Physicians' Support for Single Payer May Be Increasing

Ken Terry

April 04, 2017

The percentage of US physicians who support the idea of a single-payer, government-run healthcare system is on the rise, according to a new survey. Forty-eight percent of the more than 500 physicians who responded to a LinkedIn poll in February favored switching to a single-payer system, while 32% of them opposed it and 21% were uncertain. In contrast, a study published in 2009 in the Journal of General Internal Medicine found that 42% of US physicians endorsed a single-payer approach.

The sample in the latter poll was more than triple the size of that in the LinkedIn survey. Nevertheless, a LinkedIn article on the results said that the physicians in the survey were "chosen at random, and reflect a number of different specialties and years of experience." Of the 511 respondents, 449 were practicing physicians.

The survey shows that physicians who supported single payer were often motivated by a desire to increase efficiency. "They cited the administrative hassle of working with multiple insurance companies, each with its own rules and billing procedures," the article said. Even if their revenues sank under similar payer, these respondents said, shedding the time and cost required to collect from insurance companies would more than counterbalance the decline in income.

Physician practices in the United States spend approximately $70 billion a year on costs related to billing and insurance, according to a 2014 study in BMC Health Services Research.

Up to 64% of the doctors in this new  survey said they had implemented various measures to collect from patients with high-deductible insurance plans, which are on the upswing. These approaches include offering payment plans (33%), requiring payment upfront (26%), hiring additional staff such as financial counselors (19%), requiring patients to meet their deductible prior to certain procedures (10%), and steering patients to a mid-level provider or lower-fee services (6%).

Fifty-four percent of the respondents said their job includes negotiating with insurance companies — a task on which they spend an average of 4 hours per week. These duties include calling to get prior authorization for procedures or when health plans deny coverage for the treatments they prescribe, according to the LinkedIn article.

Physicians for a National Health Program (PNHP), which has long led the fight for a single-payer system in the United States, last year formed a working group that introduced a single-payer proposal at the same time that Sen. Bernie Sanders (I-VT) was advocating "Medicare for All" on the presidential campaign trail.

Signed by 2200 physicians and medical students, the proposal for a tax-supported healthcare system would allow patients to go to any doctor or hospital they chose. Prescription drugs, mental health care, dental care, and long-term care would all be covered, and the government would negotiate drug prices with pharmaceutical companies.

Under the PNHP proposal, doctors and hospitals would continue to be privately owned and operated. But, as in Canada, they would receive a budget from the government to cover all of their operating costs. Physicians could continue to practice on a fee-for-service basis or could receive salaries from group practices, hospitals, or clinics.

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