Top ways Bernie Sanders would change the healthcare industry

April 29, 2016

Democratic presidential candidates Bernie Sanders and Hillary Clinton both vow to make healthcare more affordable, accessible, and higher quality. Here’s a closer look at two of the ways Sanders proposes to do this.

Democratic presidential candidates Bernie Sanders and Hillary Clinton both vow to make healthcare more affordable, accessible, and higher quality. Here’s a closer look at two of the ways Sanders proposes to do this.

1. Create a Medicare-like universal healthcare system

Sanders wants to create a Medicare-like universal healthcare system funded by federal and state governments, relieving employers of the responsibility to provide coverage. “All providers would be paid under a simplified payment system,” says James Smith, MBA, FACHE, executive vice president, GE Healthcare Camden Group, Rochester, New York. “This top-down strategy will require more investment and radical changes to healthcare and the health insurance economy.”

Joseph M. Mack, MPA, president, Joseph Mack & Associates, Dana Point, California, says Sanders’ universal healthcare proposal is the “most threatening” to payers of all candidate’s healthcare stances because it relies on a single-payer system.

“Participating states would be required to set up their own single-payer system and a national oversight board would establish an overall budget,” says Mack. “Under his plan, for-profit health insurance companies would only provide supplemental coverage.”

Some economists, as well as Sanders and Clinton, believe that individuals should be at the forefront of insurance purchasing and provider utilization decisions, rather than the existing employer-based system.

“However, pricing and rating of individuals delinked from insurance would be challenging under Sanders’ and Clinton’s plans,” Mack says. “Presumably, community ratings would be required, which would most likely result in higher premiums for individuals.”

Next: Enable the government to negotiate with pharmaceutical companies

 

2. Enable the government to negotiate with pharmaceutical companies

Sanders also vows to have an integrated system which would enable the U.S. government to negotiate fair prices with pharmaceutical companies for Americans collectively.

Sanders wants to reduce prescription drug prices, increase transparency of pricing, increase the cost-effective use of generic drugs, import lower cost drugs from Canada, and allow Medicare to negotiate drug prices with pharmaceutical companies, Mack says.

“Sanders would also require drug companies to publish the portion of their drug development expenses offset by tax credits or paid for by federal grants,” he says. “Implementation of Sanders’ proposals may assist health plans in refining their formularies, and in reducing pharmaceutical costs at least for commonly used drugs. It remains to be seen if costs for expensive, lesser used drugs would skyrocket higher as subsidies within the existing market are eliminated.”

Karen Appold is a medical writer in Lehigh Valley, Pennsylvania.