This story additionally ran on USA Today. This story will be republished at no cost (details).
If you tuned in for the primary 5 nights of the Democratic presidential debates, you may suppose “Medicare for All” and offering common care are the one well being care concepts Democrats have.
With 4 months to go earlier than the Feb. three Iowa caucuses, proposals on points just like the opioid epidemic have attracted much less consideration.
That is as a result of big-ticket coverage concepts ― like enrolling all U.S. residents right into a Medicare-style program and eliminating personal insurance coverage ― might help candidates stand out within the eyes of voters throughout a major, stated Robert Blendon, a professor of well being coverage and political evaluation at Harvard University and director of the Harvard Opinion Research Program.
But Blendon stated he has not seen polling suggesting voters have an urge for food for one more main well being care debate. Voters are extra involved with how a lot they need to pay for medical care, like prescribed drugs ― “very practical, pocketbook issues,” he stated.
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“So it’s just my belief that whoever wins is going to have to switch back to pocketbook issues,” Blendon stated of the eventual Democratic nominee.
A brand new ballot echoes that. Democratic voters are keen to listen to extra from the candidates about different well being care points, in response to a Kaiser Family Foundation poll launched Tuesday. The outcomes present 58% of Democrats and Democratic-leaning independents imagine the candidates aren’t spending sufficient time speaking about girls’s well being, together with entry to reproductive well being providers, as an illustration. And greater than half stated the candidates have been spending too little time discussing shock medical payments and methods to decrease the prices folks pay for care. (KHN is an editorially unbiased program of the muse.)
The subsequent Democratic presidential debate on Oct. 15 will give 12 of the candidates a contemporary likelihood to speak about their concepts past sprawling well being care reform. Let us stroll you thru a couple of proposals they’ve championed, plus what President Donald Trump is providing.
Sanders’ Plan To Cancel Medical Debt
Sen. Bernie Sanders of Vermont rolled out a sweeping proposal final month to overtake medical debt assortment with a headline-catching promise: to wipe clear the roughly $81 billion Americans owe in past-due medical debt.
And the difficulty is ubiquitous since polls present voters are deeply involved about their out-of-pocket prices. Raymond Kluender, an assistant professor at Harvard Business School who researches medical debt, stated about 20% of households have medical payments in collections.
Kluender stated Sanders’ plan targets debt that’s not often repaid anyway, noting that solely about Eight% of what’s despatched to assortment companies is ever repaid. Although some restricted analysis suggests debt forgiveness could have psychological well being advantages, Kluender stated, the impact Sanders’ transfer would have “is hard to know.”
Here are highlights of Sanders’ proposal:
Empower the federal authorities to barter, then repay past-due medical payments which have been reported to the credit score companies. To calculate how a lot that debt is, the Sanders marketing campaign factors to a 2018 study that confirmed 1 in each 6 Americans has a past-due medical invoice on their credit score report, with debt totaling about $81 billion. Curb “abusive and harassing” debt assortment ways, together with imposing statutes of limitation that typically run from three to 6 years, relying on the state; limiting how typically debt collectors can contact those that owe; requiring debt collectors to confirm whether or not the knowledge they’ve is correct earlier than making an attempt to gather; limiting the seizures of property and garnishing of wages. Task the Internal Revenue Service with inspecting nonprofit hospitals to make sure they meet the “charitable care standards” for services with nonprofit tax standing. Reform the chapter courtroom system to assist these in debt.
Biden’s Plan To Curb Gun Violence
Former Vice President Joe Biden introduced a plan this month to scale back gun violence, a problem that has grow to be a must for most Democratic voters.
In addition to outlining his proposal to ban the manufacture and sale of assault weapons and require common background checks, Biden took the chance to speak about his legislative historical past on weapons: In 1993, he helped move the regulation that established the background test system, and in 1994, he helped safe the 10-year assault weapons ban that has since lapsed.
He additionally drew consideration to his newer concepts to alter the system, together with a push towards transitioning to “smart guns.”
But Biden’s plan doesn’t go so far as that of a few of his opponents ― together with Sen. Cory Booker (N.J.), who would require a license to personal a firearm.
