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Author response to JHSU125

Posted by ccai on 03 Feb 2020 at 19:33 GMT

Hi !

Thanks for your comment. We appreciate the your attention and debate is healthy!

The concerns you raise are addressed in our paper . I'll highlight a few points
-We only included papers that accurately modeled the legislation they were seeking to study. The Mercatus study you are referring to had many scenarios. The 2017 bill it was studying assumed Medicare payment rates. Therefore we included the scenario that most closely mirrored the legislation.
-You may think it is unrealistic for the government to pay Medicare rates. However, the goal of our study was to understand true single-payer bills and we cannot change the legislation.
-Moreover, both current Congressional bills propose to pay hospitals via global budgets, not Medicare payment rates. Concerns over whether Medicare payment rates are “realistic” may not accurately reflect the substance of the legislation, at least for hospital financing.
https://www.healthaffairs...
-What's more, there is empirical evidence hospitals will pay less under global budgeting
https://www.healthaffairs...
-The Urban institute study includes private intermediaries so it did not meet inclusion criteria. We address this in our discussion and introduction
-PNHP had no role in study design data collection or decision to publish. The funding ($3000) is small compared to the value of the work that went into this paper: 9 people working part time over two years

No competing interests declared.