Jonathan Harte: Relax, embrace Medicare for all
As a practicing physician, I feel compelled to counter the points made in the letter from Dr. Stacy Childs regarding his apocalyptic portrayal of a Medicare-for-all system.
First, a huge and growing number of physicians would prefer single-payer health care. Dr. Childs seems concerned that physicians will quit, won’t be able to pay office staff and that the brightest individuals will no longer go into medicine.
There have been several upheavals in the medical system over the decades including the introduction of HMO’s, the Affordable Care Act and electronic health records. During each of these changes, some physicians warned of the same points as Dr. Childs. In each of these transitions, some older physicians did retire rather than adapt, but young physicians happily filled the gaps.
The frequent argument that medicare pays only 30 percent of billed charges should be understood. It’s a contrived argument of an arbitrary charge.
Viewing an insurance explanation of benefits from a medical visit is beyond convoluted. Every hospital and doctors office has a master charge list detailing what they think they deserve to get paid.
Medicare decided that each diagnosis or procedure gets a specific reimbursement regardless of what is billed. Insurance companies pay more depending on whether there is competition, but it is rarely close to the list charges that are submitted.
Reimbursement from insurance companies is a complex mess of percentage billed charges, pre-negotiated rates or other voodoo. The fact is that the only people told to pay the list charges are uninsured patients. Let that sink in.
The fear that many office staff would be laid off is also not supported by facts. There absolutely should be less need for administrative costs since Medicare’s bills/codes are submitted electronically, are paid quickly and don’t intentionally deny payments as insurance companies do to increase profits. The savings from needing fewer staff for appeals would itself boost salaries.
Lastly, I’m doubtful that a Medicare-for-all system will inhibit bright young people from entering our field. Newer medical graduates are largely in favor of universal healthcare and are willing to take home less income in exchange for a better quality of life and a more equitable health care system.
Young individuals valuing a larger income over a passion for medicine should probably consider a different career.
Our current health care system sadly causes denial of basic care, people to forego needed medications and sends sick or injured patients to bankruptcy.
We should demand better.
Jonathan Harte, MD
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