What They’re Watching: Arielle Kane

Arielle Kane is the Director of Health Care at the Progressive Policy Institute and is currently advising Mayor Mike Bloomberg’s presidential campaign on health care policy. She joins us in this edition of “What They’re Watching” to discuss the potential benefits of a model often absent in the national health care policy conversation: an all-payer rate setting model.


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I think everyone is watching what the Democratic candidates are saying and proposing and how much wind those proposals are gaining. Something specifically that I would like to see more is a conversation around health care costs rather than just coverage. I think that we are going to be faced with hard questions about how much to pay for health care and how we should rein in health care spending. That’s what I’m looking for and trying to find information and more people talking about those types of issues.

What I think is missing from the debate is an all-payer rate setting model. I don’t think we need to do exactly what Maryland has done on a national scale, but I don’t understand why what Maryland has done hasn’t risen to the national conversation. I recently wrote a paper that talked about bringing the Medicare Advantage Model where you have a price cap for health care services into the commercial market and insurers and providers could still have contracts and pay a little more or less than that price cap based on what they think the service is worth in their market. But at the end of the day, if you go to an out-of-network service or you end up at a hospital, there is a cap and you know how much you’re going to owe. 

State policy when successful informs federal policy and so the more can do pilot project demonstrations, different examples of what’s working at the local levels, that can then scale and maybe rise to the national level. An organization like State of Reform brings industry leaders state policymakers together, and that type of opportunity allows for cross pollination and for ideas to bubble up and scale larger than where they’re just happening right now.”