Here is what Biden has said he would do on gun control:
Ban the manufacture and sale of assault weapons and high-capacity magazines, and in any other case regulate and purchase again present weapons. Require background checks for all gross sales, and shut sure loopholes, together with those who enable folks with psychological well being points and hate crime convictions to have firearms. Reward states that arrange firearm licensing packages, require house owners to securely retailer their weapons, and crack down on “straw purchasers” who purchase firearms for many who can’t move a background test.
Buttigieg’s Plan To Strengthen Mental Health Care
Mayor Pete Buttigieg of South Bend, Ind., launched a wide-ranging, $300 billion proposal in August to enhance therapy for psychological well being and substance abuse.
Few disagree on the necessity to enhance entry to psychological well being care within the United States, making the difficulty one that’s unlikely to maneuver voters by itself, Blendon stated. But Buttigieg’s plan stands out for tripling the investments proposed by different Democratic candidates, together with Massachusetts Sen. Elizabeth Warren.
True to his mayoral roots, Buttigieg adopts a regionally pushed method. Among different methods in his 19-page plan, he would give communities “most affected” by psychological sickness and dependancy $10 billion yearly for 10 years to handle prevention and care.
His marketing campaign claims the plan would allow about 10 million extra folks to entry care over the primary 4 years of this system. Here are some methods Buttigieg stated he would do this:
Enforce psychological well being parity in protection, together with beneath Medicare and Medicaid. Expand entry to dependancy therapies, together with by deregulating buprenorphine, a medication-assisted therapy confirmed efficient for opioid use dysfunction. Reduce associated incarceration, partly by decriminalizing all drug possession and expunging previous convictions. Hold drug firms “accountable” for his or her position within the opioid epidemic, together with by supporting state-level lawsuits. “Combat the epidemic of social isolation and loneliness,” together with via a nationwide service program that will pair older and youthful Americans.
Warren’s Plan To End The Opioid Crisis
Warren unveiled an aggressive plan to fight the nationwide opioid epidemic final spring, proposing to unfold $100 billion throughout the nation to assist state, native and tribal governments reply to the disaster.
And not like Buttigieg and his $300 billion psychological well being and dependancy plan, Warren outlined how she would pay for it ― with a tax on the richest 75,000 households.
“This crisis has been driven by greed, pure and simple,” she wrote in a Medium post detailing her plan.
Here is a few of what her plan would do:
Prioritize and allocate cash for public well being departments, first responders and others in “front-line” communities. Give states incentives to cowl dependancy providers via state Medicaid packages. Expand surveillance, analysis and entry to therapy, together with naloxone, the overdose reversal drug.
Trump’s Efforts On Medicare, Public Health And Drug Price
President Donald Trump triggered a stir this yr when he declared the Republican Party would grow to be “the party of health care” and recommended he was engaged on one other proposal to interchange the Affordable Care Act.
But he has stated little on the topic since then, and a Washington Post report last month said the White House has deserted that effort in favor of harm management ought to the fifth Circuit Court of Appeals strike down the Affordable Care Act.
Instead, the Trump administration has picked up on a sequence of typically disparate well being points, together with modifications to how the federal government pays for care, investments in public well being crises and steps meant to strain drugmakers to decrease costs.
One of his newest strikes got here on Oct. three, when Trump signed an executive order making a wide range of modifications to Medicare, together with increasing the personal Medicare Advantage plans accessible to seniors and altering the enrollment course of. He took the chance to pan the progressive push towards a single-payer well being care system as “socialist,” framing his modifications as protections for seniors.
In addition to an ambitious plan to end HIV/AIDS introduced in February, the Trump administration unveiled a kidney care initiative in July that adjusts cost incentives to encourage preventive care, residence dialysis and transplants. And final month, the administration stated it was getting ready to ban the sale of flavored e-cigarettes amid a public well being scare over vaping and considerations about widespread use amongst teenagers.
And after promising to decrease drug costs, Trump has struggled to make changes amid disagreements with the pharmaceutical trade and even fellow Republicans.
The administration has tasked the Department of Health and Human Services to work on different insurance policies, together with requiring hospitals to reveal costs and laying out a framework to permit, for the primary time, the authorized importation of prescribed drugs from abroad.
This story additionally ran on USA Today. This story will be republished at no cost (details).
Emmarie Huetteman: ehuetteman@kff.org”>ehuetteman@kff.org, @emmarieDC
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