Skip to content

Doctors Prefer Single Payer Insurance

A new survey of US doctors shows that 48% of them are in favor of a single-payer health insurance system (like Medicare for all), while only 32% are against it, and 21% answered “I don’t know”.

What was especially interesting was that the doctors acknowledged that they might take a financial hit under a single-payer system, but they said it would be worth it because it would relieve them of having to collect money and deal with a plethora of insurance companies, each with their own rules and forms.

Duh. Doctors want to practice medicine and don’t want to spend their time doing aggravating paperwork and collecting overdue bills from patients.
As one doctor put it:

As a doctor, it’s really against my best interest to support single-payer healthcare. It reduces my earning potential. At the same time, it’s about human rights and taking care of people that need help—that is why I do this work.

Costs include the time they spend dealing with insurance companies: getting prior authorization from them, calling when their treatments denied coverage, changing prescriptions when the drugs they have prescribed aren’t covered.

And there are other costs for doctors. Because different insurance plans have different networks of hospitals, specialists, and laboratories, doctors and their staff have to spend hours looking for in-network providers. A single unified insurance plan would avoid that problem entirely.

And then there are costs due to fragmentation of health insurance. As people move from one job to another, often their insurance company changes. The same thing can happen even when they don’t change jobs, but their company decides to change health insurance plans. This can force employees to change doctors to one that is in their new insurance company’s network. In many cases, this will cause tests, procedures, and paperwork to be repeated.

The results of this survey are surprising, given that doctors in the US face a unique problem. Medical school in the US is very expensive compared to other countries and 79% of new doctors here face more than $100,000 in debt from their education. Doctors need substantial income to pay that debt off.



  1. ebdoug wrote:

    I’m on Medicare. The plan is administered through a private insurance company and has changed many times. Meanwhile I just swipe the card at the MDs if it changes. What’s to lose? Private insurance stays in business and handles it all on their end. No jobs lost there.
    I’ve been arguing this since I worked as a nurse in Berkeley in 1966.

    Medical insurance is like the Bathroom laws in NC, Arizona, Texas. Much ado about absolutely nothing.

    Always, always in this state there is financial help for medicare insurance. I found that out when I went on Medicare. They asked me over and over if I could afford the 1K plus a year. Medicare is optional. No one needs to sign up for it. And as I said, in New York it is income adjusted.

    Sunday, April 2, 2017 at 3:58 am | Permalink
  2. Wildwood wrote:

    Having insurance not tied to a company you work for is very liberating. Many are stuck in a job because they can’t aford to lose insurance coverage when they change employers. Decades ago, my husband wanted to move us across country to job with a start up that offered no medical for employees. After some “discussions” he opted to stay where he was. It turns out it was the right choice, but it could have also been a great choice. There are probably many people who stay with jobs they don’t like because of losing their health care. Single payer could be the best thing ever for the job market, giving people the freedom to choose a job that interests them instead of one that covers medical. It should never have been something that your employer controlled. Single payer means that employers might have to raise salaries and other benefits to keep good people.

    Right now, since our Medicare is through husbands former employer, we can only get coverage where the employer has facilities. That limits us to about 4 or 5 states if we wanted to move. We are only partially covered if we are traveling as well. That doesn’t give me incentive to travel as much as we would if we were covered. All sorts of wonderful things can happen with single payer.

    Sunday, April 2, 2017 at 8:17 am | Permalink
  3. Ralph wrote:

    The same people feeling trapped in a job they hate for fear of losing their health insurance want us to believe Obamacare is a government conspiracy trying to shove socialism down our throats.

    Sunday, April 2, 2017 at 9:50 am | Permalink
  4. ebdoug wrote:

    Ralph, And yet, they all take Medicare without thinking.

    Theoretically, if companies get rid of health care costs, the cost of goods should go down.

    Being self employed (or part time jobs like Tax Collecting and tax preparation) most of my life, until I went on Medicare, I paid my own. Only for about six years did someone else pay it. Gave me freedom.

    Sunday, April 2, 2017 at 12:03 pm | Permalink
  5. notycoon22 wrote:

    EBDoug and Wildwood, I’m confused by your use of the term “Medicare.” Medicare is administered by private companies, true. That they change due to periodic awards of new contracts is also true, and the change is transparent to the client. This doesn’t mean, though, that all private insurance companies would be picking up Medicare contracts. It does mean that insurance companies would be much more limited in the clientele for which they are competing. Medicare supplemental insurance may well be the new target of the private insurance industry.

