the “Medicare-for-all” bill introduced in the House this week would fundamentally alter how hospitals are paid. The new system would likely give hospitals a set payment for the year to handle all their costs, and administrators would need to make that work.
  • One of the biggest changes for consumers under that House bill would be adding long-term care expenses to the government coverage. Under the current system, Medicare does not pay for most long-term care and Medicaid covers it only if patients have expended most of their resources.
  • The hearing this week with CEOs of major drug manufacturers did not produce many of the anticipated fireworks. Senators seemed to shy away from the tough questioning seen in earlier hearings, as in the 1990s when tobacco executives were called before Congress.
  • Surprisingly, the Trump administration’s proposal to set U.S. drug prices in line with what people pay in foreign countries did not come up at the Finance Committee hearing. That effort puts Republican lawmakers in a difficult position, because they have a long history of opposition to the government being in a position to set prices on goods.
  • If Planned Parenthood clinics are pushed out of Title X, other providers may move in to help meet the needs of women. But that could take years in some cases. In the meantime, women would likely be without services, and unintended pregnancies could increase.
  • Planned Parenthood still gets the bulk of its federal funding through state Medicaid programs, and the changes to Title X would not affect that. Nonetheless, some conservative states are mounting challenges to that funding, too, and those fights are expected to move slowly through the court system.

Also this week, Rovner interviews KHN senior correspondent Julie Appleby, who investigated and wrote the latest “Bill of the Month” feature for Kaiser Health News and NPR. It’s about a wildlife biologist who was bitten by a feral cat — and got a big bill for a rabies shot. You can read the story here.

If you have a medical bill you would like NPR and KHN to investigate, you can submit it here.

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

Julie Rovner: Kaiser Health News’ “Talk About Déjà Vu: Senators Set To Re-Enact Drug Price Hearing Of 60 Years Ago,” by Jay Hancock

Margot Sanger-Katz: The Washington Post’s “Anti-Vaxxers Face Backlash as Measles Cases Surge,” by Lena Sun, and The New York Times’ “After a Debacle, How California Became a Role Model on Measles,” by Emily Oster and Geoffrey Kocks

Paige Winfield Cunningham: Kaiser Health News’ “Cancer’s Complications: Confusing Bills, Maddening Errors And Endless Phone Calls,” by Anna Gorman

Jennifer Haberkorn: The New York Times’ “Build Your Own ‘Medicare for All’ Plan. Beware: There Are Tough Choices,” by Austin Frakt and Aaron E. Carroll

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