Can Medicare For All Reduce the Cost of Care?

Traditional Medicare’s cost-sharing structure has not changed since 1965. Beneficiaries face separate Part A and Part B deductibles, per-day hospital copays, no coinsurance on certain services, and no annual out-of-pocket cap. This brief lays out reform templates proposed by the Simpson-Bowles Commission, the Congressional Budget Office, and others, compares a decade of budget scores, and analyzes a pending Senate bill that would add a spending cap without the offsetting cost-saving reforms.

The federal 340B drug pricing program lets hospitals buy outpatient drugs at steep discounts and keep the difference when insurers pay full price. It requires no proof that the savings reach low-income patients. The program rewards costlier drugs, drives hospital acquisitions of independent physician practices, and pushes clinics into wealthier neighborhoods. This brief proposes ending 340B discounts for hospitals and replacing them with a patient-centered fund financed by drug manufacturers.

Medicare Advantage was built to let private plans compete with traditional Medicare without costing taxpayers more. Decades of corrections have made the payment system complex and may have increased costs over traditional fee-for-service Medicare. This brief proposes three simplifying reforms to remove distortions, restore market discipline, and save taxpayers money.