Case Study: Medicare and Healthcare For all Proposal

For this case study, submit a maximum two-page write-up of your answers to the
case questions. This write-up must be your own original work. Construct your answers in
paragraph form, use 12-point Times New Roman font, double spaced, with justified
alignment (ie. both the left and the right side of your paragraphs should be straight).
In your write-up, reference at least two scholarly journal articles to support your
answer. Sources should be properly cited in Chicago “author-date” style. Do not use
footnotes or endnotes. Use in-text citations that include author, year of publication, and the
page number containing the referenced material. For sources without page numbers, use
the paragraph number.
Include the full bibliographic citation in a references section either immediately
following your paragraph answers, or on a separate attached page. Bibliographic references
should be i) single-spaced, ii) alphabetically sorted, and iii) properly formatted in Chicago
“author-date” style. Additionally, for a given reference, every line should be indented
except for the first line.
In-text citation example (in the body of the paper):
These mechanisms leave patients exposed to risk and “compromise the purpose of
insurance” (Eggleston 2000, 173). Alternatively, regulators could improve accuracy simply
by using payment categories as regressors in a simple OLS regression (McGuire et al. 2013,
1264).
Reference example (in the bibliography)
Eggleston, K. 2000. “Risk Selection and Optimal Health Insurance-Provider Payment
Systems.” The Journal of Risk and Insurance 67 (2): 173-196.
McGuire, T. G., J. Glazer, J. P. Newhouse, S.-L. Normand, J. Shi, A. D. Sinaiko, and S.
H. Zuvekas. 2013. “Integrating risk adjustment and enrollee premiums in health
plan payment”. Journal of Health Economics 32(6), 1263–1277.
The case and questions can be found on the next page. 2
You are a health care specialist advising a sitting representative in the U.S.
Congress. You are called into the representative’s office to offer your immediate counsel
regarding a recent development.
In advance of the 2020 Presidential Election, candidates for the Democratic Party
nomination have announced their intent to introduce a “Medicare For All” bill. This bill, if
passed, would replace the current system of largely employer-based private insurance
coverage with a single, nation-wide public health insurance plan. It roughly follows
Senator Bernie Sanders’ proposal from two years ago:
http://www.npr.org/2017/09/14/550768280/heres-whats-in-bernie-sanders-medicare-forall-bill
http://www.cnn.com/2017/09/13/politics/bernie-sanders-medicare-for-all-plandetails/index.html
Upon reading the description of the Medicare For All proposal, you are reminded
of a real-world health care system that has some similarities: the single-payer system in the
Canadian province of Ontario. Being an expert, you are reminded of several recent
developments there:
https://www.fraserinstitute.org/sites/default/files/waiting-your-turn-2018-exsum.pdf
https://ottawacitizen.com/news/local-news/hospital-crowding-getting-worse-acrossprovince-report-shows
https://www.cbc.ca/news/canada/hamilton/ontario-health-care-1.4912674
https://www.cbc.ca/news/canada/kitchener-waterloo/ontario-health-coalition-long-termcare-report-waterloo-1.5002839
https://www.cbc.ca/news/canada/toronto/ontario-doctors-awarded-new-contractarbitrated-settlement-1.5025350
Leaving aside the political considerations (the representative has other advisors for
that!), your job is to produce a two-page analysis answering the following questions:
Questions:
1. What are the key similarities and differences between the existing system in Ontario
and the proposed system in the Medicare For All bill? What would this mean for
access, quality, and cost under the Medicare For All proposal?
2. Should the representative throw his or her support behind Medicare For All? Why
or why not? Justify your answer.

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