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Throughout 2019 and into 2020, Medicare for All was a significant talking point for nearly every Democratic presidential candidate. Then, the coronavirus swept in, and the need for healthcare reform in an employer-based system became all the more clear.
As Medicare for All is touted by some lawmakers as the ideal option for America, the debate rages about the validity of this notion. Such reform would remodel the American healthcare system into one in which taxpayers are the single-payer source of medical costs. This would essentially eradicate private insurance, according to many proposed plans.
However, the implementation of a single-payer system would ensure that every American can afford medical costs. The mass unemployment caused by the pandemic left many without health coverage provided through their employer. Medicare for All would prevent such losses from ever happening again.
But how do the medical professionals that handle our care feel about Medicare for All? Do they see such reform as beneficial? Would it impact their ability to provide quality care?
While opinions differ among healthcare professionals, there seems to be a growing consensus about the benefits of Medicare for All. With views both for and against Medicare for All, one thing seems certain: change is inevitable.
Here, we’ll explore differing views and look for common ground among medical professionals.
Healthcare Professionals Against Medicare for All
The state of the American healthcare system is complicated. Average citizens and medical professionals alike struggle to reach an agreement about what constitutes ideal reform. A Gallup poll shows that while a majority of Americans agree the government should ensure coverage for everyone, they don’t agree on the government running or funding such a system.
Across the healthcare system, you’ll find a similar complexity of opinions. Dissenters in the Medicare for All debate point to other methods of improvement, some even arguing the system is functioning well enough as is. The common ground on which Medicare for All opponents can unite is the lack of belief in a single-payer system.
Perhaps the most prominent coalition of organizations within the medical industry is the Partnership for America’s Health Care Future (PAHCF). This partnership is made up of a variety of healthcare groups, many with a hand in pharmaceuticals and insurance. PAHCF is vocal in their dissent of public option legislation. The coalition was created to contribute to lobbying and advertising against Medicare for All and healthcare reform. According to a report by the Center for Responsive Politics, healthcare lobbyists have already spent over $300 million, nearly $52 million more than any other industry across 2020.
A selection of members of Partnership for America’s Health Care Future.
For years, the most powerful voice in the medical industry was also a member of the PAHCF. The American Medical Association (AMA) has been instrumental in shaping the state of the American healthcare system throughout the last century. Their ability to lobby the government has influenced everything from smallpox vaccinations at the turn of the 19th century to Medicare reforms in 2015.
The AMA does not explicitly dictate healthcare legislation. Instead, public health policy is shaped by a representative government. However, the power of the AMA as a voice to lobby these representatives gives it special power over the medical industry. The association—composed of physicians and medical students—has been a long-time opponent of single-payer healthcare.
However, that nearly changed in June of 2019. During a vote to overturn the AMA’s opposition to single-payer healthcare, 47% of the organization voted in favor of changing the long-held policy. Even though the vote to overturn was defeated by a 53% majority, this near-tie prompted a change. The AMA dropped out of the PAHCF.
This shift in support demonstrates changing views within the healthcare industry. However, proponents of the traditional system retain their disdain for single-payer healthcare. Often these proponents have ties to specialized care, health insurance, and pharmaceuticals—all of which have the most to lose in a shift in a single-payer system.
But what are the arguments being made by healthcare professionals against Medicare for All?
Arguments Against Medicare for All
Opinions in dissent of Medicare for All are varied and widespread. However, medical professionals against single-payer healthcare bring up a few common points. These are:
- Increased demand for care on an already overburdened system.
- Longer wait times for care.
- Loss of physicians desiring the job over time.
The potential for increased demand with broader, cheaper healthcare coverage to the average consumer is a near-guarantee. Roughly 25% of Americans say they or a loved one put off care due to healthcare costs in 2019. A Medicare for All system would almost certainly allow these individuals to seek care without fear of the financial repercussions. The result will be a greater need for American care practitioners.
The United Kingdom, for example, operates a state-funded healthcare system. There, general practitioners see up to 60 patients a day. This is twice the number deemed safe. The demand for the system means busy hours for physicians of every type. Many worry that if such a system were integrated in the U.S., our medical professionals will be similarly overburdened.
These fears are valid. U.S. healthcare professionals already work weeks well over full-time hours. On average, U.S. physicians work 51 hours per week. This can be draining on mental health, leading to burnout and loss of performance quality.
Additionally, the limitations that increased demand would place on labor and resources are likely to increase wait times for everyone. In the UK and Canada, wait times for care range higher than in the United States, especially for specialist services.
All these factors culminate in a fear that the medical field will continuously lose its employees overtime. High burnout rates cause physicians to quit. In turn, fewer would be left to take their place due to a lack of desirability for a high-stress job. Because of this, opponents of Medicare for All are arguing Medicare and Medicaid can do enough without expanding to a fully single-payer system.
Currently, Medicare covers Americans 65 and up. Medicaid is directed to a lower income bracket that is often priced-out of affordable care. The existence of these programs has helped provide care to millions of Americans, but some legislators maintain that public funding should be more wide-spread.
Healthcare Professionals in Favor of Medicare for All
A consensus appears to be growing in the healthcare community that Medicare for All is at the very least worth looking into. Change may be on the horizon. With the AMA’s decision to pull from the PAHCF after nearly overturning opposition to single-payer healthcare, more healthcare professionals and institutions are showing support for major reform. The positive impacts of the Affordable Care Act demonstrated that change was possible. Now many healthcare professionals want to take it even further.
A bastion of support for Medicare for All is America’s largest medical specialty organization. The American College of Physicians, composed of 159,000 internal medicine physicians, promotes a single-payer healthcare system as an option for the reform needed in America’s healthcare system.
