The official Medicare for All bill submitted by House Democrats in February has doctors, hospitals, and insurance companies fearing how the switch to a single-payer system would affect their bottom line.
What is Medicare for All?
There are currently dozens of proposed bills floating around Congress which would attempt to move the United States closer (if not fully) to a single-payer healthcare system. Most bills fall under the umbrella of Medicare for All and share the commonality of providing healthcare coverage for every single American.
This system would provide coverage similarly to the way Medicare provides coverage for all Americans over age 65 and some Americans with disabilities. If Medicare for All becomes the new American healthcare system, many healthcare industry professionals could face major changes.
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The impact of Medicare for All on private insurance companies would be the most drastic, aggressive change by far. Many of the proposed Medicare for All bills advocate for a complete elimination of private insurers. According to data from the Kaiser Family Foundation, 56 percent of Americans are covered by private insurance, 36 percent are covered by government-funded insurance, and about 9 percent of Americans are currently uninsured.
Private insurance companies typically report billions of dollars in profit every year. These companies would have to adjust their business models and find a new way to prosper within the new healthcare industry, or shutter their doors altogether.
The potential impact of Medicare for All on hospitals is still unclear, and possibly the most important change to consider.
One positive impact of Medicare for All would be that hospitals are guaranteed payment under a single-payer system. This would be especially beneficial to hospitals in rural communities that often serve larger proportions of uninsured or impoverished patients.
However, a negative impact of Medicare for All would be that a single-payer system would almost certainly decrease profit margins of hospitals across the country. Private insurers pay around 100-200 percent more than Medicare pays for the same services and treatments, so eliminating this sector of the American healthcare industry would greatly affect hospital profits. This is a problem because hospitals often use excess funds to invest in healthcare innovations.
Although single-payer healthcare systems have been proven to provide better health outcomes for much less money than the U.S. spends on healthcare, people are still concerned Medicare for All will cause doctors to take a pay cut. The fear is that less money will make doctors less inclined to help sick or injured people.
However, if physician salaries are affected at all by a shift to a single-payer system, it would be the result of shrinking long-term pay raises rather than direct salary reductions. Would this shift be a painful sacrifice for physicians? Possibly, but increased salary doesn’t always equate to personal happiness, as indicated by the 2017 World Happiness Report.
One positive impact of Medicare for All for doctors is that a single-payer system would reduce many of the administrative hassles doctors face daily under the private healthcare system. For example, doctors would spend less time going to battle with insurance companies over coverage determinations, payment denials and requests, etc.
If a doctor pushes hard enough for their patient, the insurance company may budge, but that kind of ruthless advocacy can take a mental toll and isn’t sustainable when doctors have hundreds of patients. Canadian doctors are less than one-third as likely to dispute with insurance companies compared to American doctors.
The financial impact of Medicare for All can only be theorized, but if one of the many proposed bills passes through the Republican Senate, it will certainly require healthcare professionals across the country to make adjustments in order to work within the new system.
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