Consider last year’s Kaiser Family Foundation’s analysis of the August, 2017 Merritt Hawkins survey of 1,033 US physicians which showed for the first time a plurality of US physicians favored movement to a Single Payer system. Compared to 2008, when 58% of physicians opposed such a shift, 56% now support it (42% “strongly”, 14% “somewhat”).
Merritt Hawkins attributed the shift to four factors:
- Physicians are seeking “clarity and stability”. They believe “single payer” will reduce “distractions.”
- There is a generational shift underway. “Younger doctors are more accepting.”
- Physicians have become resigned that “we are drifting toward a single payer system” – so let’s get on with it.
- There is a philosophical change occurring that increasingly embraces the societal value of universal coverage.
The Kaiser release also referenced a June 2016 American Public Health Association published proposal drafted by the Physicians for a National Health Program with now nearly 22,000 physician and medical student members. That proposal echoed some of the five Code Blue points – universality, single administration, local delivery, health planning, and inclusive transparency.
Specifically it also unveiled weaknesses in the incremental approach under the ACA including:
- Not Universal: A CBO report predicting 27 million remaining uncovered by 2026.
- Reporting Requirements: “Mind numbing” and time consuming requirements for documentation and reporting.
- Administrative complexity”: Robs time with patients.
- Limited comprehensiveness: A trend toward “skinny plans” which are little better than no coverage at all. Plus they push narrow physician and hospital panels.
- Underinsurance: A tripling of deductibles and “punishingly high copayments” paid by consumer.
- Failure to Control Costs: A decade of Republican attacks on ACA “has elicited ubiquitous gaming of risk adjustment and quality measure” incentives, spawning giant moves toward hospital and insurer consolidation.
- Market-Based: “Any method of payment can create perverse incentives in a market-based system.”
You can’t cure crony capitalism with more capitalism – even if it comes from Bezos and Buffett.