Senate Bill 4204 – The Medicare for All Act of 2022.

Jack Bernard was previously SVP of a national health care company and the first director of health planning for GA. He served as Jasper County GA GOP Chairman. He is now a vice chairman of a health board in Fayette County, a suburb of Atlanta.

As someone who has spent most of their career in health policy and/or health care corporations, I support the recently introduced Senate Bill 4204 – the Medicare for All Act of 2022. One of Key aspects of the bill are that it prohibits the federal government from reimbursing provider marketing costs, worrying about provider bottom lines, or being influenced by political contributions. This money will be spent on patient care.

It’s time for the United States to seriously consider single-payer health insurance that provides freedom of choice. Citizens can go to any doctor or establishment. Under 4204, all US residents will be automatically enrolled in Medicare at birth and will be able to obtain health services as a right…rather than a privilege as is currently the case for those under 65. Additionally, all US healthcare providers in good standing will be able to participate in Medicare for All as outlined in the bill.

Specifically, the following services will be covered: hospital services, including inpatient and outpatient hospital care, paediatrics, emergency services and medication; Outpatient services to patients; Primary and preventive services; prescription drugs and medical devices; Mental health and addiction services; Laboratory and diagnostic services; Comprehensive reproductive, maternity and newborn care; Oral health, audiology and vision services; Rehabilitation and adaptation services; and Long Term Home and Community Services.

The key to understanding this legislation is the fact that there is no cost sharing. A US resident is fully covered without deductibles, coinsurance and co-payments.

Under this law, the single payer will be affordable. In fact, affordability is the concept behind establishing a broad-based annual “national health budget”. As specified in the bill, it will mainly consist of an operating budget, a capital expenditure budget and a special projects budget.

This aggregate budget is the basis for lump sum payments to institutional providers, including hospitals, skilled nursing facilities, and independent dialysis centers, adjusted quarterly based on past and projected volume of services, actual provider expenditures/expenses operating costs, salaries, accessibility and other considerations.

Non-institutional vendors will be compensated through a fee-for-service arrangement based on the expertise of those vendors and the value of the items and services they provide. This fee schedule will be updated annually. These providers can be individual or group practices (non-salaried, working for an institution) and home and community service providers. To improve the current maze of electronic records systems, DHS will establish a uniform national electronic billing system for provider payments.

The prices paid by DHHS for covered pharmaceuticals, medical supplies, and medically necessary assistive equipment will be established annually. And a formulary will be established to ensure best prescribing practices, discourage the use of ineffective or overly expensive drugs, and emphasize generics.

We are the strongest and richest democracy in the world. Yet studies have shown that the health status of American citizens is far below that of other democracies. In fact, even after the ACA, 12% of Americans under 65 still do not have insurance.

But the figure is much higher for Georgia, which has the third highest uninsured rate in the nation, 16% for the non-elderly. That’s nearly 1.4 million Georgians without coverage and millions more with inadequate private policies, leaving them underinsured.

Georgians who are lucky enough to have good insurance tend to love their doctors, nurses, clinics, and hospitals. However, few will say they “love” their commercial insurance plan…especially after they get sick and have high deductibles and co-payments for vendors and products. pharmaceuticals.

Senate Bill 4204, the Medicare for All Act of 2022, is sponsored by senators from Rhode Island to Hawaii. Georgians elected to the US House, including Representatives Nikema Williams and Hank Johnson, are established co-sponsors of HR 1976, a similar Medicare for All bill. I believe the majority of Georgians are ready to support single payer and I hope our two senators will join them.

Jack Bernard was previously SVP of a national health care company and the first director of health planning for GA. He served as Jasper County GA GOP Chairman. He is now a vice chairman of a health board in Fayette County, a suburb of Atlanta.

Norman D. Briggs