An Analysis of The Physician Perspective On Single-Payer Health Care System
Single-payer health care is a controversial idea in the U.S., but a majority of physicians now support it, new survey finds.
Fifty-six percent of doctors registered either strong support or were somewhat supportive of a single-payer health system, according to a Merritt Hawkins. In its 2008 survey, opinions ran the opposite way — 58 percent opposed single-payer survey. What’s changed?
Red tape. Doctors tell Merritt Hawkins, physician consulting firm, that based on thousands of conversations with doctors each year, physicians state that they are tired of dealing with billing and paperwork, which takes time away from patients. Physicians also miss the clarity and simplicity of single-payer. In their minds, it would create less distractions of taking care of patients — not reimbursement.
A single-payer system – public entity such as the government – would pay all the medical bills for a certain population, rather than insurance companies doing that work.
A long-term trend away from physicians owning their practices may be another reason that single-payer is winning some over. In 2016 fewer than half of practicing physicians owned their practice — 47.1 percent — according to the AMA surveys from 2012-2016. Today many doctors are employed by hospitals or health care institutions, rather than working in traditional solo or small-group private practices. These doctors appear less invested in who pays the invoices.
Doctors Sense A Growing Sense of Inevitability In Single-Payer Coverage
The August 3, 2017 survey below was mailed to 70,000 physicians; It received 1,003 responses
The ACA established the principle that everyone deserves health coverage. Inside the medical profession – certainly key players in the scenario – the conversation has changed as to how best to provide universal coverage. Dr. Steven Schroeder, a researcher on how physicians are paid, says the attitude of medical students is shifting. As an instructor of medicine at the UC-San Francisco Medical Center since 1971, he sees students’ increasing support for a single-payer system, which he predicts will likely carry into their professional careers.
In February, a LinkedIn survey of 500 doctors found that 48 percent supported a “Medicare for all” type of system, and 32 percent opposed the idea. Nearly half of the responding doctors said they would support a single-payer system, not just the elderly,instead of the current patchwork model of insurance coverage.
A second survey conducted by the Chicago Medical Society in June sent to more than 1,000 doctors, found that 56 percent of “area” doctors picked single-payer as the “best care to the greatest number of people.”
As of June 2016, more than 2,500 doctors have endorsed a proposal drafted by the Physicians for a National Health Program (PNHP), representing 21,600 doctors, medical students and health professionals, want a single-payer program to replace the ACA.
Many physicians say that the reasons that patients delay care until they can’t wait any longer are complex. But a barrier doctors said they consistently see is a fragmented system: People either don’t have health insurance or can’t find a doctor who accepts their coverage.
The physician are concerned about the ongoing ACA status debate. For many, the issue comes down to efficiency. They cited the administrative hassle of working with multiple insurance companies, each with its own rules and billing procedures. They also don’t like the hidden costs, like patients who bounce from one healthcare provider to another as their health plans change.
Collections – Negotiating – Payment Plans
Interestingly, even though doctors acknowledged they might take a financial hit under a single-payer system, many respondents said it would be more than mitigated by getting out of the collection business. In other words, even if they earned less, there would be more patient care and less of the aggravation that comes with negotiating with and tracking down payment from multiple insurance companies.
In 2012, billing and insurance related costs totaled $70 billion for physician practices. As many as 64 percent of doctors in LinkedIn’s survey said they have implemented measures to collect from patients with high deductible plans. One-third of respondents now offer payment plans; 26 percent are requiring up-front payment. Nineteen percent have hired additional staff, like financial counselors, to handle payment issues.
Under the current system, patients who venture outside their insurance network of healthcare providers can find themselves on the hook for hefty co-pays. To help patients avoid that, doctors and their staff spend hours looking for in-network labs, pharmacies and physical therapists.
And then there’s the time spent dealing with insurance companies. More than half of the physicians in LinkedIn’s survey, 54% said their job includes negotiating with them, at an average of four hours weekly: They have to call to get prior authorization to do a procedure. They have to call when their treatments are denied coverage. They have to change their prescribing plans when certain drugs aren’t covered.
There are a lot of players in the ACA universe and physicians play a center-stage role in the process. Their perspective is vital to finding a solution that makes health care conducive to everyone.
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Source: US News