Most Physicians Prefer Single-Payer Option Over Medicare For All

Providing affordable health insurance coverage is a top goal for physicians and most believe healthcare can achieve that through a single-payer option, a new survey reveals.

The final installment of The Physician Foundation’s 2020 Survey of America’s Physicians series recently found that 67 percent of physicians prefer a two-tiered system featuring a single-payer option in addition to more traditional private payer coverage.

Conversely, responding physicians ranked a single-payer or Medicare for All system as the least favorable option for improving key issues in healthcare, like patient access, value and quality, health system efficiency, and physician compensation.

Other options included maintaining or improving the Affordable Care Act (49 percent favored) and moving to a market-driven system with health savings accounts and catastrophic policies (45 percent favored).

Providing affordable health insurance coverage was also the most important step for ensuring high-quality, cost-efficient care in the near future, with 89 percent of physicians saying it was either “important” or “extremely important.”

Most physicians (84 percent) also agreed that increasing physician leaders in key decision-making positions was an important step for the near future, followed by establishing price transparency (79 percent) and reducing health inequity and inequality of access (75 percent).

“Our current health care system is directed by policymakers and business executives, instead of physicians,” Robert Seligson, CEO of The Physicians Foundation, said in an announcement. “Physicians are the foundation of health care, and as such they know what is best for our system, and the patients they serve. These data provide a clear picture of what physicians want to see in our health care system. It’s critical these insights are included in any and all health care reform discussion if we hope to improve access to quality care.”

Health insurance coverage has been a major challenge of access to quality care, especially during the COVID-19 pandemic.

Two in five working-age adults did not have stable health coverage earlier this year because of pandemic-related job disruptions, the Commonwealth Fund reported. And up to 3.5 million of adults could end up losing their coverage altogether if employers decide to not bring workers back, according to estimates from the Urban Institute.

The changes in coverage among working adults has already led to increases in uncompensated care and bad debt for over 40 percent of hospitals, consulting firm Kaufman Hall recently reported. About the same proportion of hospitals are also seeing increases in uninsured or self-pay patients and Medicaid patients, respectively.

Ensuring coverage would mitigate some of the financial troubles brought on by a higher uninsured rate, while also increasing access to care, which physicians believe will be in high demand in 2021 as patients experience chronic conditions and those conditions worsen because of pandemic-induced care delays.

Physicians also agreed that prior authorization reform would also be needed sometime in the future to ensure access to high-quality, cost-efficient care. About 89 percent of responding physicians said simplifying or streamlining prior authorizations for medical services and prescriptions is important for achieving high-quality, affordable care.

Additionally, simplified access to integrated mental health services (86 percent), insurance coverage for COVID-19 care (83 percent) and telemedicine reimbursement (82 percent) also topped the list of important or extremely important policy steps.

Most physicians also said eliminating surprise billing and reimbursing physician-directed efforts to address social determinants of health were key to delivering high-quality, cost-efficient care for all. However, the policy steps were deemed less important by responding physicians (78 percent and 63 percent, respectively).