Higher Wages for Workers; Trump’s Inadequate Insulin Plan; ‘Retrospective Denial’ Scam
Public Citizen Has You Covered
Welcome to this week’s edition of “We’ve Got You Covered,” a weekly tipsheet designed to highlight key news about Medicare for All and call out the biggest health care industry lies and falsehoods about universal health care. Please send tips, feedback and questions to Mike Stankiewicz at mstankiewicz@citizen.org or (202) 588-7779.
‘RETROSPECTIVE DENIAL’
Health insurers are progressively scamming patients into paying more out-of-pocket costs by revoking preapproved tests.
In a USA Today article, Darla Markley of Beloit, Wis., describes how her insurer preapproved several medical tests before revoking approval after the services were completed.
The practice is known as “retrospective denial” and there is little that patients can do, because legally they are still on the hook for these medical bills.
“I feel for anyone that finds themselves in that predicament,” said Markley. “You can go from an upstanding middle-class American citizen to completely under the eight ball.”
Retrospective denial is a creation of the for-profit insurance industry to scam more out-of-pocket dollars from patients. Under Medicare for All, no patient would face out-of-pocket medical costs or be susceptible to scams like these.
MEDICARE FOR ALL MEANS HIGHER WAGES
Increasing evidence is showing that Medicare for All would lead to higher wages for workers and that insurance premiums function basically like a tax.
In 2019, employer coverage per worker cost $7,188, with employees directly contributing 18% on average. Family coverage in 2019 cost $20,576, of which employees paid 30%, according to the New York Times. Under Medicare for All, workers no longer would have to pay these hidden “taxes.”
“While employers pay a large share of insurance premiums, workers are actually paying the entire thing through a reduction in their take-home pay,” Gabriel Zucman, an economics professor at the University of California, Berkeley, said on a November 2019 telephone press call hosted by Public Citizen. “With Medicare for All, these premium ‘taxes’ will no longer be hidden from workers, and Americans will know exactly where their money is going.”
TRUMP’S INADEQUATE INSULIN COST PROPOSAL
The Trump administration is working on a proposal to reduce insulin costs, but it’s unlikely to force prescription corporations to meaningfully lower prices.
While many details of the plan are unknown, reportedly the idea is to provide incentives to insurers to offer plans with lower out-of-pocket insulin costs. This proposal only would tinker around the edges of reducing drug costs, while Medicare drug price negotiation under Medicare for All would have saved patients $4.4 billion on insulin in 2017 alone.
“If he was serious about getting tough on Big Pharma , he would ‘negotiate like crazy,’ enthusiastically support other legislation to rein in the pharmaceutical industry and challenge monopolies, which would lower costs dramatically for patients,” said Steven Knievel, advocate for Public Citizen’s Access to Medicines program.
REMINDER: Despite corporate spin, Medicare for All would reduce overall health care costs. Our health care spending is estimated to continue rising and will reach nearly $6 trillion a year by 2027, meaning we will spend around $47 trillion on health care over the next decade if we maintain the status quo.
A study from the Political Economy Research Institute (PERI) at the University of Massachusetts Amherst found the U.S. could reduce total health spending over a 10-year period by more than $5 trillion under Medicare for All. PERI found that Medicare for All spending would be approximately $37.8 trillion from 2017 to 2026, compared with the government estimates of the current U.S. health care system costing $42.9 trillion during that same period.
To speak with a Medicare for All policy expert, or if you have questions about Public Citizen’s work, please contact Mike Stankiewicz, mstankiewicz@citizen.org, (202) 588-7779.