The potential implications of "Medicare for All" and "public option" for bariatric surgery

Role of weight bias and patient-physician communication in the underutilization of bariatric surgery

A growing body of evidence supports the efficacy and safety of bariatric surgery for clinically severe obesity. Despite this empirical support, bariatric surgery remains profoundly underutilized. The reasons for underutilization are likely multifactorial, including health insurance coverage and benefits design, lack of awareness about bariatric surgery by patients, and anecdotal concerns about safety. We believe that there are two other factors-the occurrence of weight stigma and bias and suboptimal communication between patients and providers-that also serve as barriers to greater utilization. The article reviews the existing literature related to these two factors. The review also highlights the science of shared medical decision-making as a potential strategy to promote appropriate conversations between patients and providers, both surgical and nonsurgical, about the efficacy and safety of bariatric surgery. Shared medical decision-making is used in other areas where complex medical decisions are required. We believe that it has great potential to contribute to the increased utilization for the millions of individuals who could benefit from bariatric surgery.

Pharmacists need to participate and pay closer attention to the Medicare for All discussion

It has been a decade since the Patient Protection and Affordable Care Act (ACA) was signed into law. The ACA's reception remains mixed, despite its moderate success in increasing insurance coverage, and discussions of health care reform have not abated. Among ongoing efforts to reform or repeal the ACA, "Medicare for All" appears in several prominent policy proposals. Public opinion polls from across the United States have demonstrated the growing popularity of reform proposals, which has encouraged legislators to be stronger advocates for such changes. Between 2017 and 2020, the 115th and 116th U.S. Congress introduced more than a dozen legislative proposals aimed at health care reform. Unfortunately, the variety and nuance of these legislative proposals have resulted in considerable confusion and division across the nation among health care providers and patients regarding definitions and implications of Medicare for All. This commentary aims to improve pharmacists' understanding of Medicare for All, discuss the possible impact of Medicare for All on pharmacy practice, and serve as a call for U.S. pharmacists to participate in advocacy and reform of the health care system in which they practice. We argue that only through proactive participation in legislative advocacy will the pharmacists' role in patient care continue to evolve. This brief commentary is divided into 5 major sections: (1) support for Medicare for All, (2) definitions of existing Medicare for All policy proposals, (3) estimation of the impact of Medicare for All proposals on the health care system, (4) the pharmacist perspective on the impact of Medicare for All, and (5) recommendations for pharmacy practice and advocacy.