    Medicare doesn’t come through an employer – either current or former. It is a Federal program and once one enrolls, the employer doesn’t matter anymore. One does have an option to enroll in Medicare, but that can exact a very tall penalty if one chooses to enroll later in life (unless one has current insurance through an employer). Enrollment eligibility is based on age and participation through payroll tax contributions. Right now, not everyone who turns 65 is eligible.

    Medicare covers all 50 states (I don’t know if it covers the colonies like Puerto Rico or American Somoa). There is no restriction on services in the US. It does not cover on outside the US. Wildwood, I’m not sure what would be limiting your ability to travel.

    Sunday, April 2, 2017 at 12:30 pm | Permalink
  6. Iron Knee wrote:

    Not just the cost of goods. When I lived in New Zealand, the cost of car insurance was so much less than the US, because it didn’t have to cover medical liability.

    Sunday, April 2, 2017 at 12:30 pm | Permalink
  7. notycoon22 wrote:

    Oh, I forgot to mention: as far as income adjustments to premium costs, there is a flat fee (different for different groupings based on date of enrollment and whether or not payment for premiums is deducted directly from one’s Social Security check) for Part B until one reaches a joint income of $170,000.

    Sunday, April 2, 2017 at 12:34 pm | Permalink
  8. Ed Alexander wrote:

    Oh, yeah, doctors really get screwed under single payer systems like here in Canada. How much do they make in the US? The average family doctor in Canada makes $271K, with the physician average $339K, and some specialists 4-500K. This is somehow not enough? Source:

    Sunday, April 2, 2017 at 1:42 pm | Permalink
  9. Iron Knee wrote:

    Ed, those are misleading numbers. According to the article you linked to, those are *gross* numbers. From that, they have to pay the salaries of staff, pay the rent for their office, buy medical supplies, etc. Even $500K to run an office with employees doesn’t seem out of line.

    Sunday, April 2, 2017 at 5:30 pm | Permalink
  10. Wildwood wrote:

    Noty, my husband retired from a huge company and they provide us with a choice of policies every fall. They are Medicare aligned, (we have Medicare deducted from pension as well as insurance costs), but are not the same as policies offered on the open market. We have an Advantage Gold Plan that is not exactly the same as if we bought one on the market from the same provider. There are differences, I can’t tell you what they are because it’s like buying a mattress. Who knows if the Serta Deluxe Soft is the same as the Sears Serta Deluxe Comfort, or the Macy’s Serta Deluxe Supreme. I am assuming that they might be paying something to the insurance companies to provide us with these choices, but I don’t know that either. We have kept it for years because, first, if we drop it, we can’t get it back, and second because we can not be excluded because of preexisting conditions. That has always been a big problem with both of us. Everyone could be excluded for minor preexisting conditions, at least prior to the ACA and we both have major reasons for exclusion.

    And contrary to what you have stated, we have only limited coverage while out of this area. I’m part of a group of older people who have health care discussions and I can tell you that it is not unusual with some Medicare Advantage policies to not cover you in other states or areas, and then only for an emergency. I guess the Medicare part would pick up some costs, but that can be very limited. Some Advantage Plans offer emergency coverage outside the US, but not all.

    Original Medicare does not offer coverage outside the US. But it does offer coverage in any hospital that accepts Medicare in the US, including places that we govern, like Puerto Rico and American Samoa etc. But this is not the policy we have.

    And for us to keep our employer sponsored coverage we must be in an area where the company has facilities. So we are limited to 5 or 6 states should we want to move, dictated by the where the company has locations, and risk when we travel outside this area because of our Medicare Advantage Plan.

    We have kept this plan primarily because the preexisting condition problem. After enactment of the ACA, I had hope that we might be able to drop our plan and go on the open market. But I decided to give it a couple of years to see what would happen and now I’m glad I didn’t make that change. With our health and finances in the balance, we are better off staying with what we have, restrictions and all.

    Monday, April 3, 2017 at 1:37 pm | Permalink
  11. Ed Alexander wrote:

    Oh, I just love to make you Yanks drooool!! Our universal single payer health care in Ontario pays for me NO MATTER WHERE I GO IN THE WORLD!!
    The Globe article is not clear. Here’s another which is

    Tuesday, April 4, 2017 at 10:07 am | Permalink