Hospitals

Medicare for All's winners and losers

Adapted from Zirui Song, 2019, "The Pricing of Care Under Medicare for AllImplications and Policy Choices"; Chart: Andrew Witherspoon/Axios

Many specialties would still take a pay cut even under versions of "Medicare for All" that aren't as full-throated as what Sen. Bernie Sanders has proposed, according to recent analysis in JAMA by Harvard's Zirui Song.

The big picture: This is a feature, not a bug, of Medicare for All. Part of the point is to spend less on health care — through steep cuts in how much many doctors and hospitals get paid.

When a hospital wields monopoly power

Illustration of a giant health plus on top of a pile of cash, the ground underneath is cracking.
Illustration: Aïda Amer/Axios

NorthBay Healthcare, a not-for-profit hospital system in California, recently gave a candid look into how it operates, telling investors it has used its negotiating clout to extract "very lucrative contracts" from health insurance companies.

Why it matters: This is a living example of the economic theories and research that suggests hospitals will charge whatever they want if they have no or minimal competition.