I retired last year from a psychology practice and was on Medicare and Medicare Advantage panels. So my first point is that there are additional healthcare providers who would be included. Providers is a term that includes all of us.
In addition to low fees, Medicare would need to solve another big hassle that has turned off many providers. Applying to be empaneled in much more onerous than joining an insurance panel, which is done via shared accrediting sites, like CAQH. Medicare provider applications are excessively lengthy and it takes many months for them to be reviewed.
Returning to the fee issue, though, that’s a big deal. Once Medicare sets its fees, you’re stuck. That’s it, except for supplemental insurers, and then we would still have the same administrative mess with them. I don’t think it would go away. I haven’t checked into it, but I think Canada would be an example of such a two-tiered coverage situation. You have government insurance, with some access problems. Then you have private insurers as an alternative. I wonder if you can point to other countries and their experience of at least partial success, once an insurance system is established.
Last and not least, we would all have to pay extra taxes for Medicare for all. We would probably still save money except for wrenches thrown into legislation by lobbyists who resist universal healthcare.
With all of that, would providers be able to unionize so that they could at least have some bargaining power? I expect that they would unionize by profession, so that MDs would have a different union than social workers, for instance, and then you have turf struggles. An example is that under existing Medicare, I don’t think that psychologists have hospital privileges comparable to psychiatrists. And, some lower tiers of degrees and licensing must be supervised by a higher tier, which is often wasteful and unnecessary.
Moving onto the hospital system or inpatient care, we would probably have to provide some sort of government assistance to facilities whose staff and service levels have been hollowed out by private equity.
The long of it is that this would be a complex implementation over a transitional period, and we wouldn’t be able to get it done without Democratic control of the House, the Senate, the White House and the Supreme Court. And, we would still need the voting public to support universal healthcare in overwhelming numbers while they are bombarded by messaging that would instill fear, uncertainty and doubt. It may be awhile.
That’s the glass half empty scenario, at least. How do we further fill that glass so that the whole system would be more ready to transition?
Alan,
I retired last year from a psychology practice and was on Medicare and Medicare Advantage panels. So my first point is that there are additional healthcare providers who would be included. Providers is a term that includes all of us.
In addition to low fees, Medicare would need to solve another big hassle that has turned off many providers. Applying to be empaneled in much more onerous than joining an insurance panel, which is done via shared accrediting sites, like CAQH. Medicare provider applications are excessively lengthy and it takes many months for them to be reviewed.
Returning to the fee issue, though, that’s a big deal. Once Medicare sets its fees, you’re stuck. That’s it, except for supplemental insurers, and then we would still have the same administrative mess with them. I don’t think it would go away. I haven’t checked into it, but I think Canada would be an example of such a two-tiered coverage situation. You have government insurance, with some access problems. Then you have private insurers as an alternative. I wonder if you can point to other countries and their experience of at least partial success, once an insurance system is established.
Last and not least, we would all have to pay extra taxes for Medicare for all. We would probably still save money except for wrenches thrown into legislation by lobbyists who resist universal healthcare.
With all of that, would providers be able to unionize so that they could at least have some bargaining power? I expect that they would unionize by profession, so that MDs would have a different union than social workers, for instance, and then you have turf struggles. An example is that under existing Medicare, I don’t think that psychologists have hospital privileges comparable to psychiatrists. And, some lower tiers of degrees and licensing must be supervised by a higher tier, which is often wasteful and unnecessary.
Moving onto the hospital system or inpatient care, we would probably have to provide some sort of government assistance to facilities whose staff and service levels have been hollowed out by private equity.
The long of it is that this would be a complex implementation over a transitional period, and we wouldn’t be able to get it done without Democratic control of the House, the Senate, the White House and the Supreme Court. And, we would still need the voting public to support universal healthcare in overwhelming numbers while they are bombarded by messaging that would instill fear, uncertainty and doubt. It may be awhile.
That’s the glass half empty scenario, at least. How do we further fill that glass so that the whole system would be more ready to transition?