Beware MDs for Medicare for All

Such a system would be disastrous for patients.’ physicians — and

THE self-described “house of medicine” is entertaining support for a government takeover of health insurance for the second time in five years. A group of New England doctors pressed the American Medical Association’s House of Delegates this month to drop the organization’s opposition to single-payer health care. The effort ultimately failed (for now). And good thing. Such a system would be disastrous for physicians — and patients.

Single-payer health care is what it sounds like — an insurance program where the government is the only insurer. Private insurance would be banned. And the government would pay health-care providers whatever it deemed appropriate and affordable.

In countries with government-dominated systems of universal coverage, those public payments are much lower than what American doctors are used to earning. The average physician in America makes $316,000 a year, compared with $183,000 in Germany and $138,000 in the United Kingdom, according to a 2021 survey.

Even here in the United States, public insurers pay less than private ones. Medicare, the government health plan for seniors, pays doctors roughly 30% less than private insurance. It cut Medicare reimbursements in 2023 — and is set to do so again in 2024.

Medicaid, the public health plan for low-income Americans, pays even lower rates — 30% less than Medicare.

Seemingly every year, Congress considers slashing Medicare reimbursement rates for doctors. And seemingly every year, the AMA descends on Capitol Hill to lobby against those cuts, arguing that lower pay will cause doctors to turn away Medicare patients — and thereby make it harder for patients to access care.

Yet the AMA is flirting with

Medicare for All, which would result in bargain-basement government payment rates for every man, woman and child in the United States. What gives?

American doctors battling private insurers over billing, prior authorizations and paperwork may think that a government-run system will be simpler and easier to deal with. But government-run systems stretch doctors to their professional breaking point.

A 2023 Commonwealth Fund survey of primary-care providers in 10 high-income countries found that 47% of American doctors were satisfied overall with their practices. That’s a higher level of satisfaction than what primarycare doctors in Britain, Germany, Australia, New Zealand and Canada reported.

Just 7% of British and German doctors were happy with how much time they saw each patient, compared with nearly one-fourth of US primary-care providers. And German, British and Canadian doctors all reported lower levels of work-life balance satisfaction than American counterparts.

Doctors in England’s National Health Service have undertaken a series of short-term strikes over the past year to protest working conditions and seek better pay and hours.

Low government payment rates in countries with single-payer or government-dominated universal-coverage systems result in chronic shortages of care. Who wants to work long hours for a salary that doesn’t reflect one’s level of productivity?

Patients may have ostensibly “free” care through a governmentrun health plan. But they must wait for that treatment.

In the United Kingdom, the wait list to receive care from the National Health Service has reached 8 million, in large part because of staff shortages and underfunding.

In Canada, the median wait for treatment from a specialist following referral by a general practitioner was more than 27 weeks last year.

Many Brits are responding to these waits by paying for care privately out of pocket. Similarly, several Canadian provinces are increasing their reliance on private clinics to help clear backlogs of people waiting for care.

In other words, as progressive Americans make the case for singlepayer, foreign countries with such systems are going the other way.

Contrary to popular belief, just one-quarter of practicing physicians in the United States are members of the American Medical Association. That number may decline further if the organization keeps flirting with a single-payer system, which would prove devastating for physicians and patients alike.