Health Care Spending and 'Medicare for All'

Special Guests: Robert L. Bixby, Joshua Gordon

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Concord Coalition Executive Director Robert L. Bixby and Policy Director Joshua Gordon joined the latest Facing the Future to discuss the nation’s health care system and “Medicare for All” proposals.

“There’s probably no bigger challenge for the federal budget than health care costs, primarily through Medicare and Medicaid,” Bixby said. “You wrap all of the federal health care programs together, and factor in that they tend to grow faster than the economy . . . and the fact that there are increased beneficiaries . . . this is really the driving force on the spending side of our long-term fiscal challenge.”

Gordon said, “Cost growth is really the big issue for the United States and health care overall.”

“The health care sector in the United States is projected to grow from one-sixth of the entire economy to one-fifth of the entire economy — just over the next 10 years,” he said. “The reason for that inflation is very varied.”

Gordon said that our country is uniquely inefficient in translating health care spending into better health care outcomes.

“That basic problem is why you hear a lot of talk about having really major changes to health care in the United States,” he added. “When we talk about overall savings and cost control, it really is more than just administrative efficiency, it’s the broader efficiency; ‘Are we getting what we pay for?’”

Bixby said a broader conversation about health care costs, and what’s driving them, is missing from the national conversation right now. He would like to hear a less political conversation about realistic options to reduce cost growth.

Regarding “Medicare for All,” Bixby said he is concerned that a lot of politicians and other people have thrown their hands in the air over the frustrating debate over the Affordable Care Act and have said: “Cover everybody and let the government pay for it.”

He said that idea can be attractive because it is easily framed as “Everybody would be covered and nobody has to pay for it.”

Gordon said: “It’s not enough to talk about the details for how people are going to become eligible to get insurance from whatever new Medicare system you’re creating, you also need to talk about once they are on that system how you are going to control health care costs.”

Gordon said, “We do need to change our health care system, and some of that change is going to be dramatic, no matter what.”

“Right now we have this ‘do nothing plan,’ where we just don’t want to talk about what we have to do as a society to get lower health care costs,” he said. “We need to really understand that our current system is unsustainable.”

Bixby and Gordon agreed that candidates running for president and current policymakers should put more meat on the bones of their proposals related to health care, and even if they subscribe to a particular plan or proposal that they did not come up with, they should be held accountable for the details of that plan.

“When we ask for a description of how they’re going to pay for it, we’re not just talking about taxes or premiums, we’re talking about the debt,” Gordon said. “Health care is one of those things that we should be paying for; it is not one of those things that we should be paying for by debt.”


Hear more on “Facing the Future.” I host the program each week on WKXL, (N.H.), and it is also available via podcast. Join me and my guests as we discuss issues relating to national fiscal policy with budget experts, industry leaders, elected officials and candidates for public office. Past broadcasts are available here. You can now subscribe to the podcast on iTunes, Google Play or through RSS.

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