As Congress holds hearings on the Medicare for All Act introduced in the House in March, a Medscape poll finds that healthcare professionals are roughly equally divided on the subject.
Fewer than half of the 1306 physicians, nurses/advanced practice registered nurses (APRNs), pharmacists, and those who work in health business/administration who responded to the poll, which was first published on March 6, say the United States should move to a Medicare-for-All system.
The bill seeks to replace private insurance with a federally financed healthcare system that would be phased in over 2 years. Benefits would include coverage for women's reproductive care, prescription drugs, mental health and substance abuse services, dental and vision care, and hospital and outpatient services.
Proponents say Medicare for All would put the United States in line with what other industrialized countries offer their citizens, save money, and improve outcomes. Critics say it would strain government resources, and they argue there are better, less expensive solutions.
Varied Levels of Support in Healthcare
Physicians agreed most with the Medicare-for-All concept (49%), followed by nurses/APRNs (47%), those in health business/administration (41%), and pharmacists (40%).
Although there wasn't much difference in physician support by gender, the gap was larger with respect to nurses. Male nurses were more in favor of Medicare for All than were their female counterparts (60% vs 46%).
Notable differences in support were also seen by age among physicians and nurses.
Table. Percentage of Physicians/Nurses Who Support Medicare for All by Age
| Provider Type | <45 Years | 45–54 Years | 55–64 Years | 65 or Older |
|---|---|---|---|---|
| Physicians | 54 | 48 | 41 | 54 |
| Nurses/APRNs | 56 | 47 | 48 | 41 |
Poll responders in all four categories said that the biggest challenge in switching to Medicare for All would be in determining how to pay for it. Fifty-two percent of physicians put that challenge at the top, as did 57% of nurses/APRNs, 64% in health business/administration, and 59% of pharmacists.
How to pay for it was also the subject of several comments on the poll story.
One commenter wrote, "In a utopian world where money flows like the River Nile and the federal government truly holds the interests of its constituents as paramount, then yes, medicare for all is a wonderful idea."
But another said, "The [US government] already funds over 60% of [US] healthcare. [U]niversal coverage would be a minor increase.”
The second-biggest challenge, according to responders, was bureaucracy, chosen by 51% to 54% in the four categories of responders.
More Than Half Concerned That Physicians Could Lose Income
More than half of providers across all four categories said they were concerned or somewhat concerned that Medicare for All could reduce physician compensation. The breakdown for this worry was 59% for physicians, 51% for nurses/APRNs, 54% for pharmacists, and 59% for those in health business/administration.
Responders to the poll story noted other concerns.
A responder from health business/administration wrote, "[W]hen everyone has 'Medicare for all,' who exactly is going to see all these patients? The offices will be flooded with patients who now have 'Medicare for all.' ”
A gynecologist wrote, "You mean we want to turn over all healthcare to the government? The same Medicare who has done nothing but drive down our reimbursements over the last ten years? As physicians, we are collectively out of our minds to let this happen. We and our patients will pay in the end."
What Needs Changing in Current System?
The poll asked, "Whether or not you agree with Medicare for All, what aspects of current US healthcare most need to change?" Choices were access, cost, level of bureaucracy, link to employment, quality, or other.
Cost was the top target for change across the board, chosen by 39% of physicians, 48% of nurses/APRNs, 50% of pharmacists, and 43% of those in health business/administration.
The second top concern was also unanimous among the categories — added bureaucracy.
The 1306 poll respondents included 375 physicians, 655 nurses, 70 pharmacists, and 206 people in health business/administration.
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Cite this: Healthcare Professionals Almost Equally Divided on Medicare for All, Poll Shows - Medscape - May 29, 2019.
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