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Illustration: Aïda Amer/Axios

Sen. Elizabeth Warren's Medicare for All plan takes on every major health care industry — insurers, doctors, hospitals and drug companies — in her pursuit of expanding coverage and lowering costs for the middle class.

Why it matters: We've never tried any cost containment measures that are remotely close to being as aggressive as Warren's, and there could be consequences if payment rates are slashed so low.

The big picture: Experts say you can only wring so much money out of the system before it starts to impact the care people receive — and Warren is wringing out a lot.

Private insurance would be eliminated. Warren argues that would save hundreds of billions of dollars in administrative spending, and relieve patients of the hassle of dealing with their insurer.

  • Americans would no longer have to worry about reaching their deductibles or whether their doctors are in their insurance network.
  • They'd pay no premiums and have "virtually no" out-of-pocket costs, according to Warren. They'd have expansive health benefits, including long-term care, audio, visual and dental.
  • They'd also have no choice about any of this.

To pay for all of this, providers would see drastic payment reductions.

  • Doctors would generally be paid at current Medicare rates — which on average are much lower than private insurance rates — although some, like primary care-physicians, would be paid more than they currently are by Medicare and others, like "overpaid" specialty doctors, would be paid less.
  • Hospitals would be paid an average of 110% of Medicare rates, with adjustments for rural and teaching hospitals — still much lower than what private insurance pays.
  • Providers wouldn't have to worry any longer about uninsured patients, nor would they have to negotiate with insurers.
  • "The ultimate question, which we can all guess at but can’t know for sure, is whether enough hospitals and doctors would continue delivering care to a larger number of insured patients. If not, we’d see growing waits for care," said the Kaiser Family Foundation's Larry Levitt.

Drug prices would plummet.

  • The federal government would be allowed to negotiate drug prices, and penalize drug companies that refused to participate with more taxes.
  • Americans would pay no more for a drug than 110% of its average international price.
  • If negotiations don't work, Warren would override a drug's patent — allowing another company to make the drug at a lower price — or have the government manufacture the drug.
  • Warren suggests that no patient will be denied a drug based on its price.
  • Experts have warned that even less aggressive drug pricing plans would come at the cost of less innovation by drug companies, and thus fewer new cures coming to market.

The bottom line: The days of American health care as big business would likely be over. Patients may win financially, but there's no way of knowing at what cost to the quality of their care.

Go deeper

The hard math behind America's labor shortage

Data: Bureau of Labor Statistics, Congressional Budget Office; Chart: Axios Visuals

Yes, the pandemic has created unusual temporary labor market dynamics. But in the bigger picture, the 2010s were a golden age for companies seeking cheap labor. The 2020s are not.

The big picture: In the 2010s, the massive millennial generation was entering the workforce, the massive baby bo0m generation was still hard at work, and there was a multi-year hangover from the deep recession caused by the global financial crisis.

Advocates fret Roe v. Wade's 49th anniversary could be its last

Photo: Leigh Vogel/Getty Images for Women's March Inc

As Saturday marks the 49th anniversary of Roe v. Wade, the Supreme Court's landmark decision that legalized abortion access in the U.S., advocates warn the ruling is "more at risk now than ever."

The big picture: The Supreme Court in December heard a challenge to a Mississippi 15-week abortion ban that could throw Roe's survival into question, or at least narrow its scope.

Updated 14 hours ago - Politics & Policy

Omicron dashboard

Illustration: Brendan Lynch/Axios

  1. Health: Pfizer and Moderna boosters overwhelmingly prevent Omicron hospitalizations, CDC finds — Omicron pushes COVID deaths toward 2,000 per day — The pandemic-proof health care giant.
  2. Vaccines: The case for Operation Warp Speed 2.0 — Starbucks drops worker vaccine or test requirement after SCOTUS ruling — Kids' COVID vaccination rates are particularly low in rural America.
  3. Politics: Biden concedes U.S. should have done more testing — Arizona says it "will not be intimidated" by Biden on anti-mask school policies — Federal judge blocks Biden's vaccine mandate for federal workers.
  4. World: American Airlines flight to London forced to turn around over mask dispute — WHO: COVID health emergency could end this year — Greece imposes vaccine mandate for people 60 and older — Austria approves COVID vaccine mandate for adults.
  5. Variant tracker