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What constitutional/legislative actions would be required at the federal and state levels to enact uniformly throughout the United States "Medicare for All"?Way more than most people realize-As you read this you may Think I am crazyJust know this is what DoD and DoD suppliers deal with EVERY DAY ( I have 20+ years experience )I also discussed this with the former head of CareFirst Facility Management - CareFirst BC/BS is a large Maryland health care delivery system, as well as an insurers..-Since the government is doing this for every aspect of health care, under Medicaid for AllThe scope of work is much larger than just one clinical care provider in one stateWe are talking government price controls on 1/6 of the U S economy, as well as the suppliers to that 1/6 of the economyMy best guess is government will be managing the costing and prices for an added 5 T in annual GDP, with direct or indirect contracts-I did constitutional, legislative, CMS and Federal Purchasing step, since they are inter-twined. Legislators approve many of the compensation rates for Medicare, and so under M4A Everything will have a set compensation rate. Google “Medicare doc fix legislation’ to see how deeply Congress is involved in the processso some of the steps include:get a bill signedwrite an actual Medicare for All law - what we have now is an outlineDefine what services will and will not be coveredget it through the CBO without the public having a fitget it passed and signed-after it has been signedrepeal ACArepeal or amend the 10th amendment - since all states manage all insurances todayrepeal all state insurance laws for today’s Medicare Medicaid, and Health Insurancerepeal all other federal insurance lawsrevise HIPAAdisband Medicaiddisband today’s Medicaredisband all existing policies-then - assuming it passesfight it out in front of SCOTUS - since the government is nowimposing wage and price controls on earnings across well over 1/6 of the U S economy,which will impact 100% of the economy,and denying existing payments to existing providersdissolving all faith focused medical care and medical care laws-after the SCOTUS fightknow that all of the following are just a partial listandAnd each cost change in raw materials, taxes, energy costs and labor will require a Contact revision for each contract I listed below-Now comes the Medicare/Medicaid for All set up and contracting processContracts to set up a single government entity to do what multiple insurers do today ( think Social Security + each state’s Department of Health offices )develop the software to process services claims based on all of the codes in ICD-10 that will be allowed services ( you did not think everything would be covered, did you? )develop the software to process prescription claims based on all of the allowed drugs ( you did not think everything would be covered, did you? )develop the reimbursement rates that Medicare/Medicaid for All will have for each ICD-10 codeget the I T equipment in place to process the Medicare/Medicaid for All claimsget the location for claims processing centersset up secure back up server locations - larger than what SS has since it is collecting and managing far more datahire and train Government staff to process the claims ( no - claims processing is not automatic )hire claims re-submission processing teams - google “Medicare denies more claims”-Once the government side is readyissue new contracts to every medical provider,changing the payment structure for those now contracted for Medicareforcing the new payment structure on all medical providers that do not accept MedicareWith a set price for each dental serviceissue contracts to every dental providerWith a set price for each vision serviceissue contracts to every vision providerWith a set price for each pediatric serviceissue contracts to every pediatrics providerWith a set price for each natal serviceissue contracts to every natal providerWith a set price for each mental health serviceissue contracts to every mental health providerWith a set price for each nursing home serviceissue contracts to every nursing homeWith a set price for each home healthcare workerissue contracts to every home health providerWith a set price for each IN home healthcare workerissue contracts to every IN home health provider-And thenNegotiate a price for every outpatient drugissue contracts to every drug maker ( over 1,000, and many not in the U S )define each approved U S drugdefine every dose andspecify how many of each dose will be purchasedset up a drug distribution service, or contract the existing distribution systemset up a dispensary system, or contract each existing dispensary (drug store)pay displaced worker compensation to each displaced workerincluding fight it out in front of SCOTUS - since the government is now imposing wage and price controls on earnings, and denying existing payments to providersNegotiate a price for every inpatient drug ( can’t control provider prices if drug prices are not locked down )issue contracts to every drug maker ( over 1,000, and many not in the U S )define each approved U S drugdefine every dose andspecify how many of each dose will be purchasedset up a drug distribution service, or contract the existing distribution systemset up a dispensary system, or contract each existing dispensary system to get them to each health care providerpay displaced worker compensation to each displaced workerNegotiate a price for every supply and material a provider needs to provide medical services ( can’t control provider prices if supply princes are not locked down )issue contracts to every medical supply makerdefine each approved U S supply itemdefine every unit andspecify how many of each unit will be purchasedset up a supply distribution service, or contract the existing distribution systemset up a dispensary system, or contract each existing dispensary system to get them to each health care providerpay displaced worker compensation to each displaced workerNegotiate a price for every test and testing service a provider needs to provide medical services ( can’t control provider prices if lab princes are not locked down )issue contracts to every lab and testing servicedefine each approved U S test provider and lab servicedefine every test andspecify how many of each test will be purchasedset up a lab services distribution service, or contract the existing distribution systemset up a lab test system, or contract each existing lab system to get them to each health care providerpay displaced worker compensation to each displaced workerNegotiate a price for every medical waste removal service a provider needs to provide medical services ( can’t control provider prices if waste removal prices are not locked down )issue contracts to waste management servicedefine each approved U S waste removal provider and certify the servicedefine every situation andspecify how many of each service will be purchasedset up a removal service, or contract the existing removal servicesset up dumping and destruction locations, or set up contracts, or assume existing contractspay displaced worker compensation to each displaced workerNegotiate a price for every utility service a provider needs to provide medical services ( can’t control provider prices if utility prices are not locked down )issue contracts to the utility servicedefine each approved U S utility provider and certify the service andhow many of each service will be purchasedset up a contract the existing utility servicesor assume existing contracts-the set up and execute problem I outlined continues for each and every aspect of health services, including sub tier suppliers.Ask a facility manager for a hospital how big of a task this actually is-Think I am crazy?This is what DoD and DoD suppliers do EVERY DAY