Tag Archives: Finance

Growing Sentiment

A couple of months ago, I wrote that I favored transforming our complex hodge-podge of health care financing to a national single-payer system. It now seems as though a majority of physicians in the US  feel the same way, with 42% strongly supporting the idea. This is a remarkable evolution from the days when the American Medical Association vociferously opposed the creation of Medicare and Medicaid in the early 1960s. Why the shift?

The folks who commissioned the poll cite 4 major reasons:

  1. Complexity fatigue. Back in the day, Medicare was seen as a threat to the simple and straightforward fee for service relationship that physicians had with their patients. Doctors resisted the intrusion of the “government into the exam room.” Now, the exam room is crowded with so many players, each with its own rules and demands, that having only the government to deal with would seem like a relief. This certainly rings true to me.
  2. Many feel as if the handwriting is on the wall about movement toward a single payer, so they grudgingly agree that we might as well do it sooner than later. I would say that another way to look at this is that few can articulate another alternative that reduces administrative complexity and expands coverage.
  3. Shifting demographics. Merritt and Hawkins cite a generational shift, with younger physicians more inclined to support a single payer. I don’t have the data they cite to judge the validity of the explanation, but I suspect it is not just about age, but about the changing nature of physician employment. As more and more physicians are employed by health systems or other large organizations, I believe they feel more financially secure, and more insulated from the details of reimbursement which makes them more open to single payer.
  4. Changing assumptions. One of the most remarkable aspects of the recent debacle in Congress over attempts to repeal the ACA is that public opinion has changed in a fundamental way. It now seems that there is a widespread belief that the government does have a legitimate role in guaranteeing access to health care, and physicians agree.

Another sign that physicians’ attitudes are changing: record membership in Physicians for a National Health Program.

I think the time has come. What do you think?

Are You Ready for This?

I recently learned about a new business called “medibid.” Billing itself as “the only real solution” to rising healthcare costs, medibid acts as a broker, allowing patients to register (for a fee) and describe what kind of healthcare service they are seeking and allowing physicians (who also pay a fee) to “bid” for the business at a stated price. As they say on their website: “MediBid has been called the ‘Priceline of Healthcare’ or the ‘Travelocity of Healthcare’ because of this.”

Wow, I admit to being fascinated and a bit horrified at the same time. On the one hand, I had a, “Boy, I wish I had thought of that” moment, followed quickly by, “OMG, is this really where we are headed?” Continue reading Are You Ready for This?