Single Payer Healthcare — Death of Providers
An “uninformed” look at how the proposed single payer healthcare system can hurt. Painfully.
NOW. Onto the things that have had me disgruntled for awhile now. Single Payer Healthcare.
It’s understandable that the healthcare industry does not like this sort of talk, especially in the U.S. No-one wants to earn less money, but unfortunately the politicians and “experts” have emphasized that single-payer is the way to go. I agree. I wholeheartedly agree, as long as there are stipulations to the change. Single-payer is terrific to the people and patients, only thing that it creates an abyss of overwhelming hate is within the medical industry. Now, that’s not really a minority considering the size of the industry but others are fighting for the effects of single-payer, and that is decreasing the salary and income of medical professionals. Now that I do not agree with. There is a reason why medical professionals are paid a relatively fair income… college. medical school. residency. fellowship. Think of the time? Now think of the debt incurred. Now obviously this segment isn’t TOO applicable to professions such as nurses, NPs, CRNAs, PAs and what not because the reason there is that profession is due to the lack of interest in losing so much time and money. So this is focused on the physician, but understand as well, that single-payer will affect everybody, but physicians will just take a harder hit.
Currently single payer healthcare will essentially expand access to Medicare/Medicaid to all, so that everybody is covered by the basic government health insurance to cover basic needs. However, the value of the reimbursement will go down as well. Yes. There will still be private insurance and it will still be used for elective procedures and to avoid waiting times, in fact similar alternatives such as cash-clinics have started to open up in the UK and Canada as well. But those reimbursements from government insurances are one word, crap. They rarely ever cover the actual cost of care given most of the time, and that’s already being fiscal by not needlessly ordering tests and labs. Now, these physicians will take a hit to their salary and I am against that in some situations. Maybe it’s selfish, but the reason the physicians are compensated well is because of the extremes of medical training knowledge. It is truly skilled labor, and although there has been a rise in mid-level practitioners, until they get similar training, all the MLPs are good for are basic screening and physicals, and maybe some of the more intensive procedures. Debt from medical school is often upwards of $200k with an increasing percentage of interest. Now single-payer will reduce the wages, and residents already get a meager wage similar to what a recent college grad would earn… but for double the hours and 4 years lost in potential earnings due to medical school, you’re asking them to put together a house with materials like toothpicks instead of bricks… it’s hard, and almost close to impossible for them to achieve similar results… this is how it will be for medical students and newly minted residents to pay back ever increasing debts with a lowered wage now. It’s already difficult for medical students today, but increase the already widening gap, and there may even be a physician shortage in the future. These new docs MIGHT just quit, because the prospect of such a huge debt and in return for such a meager wage can be a huge turn off, bigger than what it is already.
Yes, fighting with insurance companies over reimbursement sucks, but if you don’t like it, you have the freedom to not accept a particular insurance. With a single payer system, the only scenario I can picture in my head is, “oh you don’t like your abysmal salary? Too fucking bad. What are you gonna do about it?”
Now, I do still think that single payer healthcare is a viable option, but only with a few stipulations covered and one of which I want to talk about today is, medical education. Sure, single payer can lead to cost savings and improvements in access and quality (not too sure about that yet) which are great indicators at increasing public health. But countries that typically have a single payer or national health system do have lower wages to their physicians and general practitioners, however that is also in part by heavily government subsidized medical education. Medical education must have a reform first in order to have a successful single payer implementation. It’s too much to ask the government to cover the cost of medical education, or is it?
There are about 20,000 matriculants per year, and assuming all of them stay for the 4 years of medical education, means about 80,000 medical students at any given time (not including for increasing spots and what not)… now let’s say a yearly tuition is about $60,000… not too bad, similar to some of the higher end undergraduate… but now let’s take into account cost of living? I’m just going to take on another arbitrary $20,000 meaning $80,000 per year. That comes out to about $6.4 billion a year… which is paltry in comparison to the 3 trillion healthcare industry. Now even if we decreased the cost of medical education, that’s great for new docs… but what about the current and “to-be” physicians? Those that have already amassed a large debt? Now they have an increasing debt and interest with an even lower salary… good luck raising physician morale. It’s amazing to save a life, but not when you’re losing your own to crippling debt.
Current physicians won’t like a paycut, and current students, while happy with a greatly reduced cost of education, will be unhappy when they realize that their earning curve got bent like a car hitting a tree. Yes, medical school is expensive, but being a physician is also financially rewarding– you can pay off that 300K debt in a couple years. Going debt free in exchange for millions in life time earnings is a questionable tradeoff. Of course physicians are in it for more than the money, but the idea of losing out no potential earnings is never a happy day.