• Rich Barlow

    Senior Writer

    Rich Barlow

    Rich Barlow is a senior writer at BU Today and Bostonia magazine. Perhaps the only native of Trenton, N.J., who will volunteer his birthplace without police interrogation, he graduated from Dartmouth College, spent 20 years as a small-town newspaper reporter, and is a former Boston Globe religion columnist, book reviewer, and occasional op-ed contributor. Profile

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There is 1 comment on You’ve Heard of Single-Payer. What about All-Payer Health Care?

  1. The All-Payer care model is helping Maryland more than many other trendy solutions. But the underlying foundational incentives and mechanics remain against controlling the high costs. Incentives: without skin in the game, the person choosing the most expensive healthcare path will continue to do so since someone else is paying for such choices. And the government will continue to control the spending amounts based on their political position today (ie votes) at the expense of tomorrow’s, not so visible, fallout. The system of one buys, one consumes and yet a third one decides the price is problematic. Mechanics: Pricing and hence payment amounts are determined, by CMS, that is not covering the costs of care. The most horrid example with the worst cost-shifting effects is seen in CMS mandated payment amounts for hemodialysis! A three times a week recurring treatment without which the patient cannot survive, is paid at half the cost with ZERO margin. The result of misaligned incentives and existing mechanics mandated by Law has created the largest ever social cost-shifting in the US. The reason is self-evident to the examining mind that sees the whole picture. My main concern with the All-Payer model is it will provide a partial solution while propagating the partial view of the problem while the majority remains invisible. Thank you your thoughts and allowing my thoughts to be shared. DR K

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