Doctors favor single payer, despite likely income hit

Male doctor in white lab coat
There's growing support among doctors for a single-payer healthcare system. (Getty/Saklakova)

As the latest Republican attempt at healthcare reform went down in flames this week, a new survey found that physicians favor a single-payer system by a slight margin.

That’s the case even though many say physician income will suffer under such a system and the quality of care will decrease.

An email survey of 887 physicians and advanced practice clinicians by MDLinx, a physician news site, found physicians favor a single-payer healthcare system (48%) over a multiple-payer system (45%). But while doctors are showing an increased interest in such a system, such as the “Medicare for All” proposed by 2016 presidential candidate and Vermont Senator Bernie Sanders, they also predict a single-payer system would reduce their income and possibly lower quality of patient care, according to the new survey.

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When it comes to the impact on quality, 46% said a single-payer plan would lower quality, 35% said it would improve it and 19% think quality won’t change.

Without enough votes, GOP leaders earlier this week decided to postpone action on the Graham-Cassidy bill, the latest effort to repeal and replace the Affordable Care Act, leaving the fate of healthcare reform uncertain. That bill was opposed by physician groups because millions would lose healthcare coverage.

But medical professionals are divided when it comes to how to fix the healthcare system.

“As a CPA and an M.D., I believe strongly in a single-payer system that removes the insurance industry from the medical delivery system. We must restore the sacred relationship between patient and physician, and only when we move toward a single-payer system can we ever restore it,” pediatrician Craig M. Uhl, of Palm Desert, California, commented in the survey.

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A multipayer system would provide more autonomy to patients, said Elizabeth Blasuci, R.N., of Toluca Lake, California. “Single-payer breeds dependence and strains resources that are already depleted and limited by regulations and overseeing panels,” she said.

“One-size-fits-all is a Potemkin village on steroids,” she added.

The MDLinx survey mirrored a national survey released earlier this month by Merritt Hawkins and Associates that found a growing acceptance of a single-payer system by doctors (56%)—a near reversal of a 2008 survey when 58% of doctors opposed the idea.

Doctors, however, say a single-payer system won’t be good for their pocketbooks. Some 67% said their annual income would decrease, while just over 25% predicted no change and 7% anticipated an increase, according to MDLinx.

Many respondents feared that a single-payer system would require physicians to see more patients for less money. “I do not care about the money,” said osteopath and family medicine physician Harold Kornylak, D.O., of Virginia Beach, Virginia. “It would destroy free choice, individual responsibility, innovation and make medical care like working for McDonald’s.”

The MDLinx survey indicated doctors are ready for a new approach. When asked about the "ideal scenario for U.S. healthcare," nearly 38% said they wanted something completely new because none of the current options, including the ACA, are feasible.

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