We’re almost done with the 2020 presidential election! Jeremy Schupbach, Proactive MD’s National Director of Strategy and Government Relations, once again breaks down three things to know about healthcare and the elections before we wrap up this election cycle.

1. Just how different are the two-party healthcare platforms?

From a philosophical point of view, the two parties have similar goals. As mentioned in last week’s post, there is a lot of overlap, particularly in addressing prescription drug pricing, tackling surprise billing, and getting coverage to more Americans.

But if the goals are similar, the approaches are far apart.

The Democratic plan proposed by many candidates—most notably Bernie Sanders—revolves around community-oriented solutions and building on Medicaid, Medicare, and some aspects of other state plans. The Medicare for All proposal has garnered a great deal of attention and, depending on the outcome of the election, Democrats are expected put forward a plan to move in this direction. Vice President Biden has so far not been willing to go as far as others in his party, but under his administration we do expect to see policy shifts that give more control to government—either state or federal—entities.

The Republican plan is aimed at replacing the Affordable Care Act with a new, more individualized plan. Most of the discussion concerns securing and maintaining coverage for people with pre-existing conditions. This approach is based on individual choice, with more options for families and employees. However, the plan is sparse on details. A comprehensive plan has not been presented as part of the party platform, although politicians have discussed a series of patches and fixes for key elements of the healthcare system such as price transparency or prescription drug pricing. While this would begin to unwind the mess that is health care as it stands, it has been a hard sell for Republican candidates on the 2020 campaign trail.

2. What does “Medicare for All” mean?

Generally, it means that everyone in America has some form of health coverage though the government. That’s a pretty big idea for ensuring health care coverage for many more people, but the methods for achieving this vary significantly.

Today Medicare covers many services, from the routine care to expensive surgery and high-cost prescription drugs. Medicare for All in any form would require taxes to fund the program, and a huge expansion of covered lives mean the plan would be extraordinarily expensive. A “Medicare for All” solution would require someone (likely the federal government) to create plans for coverage that would ration care and balance covered services and options against the ability to pay for it. Whether this would lead to an individual premium (not unlike today’s health plans) or tax increases is an important question. For Medicare for All coverage and those proposing it, the question of how to secure funding, maintain services, and make it all affordable is the critical question.

3. What is the difference between patient-centered care versus consumer-driven coverage?

The truth is they can be highly complementary under the right plan. Patient-centered care is about providing care that is respectful of and responsive to individual patient preferences, needs, and values, and ensuring that patient values guide all clinical decisions. It puts the patient first. At Proactive MD, this is the heart of our patient promise and what drives us to improve, innovate, and invest into our patients and communities.

A consumer-driven health plan is a health insurance plan that allows employers, employees, or both to set aside pretax money to help pay for qualified medical expenses not covered by their health plan. This approach requires a true partnership between individuals and their healthcare providers, one where the individual’s needs and aspirations drive both healthcare decisions and how outcomes are measured. Patient-centered care and consumer-driven coverage can provide the best partnership for patients seeking the best outcomes, doctors, nurses, and health centers who know patients and the financial tools to buy (often within their employer sponsored plan) the coverage their families need.

Regardless of the source of funding, everyone needs access to high-quality care. Solving the payment elements of healthcare is just one part of fixing our broken system. For more information about comprehensive patient-centered care, contact us at Proactive MD—we’d be glad to tell you how we always fight for our patients’ greatest good!