Oct 15, 2019

Four health care questions for a better Democratic debate

Photo: Win McNamee/Getty Images

If tonight’s Democratic debate is anything like the earlier ones, it will feature an extended back-and-forth about whether to eliminate private health insurance, and then move on from health care. But there’s a whole lot more that’s also worth asking about.

The big picture: We basically know what the candidates will say about the question of private insurance, because they’ve said it all before. So here are four other questions that might also help illuminate the choice voters face on such a deeply personal, wildly complex topic.

Between the lines: Health insurance — whether it’s a single-payer program or a private plan — pays health care bills. And one distinct feature of the U.S. health care system is that those bills are very high.

The big questions:

  1. We’ve heard a lot of criticism of drug companies and insurance companies, but the single biggest chunk of U.S. health care spending goes to hospitals — about $1 trillion a year. Is that too much? How will you cut it?
  2. If Medicare gains more power to set drug prices, as you’ve proposed, how should it decide what a new drug is worth? What would that decision-making process look like?
  3. Hospitals are closing across rural America. They’re expensive to run, they don’t bring in much money, and doctors are hard to recruit. None of that seems likely to change, so how are rural Americans ever going to get sustainable, affordable in-person care?
  4. Many of the things that make people sick are not the fault of bad health care — they're social factors like poverty, low-quality housing, etc. Should it be part of the health care system's job to address them?

Go deeper

Elizabeth Warren's dream health care world

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.

Go deeperArrowNov 4, 2019

Health care stocks aren't having a great year

Data: FactSet; Chart: Axios Visuals

The stock prices of major health care companies have not kept pace with the broader market so far in 2019, even though the industry is flush with cash.

The bottom line: Medicare for All and other health care reforms floated by Democratic presidential candidates, as well as higher-than-expected medical costs at health insurance companies, have made investors nervous about the future.

Go deeperArrowOct 15, 2019

The state of play in Germany's health care system

Photo: Bernd Wüstneck/picture alliance/Getty Images

In Germany's health care system, even universal coverage paired with low out-of-pocket costs hasn't led to equitable health outcomes among rich and poor people, NPR reports with Kaiser Health News.

Why it matters: Medical care is only one component of a person's health. Social determinants of health are hugely important and factor strongly into a population's well-being. "Universal health care, in and of itself, may be a first step toward increasing a community's health, but it isn't a magical solution," writes KHN's Shefali Luthra.

Go deeper: What the U.S. can learn from Germany on drug prices

Keep ReadingArrowOct 17, 2019