The bill further clarifies that items or services would be covered if they have been provided pursuant to a national practice guideline that has been recognized by HHS. Even when an item or service is not provided in accordance with a national practice guideline, it would be treated this way if the provider exercised professional judgment and acted in the patient’s best interest consistent with their wishes. Providers would also be allowed to override practice guidelines or standards if the override is a medical necessity and appropriate, in the patient’s best interest, and consistent with the individual’s wishes.
This override option was not included in the Sanders bill.
CBO’s Report On Single-Payer Health Care Holds More Questions Than Answers
Medicare-for-all backers say the program would cover all medically necessary services. But what does that truly mean?
What may seem obvious — the notion of medical necessity — isn’t so easy to distill into policy rules. And different single-payer systems around the world handle the benefits question differently, the CBO noted.
For instance, Canada doesn’t cover prescription drugs, but the United Kingdom and Sweden do. Of those three, only Sweden fully covers long-term support services, according to the report.
There are two questions at the heart of it, said Robert Berenson, a health policy analyst at the Urban Institute, a left-leaning think tank.
What benefits would be covered? Would it include dental care or prescription drugs or vision, as Sanders’ bill would? And, how does one determine the discrete services included within those benefits categories?
Single-payer architects could look at existing standards, such as the so-called essential health benefits that govern Obamacare health plans, to determine what’s covered. They could be more generous by including long-term care, which isn’t currently covered by Medicare or most private insurance plans.
Even the two “Medicare-for-all” bills in Congress have slightly different takes. Though both provide for long-term support and services, they diverge on how to pay for it.
Sanders’ bill covers only at-home long-term care and keeps Medicaid intact for services provided in institutions. The
House bill by Rep. Pramila Jayapal (D-Wash.) covers both.
A
nd there are questions about new medical treatments, and how to determine whether they provide added value. The CBO report suggested some kind of “cost-effectiveness criterion” could determine what the government is willing to cover. In practice, though, that standard could be difficult to develop and fall victim to political lobbying or trigger contentious debate.
Separately from the CBO report, McDonough noted, controversial medical services could bring up different kinds of political baggage — whether this plan would cover abortion, for instance, likely would change the single-payer debate.
Medical necessity disproportionately doesn't cover new treatments or even current treatments for African Americans.
Literally in the fukking law, if they don't think everyone needs it(all americans not just blacks) they don't have to pay for it.
Your fukking signing black death certificates with your votes

, stop listening to these liberal whites. Medicare for All needs to be FOR ALL. Listen to
BLACK PROGRESSIVES