Medicare for All is back on Congress‘s agenda. More than 100 House Democrats, led by Reps. Pramila Jayapal of Washington and Debbie Dingell of Michigan, are behind a bill that would outlaw private insurance and enroll every American in a government-run health plan within two years.
They’re joined by a surprisingly large share of health care professionals. National Nurses United, Physicians for a National Health Program and the American College of Physicians—the nation’s second-largest doctors’ group—have all come out in favor of a government takeover of the country’s health insurance system.
Doctors have moved leftward. More now identify as Democrats than Republicans, according to Gallup. But they may want to think twice about embracing Medicare for All, which would slash their pay, wrap them in red tape and lead to worse care for their patients.
Under Medicare for All, physicians would have to accept Medicare’s rates for every single patient they see. Those payments would be much lower than what doctors currently receive from private insurers—40 percent lower, according to an analysis of a previous bid for Medicare for All championed by Sen. Bernie Sanders (I-Vt.) that would’ve put everyone onto government health care within four years.
That would have significant downstream effects on the supply of doctors. Smart young people won’t go into medicine if there are more remunerative opportunities elsewhere. Practicing doctors, meanwhile, might leave the workforce for better-paying gigs in, say, pharmaceutical research or the corporate world. Those near retirement might hang up their stethoscopes earlier than they otherwise would have.
One study estimates Medicare for All would lead to a nationwide loss of more than 44,000 doctors by 2050.
Our communities can ill afford to lose doctors. Already, there is expected to be a shortage of up to 139,000 doctors by 2033, according to the Association of American Medical Colleges.
Medicare for All would wallop hospitals, too. Nine in ten would run consistent deficits under single-payer, according to research from FTI Consulting. Staffing cuts, consolidation and outright closures would follow.
People in wealthier locales might be fine. But patients in rural or traditionally underserved areas might lose the only health care facilities they have.
As demand for care outstrips supply, patients will suffer. An analysis published by the nonpartisan Congressional Budget Office last year predicted “increased congestion in the health care system—including delays and forgone care” under single-payer.
The experiences of other developed countries with government-run health care should serve as cautionary tales.
For years, the United Kingdom’s National Health Service has been plagued by a chronic shortage of health professionals. Even though the government set a goal in 2015 to increase the number of general practitioners by 5,000 by 2020, the workforce actually shrank during that period.
Those still practicing within the U.K. health system are overworked. A recent survey found that one in ten physicians see 60 patients each day, twice the recommended limit. Three of the country’s leading health think tanks assert that, thanks to the shortage of clinicians, patients will have to turn to pharmacists and physiotherapists for care they used to get from doctors.
Medicare for All would dragoon doctors into the service of the state, which would expect them to work longer hours for less pay. Patients would be collateral damage.
For themselves, and those they care for, doctors would be wise to reject single-payer.
Sally C. Pipes is President, CEO, and Thomas W. Smith Fellow in Health Care Policy at the Pacific Research Institute. Her latest book is False Premise, False Promise: The Disastrous Reality of Medicare for All (Encounter 2020). Follow her on Twitter @sallypipes.