Sally Pipes in WSJ: Medicare for All Could Mean Doctors for None


Professional groups representing doctors are buying into Democratic plans to remake health care—and thereby acting against the interests of their members. The American College of Physicians, the second-largest organization of U.S. doctors, recently came out in support of either a public option or single payer. At the American Medical Association’s annual meeting last year, some 47% of delegates voted to reverse the organization’s opposition to single payer. A new organization styling itself Physicians for a National Health Program has attracted some 20,000 members.

Some doctors evidently believe Medicare for All would deliver better health care for Americans. Some no doubt think more insurance would mean more patients. But it would also force physicians to work longer hours for less pay.

A single-payer program would pay doctors at rates similar to Medicare reimbursement levels, already at least 25% less than private insurance pays, according to estimates by Charles Blahous of the Mercatus Center. Under the current legislative drafts of Medicare for All, government rates over the first decade would be 40% lower than those paid by private insurers.

That amounts to an enormous pay cut for doctors. U.S. physicians earned on average $313,000 in 2019, according to Medscape’s international physician compensation report. The average physician in the U.K. earned only $138,000. The Commonwealth Fund reports that American general practitioners earned a little more than $218,000 on average in 2016, compared with $146,000 in Canada and $134,000 in the U.K.

Drastic pay cuts would inevitably drive physicians to give up the practice. Patients can’t afford an exodus of doctors. Nearly 80 million people live in areas with too few primary-care professionals, the Kaiser Family Foundation reports. Even under current policies, the country may face a shortage of as many as 120,000 doctors in a decade, according to the Association of American Medical Colleges.

The prospect of lower pay and stressful work would also discourage young people from entering the profession. Medical school is expensive; the median graduate takes on $200,000 in debt. It’s time-consuming, too. The typical doctor spends four years in medical school, followed by three to seven years in residency and fellowship. Lucrative jobs in finance, technology and law require far less preparation time.

One report from FTI Consulting found that Medicare for All would reduce the projected number of U.S. physicians in 2050 by about 44,000, including more than 10,000 primary-care doctors. Patients would have to compete for appointments with a dwindling number of overloaded and underpaid doctors. Everyone would have coverage, but that’s not the same thing as care.

Ms. Pipes is president, CEO and the 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).

Nothing contained in this blog is to be construed as necessarily reflecting the views of the Pacific Research Institute or as an attempt to thwart or aid the passage of any legislation.

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