News Ticker

Some cautionary words about Medicare For All


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.

For example, Medicare Interactive states that Medicare does not pay for acupuncture and chiropractic services. Or consider naturopathy. According to the Cancer Treatment Centers of America:

“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.


2 Comments on Some cautionary words about Medicare For All

  1. thanks for the referral articles, Steve. I agree, the details matter. But couldn’t we please get the insurance companies out of healthcare and then fix the Medicare for all? One great advantage that Medicare has is that it now covers the most vulnerable population, the elderly. The young are cheap to cover, their parents and the middle aged are cheaper as well. So we can expect to see, with Medicare for all, a significant savings.

    • I agree. I also remember being a state-level healthcare reporter in the 1990s, when alternative healthcare modalities had to battle to gain legitimacy here in Washington. It was a difficult fight — and one that will likely be much harder at the federal level. In the process of achieving universal coverage, I hope we don’t create a situation where even in our state only the affluent can afford alternative approaches such as naturopathy, acupuncture and chiropractic care.

Leave a Reply

Your email address will not be published.