- Roughly half of doctors responding to a LinkedIn survey said they would prefer a single-payer of Medicare-for-all type healthcare system to the current mishmash model of health plans.
- In all, 48% of the 500 physicians said they support some kind of single-payer system in the U.S., compared with 32% who oppose it and 21% who responded "don’t know."
- While a single-payer system would pay less than private insurance, it would be worth it to not have to deal with collections, supporters said.
According to the survey, 64% of doctors have established measures to ensure payment by patients with high-deductible plans. One-third offer payment plans, while 26% require payment upfront. Nineteen percent said they have hired additional personnel to deal with collection issues.
Doctors spend a lot of time dealing with insurers. Fifty-four percent of respondents in the LinkedIn survey said their job includes haggling with payers about prior authorizations, denied coverage for treatments or prescription drug coverage. The time spent negotiating with payers averaged four hours a week.
Negotiations over payment rates can also take a toll, particularly if the payer responds to proposed rates with a low-ball offer. Even if things go well, the negotiation process can take four to six months to complete.
While the federal government has yet to test an all-payer system, several states have waded in. Maryland has had a form of all-payer health insurance since the 1970s and updated it in 2014 to include quality goals mandated by the Affordable Care Act.
More recently, Vermont Gov. Peter Shumlin (D) announced preliminary federal approval to launch an all-payer system using a pay-for-performance model. Providers in the state would join a single accountable care organization for accepting payments from Medicare, Medicaid and private insurance companies.