Number one in their list of recommendations for the nation is a system that provides healthcare coverage to all at affordable costs. The organization believes this is possible through two possible reforms: a single-payer system or a public option that can cover everyone. Either way, they say reform is needed and Medicare for All is gaining momentum.
TIME cited that the percentage of physicians favoring a single-payer system has risen to 56%. Among them, activist doctors are promoting Medicare for All across political party lines. Democrat and Republican physicians alike are coming out in support of a single-payer system, recognizing a need for comprehensive coverage that cuts costs.
In a Vox article, several conservative or Republican healthcare professionals voiced their support for Medicare for All. “I’m now, despite growing up a conservative afraid of such government largesse as ‘Medicare for All,’ convinced that a single public payer, either as rate setter or as a true single-payer, is needed,” said one registered Republican.
The desire for reform is wide and spreading. Many healthcare providers recognize that there are major problems with the system. They see inequality running rampant across healthcare and look to improve it. A growing consensus is that Medicare for All can put a stop to income inequality, gender inequality, and the overall barriers to access that many Americans face.
Beyond that, there are plenty of reasons a growing majority of healthcare professionals appear to favor a single-payer system.
Arguments for Medicare for All
A host of arguments propagate in favor of Medicare for All. Physicians recognize the worth of a single-payer system in the simplicity it would add to their lives. Additionally, the reduced costs that might come with negotiating with one entity could save money for both providers and patients. All told, the savings and accessibility added by a single-payer system could enhance healthcare equality across the nation.
Healthcare professionals speak now about the difficulties of negotiation with insurance companies and dealing with associated paperwork. Right now, some physicians spend more time filling out insurance forms than actually caring for patients. This places a strict demand on physician time, making patients wait while reducing access to resources.
First quoted in the Pensacola News Journal, Dr. Benjamin Kaplan said, “In just the last four years, bureaucratic paperwork has contributed to a 25% increase in physician burnout.” The complexity of a multi-payer system forces physicians into lengthy periods of administrative work. The American College of Physicians estimates that two hours is spent on paperwork to every one spent with actual patients.
Proponents of Medicare for All argue that this bureaucratic burden could be significantly reduced in a single-payer system. Demand might increase, but so too would the availability of physicians no longer stuck behind desks. For many medical professionals, the time spent directly helping patients is why they got into the field. They see Medicare for All as a way to protect that time.
The cost burden associated with dealing with a variety of insurance companies is also difficult for healthcare providers to manage. As the Republican healthcare professional quoted in Vox’s article put it: “Other payers put up an endless set of traps against reimbursement, contracting, and other parts of the revenue life cycle that add substantial cost to services and thus increase the cost to the consumer.”
By eliminating the complexity of for-profit insurance companies and other payers, physicians no longer face as much administrative burden. The savings in both negotiated costs and labor can be passed onto the consumer for reduced care costs overall.
All these factors contribute to the equitability already brought by the nature of a single-payer system. With healthcare costs and coverage no longer an obstacle, anyone regardless of income or identity can make their important doctor appointments. In the current system, costs are frequently a challenge. This also helps to reduce unfair cost distributions, like the greater share of medical costs paid by women.
A Future of Healthcare Reforms
The idea of Medicare for All has made significant headway in recent years. Through the Democratic Presidential debates, a single-payer system has been promoted on a national stage. Now, it is a conversation within the public consciousness. Additionally, the AMA withdrawal from the largest coalition fighting single-payer reform represents a massive shift.
For decades, opposition to Medicare for All-style healthcare was the prevailing opinion of healthcare institutions. Now, the tide is turning. Medicare for All looks increasingly likely for America’s future, potentially bringing about the following changes:
- The federal government managing and paying all medical costs.
- The dissipation of private insurance.
- Coverage of millions of underinsured Americans.
- The decreased financial burden for healthcare providers and consumers.
- Higher tax rates for certain income brackets.
Shifting to a Medicare for All system means massive reform. Some healthcare physicians are against these changes, citing the increased demand and lack of resources. Overburdened doctors could lead to burnout, which would hurt the quality of healthcare.
Alternatively, many physicians are beginning to believe Medicare for All might just be the solution America needs. In recent years, expansions and changes to Medicaid prove that a publicly funded system can effectively cover many people. Medicare for All would expand that coverage to ensure that all Americans receive coverage. In turn, reducing the bureaucratic headache that comes with a multifaceted payment system could lead to reduced costs and burnout.
Regardless of whether or not healthcare professionals settle on the merits of a single-payer system, a future of reform is sure to follow. The debate regarding Medicare for All raged long before the coronavirus pandemic emerged. That event triggered millions to lose their jobs and attached health insurance. In the wake of the pandemic, a single-payer system that removes employers from the healthcare equation makes sense to more and more professionals and average consumers alike.
Medicare for All comes with its own set of problems and solutions. Healthcare professionals are weighing in, with more seemingly on the side of a single-payer healthcare system. The AMA vote that nearly overturned opposition to Medicare for All marked the shifting of a public consensus in the healthcare industry towards the value of such a system. However, obstacles abide in the integration of such reform.
Until the voices of healthcare professionals in favor of Medicare for All can outweigh the powerful lobby united against it, real change may be a ways off. In the meantime, more medical professionals are warming to the idea of a single-payer system. This shift defies party lines and institutional loyalty to focus on the good of the American public. It is yet to be seen if Medicare for All truly represents the best interests of American healthcare. To a growing majority of its professionals, however, the benefits of single-payer care seem to outweigh the challenges.