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What do Docs Think About Medicare for All?

#MedicareforAll has become the battle cry for many of the 25 candidates for the Democratic presidential nomination as they declare that every American should have easy access to #affordablehealthcare and should not have to choose between going to the doctor and putting food on the table.

"Healthcare should be a right, not a privilege," they say.

But what about a huge segment of the population that would be dramatically affected by such a massive revamping of our healthcare system, the nation's doctors? What do they think about the idea?

Traditionally, organized medicine has opposed any sort of single-payer system. However, last month, the #AmericanMedicalAssociation's House of Delegates nearly voted to overturn that position. While the AMA doesn't represent every doctor in the land, it represents by far the majority, and so what its members say is significant.

When the votes were counted, 47 percent favored eliminating the AMA's official opposition to single-payer, while 53 percent voted to maintain it.

That the vote was even that close was remarkable and represents a significant shift in opinion of AMA members whose livelihood depends upon a healthcare system that fairly and sufficiently reimburses them for their services.

The AMA supported enactment of the #AffordableCareAct, which has been ferociously attacked by the Trump administration and now faces a possible death sentence, depending on an expected ruling in federal court in a case brought by Republican-led states.

Healthcare coverage for some 20 million Americans who are covered by the ACA is at stake as it presumably would come to a halt should the court declare the ACA unconstitutional. It is just the latest instance, however, in which politics threatens Obamacare.

In fact, notes this editorial in Modern Healthcare, politics are at the root of the ACA’s failures—"not its Rube Goldberg design." The Supreme Court allowed states to opt out of the Medicaid expansion, the editorial notes, "and when the GOP-controlled Congress eliminated the individual mandate, key to making rates on the exchanges affordable, it reduced sign-ups, raised premiums and stopped the expansion dead in its tracks."

More recently, the AMA joined the Partnership for America’s Health Care Future, a group of hospitals, drugmakers, and other industry groups that opposes and lobbies against Medicare-for-all. Instead, the organization supports former #VicePresidentJoeBiden, an opponent of the idea who prefers to strengthen the ACA, the legacy of his service with President Obama.

But the winds of change apparently are affecting the AMA just as they also may be affecting much of the electorate.

Bob Doherty, a senior vice president for government affairs and public policy at the #AmericanCollegeofPhysicians, tweeted that such a strong showing within the AMA for single-payer “would have been unimaginable in years past.” As Doherty tweeted: “There is a lot more support for publicly financed coverage than ever before.”

Some political opponents of Medicare for All have warned that hospitals would close if it is enacted because Medicare payment levels are well below private insurance rates. While Medicare for All would set prices at Medicare rates, they are higher than Medicaid rates. Medicaid and the Children’s Health Insurance Program would be eliminated in #SenBernieSanders’ legislation.

Moreover, doctors' administrative overhead, including paperwork, preauthorizations, limited formularies, narrow networks, and high deductible plans would be reduced or eliminated under the plan, some experts say, providing a major incentive for their support. 

At any rate, if the healthcare provider community moves from opposing to supporting Medicare for All or a version thereof, that would be a significant boost for the idea as the presidential campaign heats up.

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