[BY S. SALMI]
Recently I asked my naturopath what she thought of Bernie Sanders’ Medicare For All proposal. She’s a staunch lefty so lauded his goal of universal coverage using a single-payer model. However, she also noted that her practice would be decimated.
Part of the problem is Medicare’s current cost structure. Although the system is relatively “efficient,” reimbursement rates are low compared to the cost of doing business with the feds. The result, argues my naturopath, is that only the bigger providers may have the economies of scale to survive.
In addition, people like me who use alternative medical approaches may need to start paying entirely out of pocket for those services. That’s because Washington state is way ahead of the federal government when it comes to support for alternative modalities.
“Only 17 states, Washington, D.C., and the U.S. territories of Puerto Rico and the Virgin Islands license naturopathic physicians. In the other 33 states, patients cannot get any type of insurance coverage to see a naturopathic physician. What’s more, naturopathic physicians in those states are restricted from practicing to the full scope of their training.”
The point of this posting isn’t to dismiss Medicare For All, but rather to note that the devil is in the policy details. Reimbursement rates and program requirements could be adjusted to avoid putting smaller providers at a disadvantage. By the same token, the other Washington could embrace the alternative healthcare innovations of our state. However, no one should live under the illusion that making those changes would be politically easy.
This is why I give at least some benefit of the doubt to Democratic leaders who have not quickly saluted Medicare For All. The general idea sounds terrific but the underlying policy needs further refinement.
ALL OUR SOURCES:
- Edwards, Eliot; 2014. “Naturopathic licensing and Medicare coverage should expand.” Cancer Treatment Centers of America. July 1; accessed Sept. 16, 2017.
- Keith, Katie and Timothy Josh; 2017. “Unpacking The Sanders Medicare-For-All Bill.” Health Affairs Blog. Posted Sept. 14; accessed Sept. 16.
- Medicare interactive.org; 2017. “What is not covered by Medicare?” Accessed Sept. 16.
- Smith, Rich; 2017. “Why Haven’t Washington Senators Maria Cantwell and Patty Murray Backed Medicare for All Yet?” The Stranger. Posted Sept. 13; accessed Sept. 16.