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sections for Beth to add to the single payer wiki page:

Physician Opinion

Criticisms

Illinois

Description

While doctors are on the front lines with regards to insurance and its effects on patient access to quality health care, many physicians report feeling helpless, uninvolved, and isolated from health care reform.,, These feelings may have some merit, as shown by the lack of any recent survey data on physician perspective regarding health care reform. While some surveys of physician perspective do exist, the data is limited and much of it is dated. These surveys, conducted sporadically in various states from 1994-2014, indicate that the majority of respondents agreed that it is the responsibility of society, through its government, to ensure access to good medical care for all, regardless of the ability to pay.,,,, While these surveys show support for universal health care, they do not clearly indicate physicians’ opinions about how best to achieve it. There appears to be a need for current data on physicians’ perspectives on health care policy, especially given the debate concerning repeal and replacement of the Affordable Care Act (ACA).

A review of the existing literature generally shows widespread dissatisfaction among patients and physicians with the current health care system, which utilizes a mix of public and private insurance sources. In their 1989 paper, Drs. Himmelstein and Woolhandler succinctly denounced the health care system as inefficient, expensive, and stiflingly bureaucratic: “Our healthcare system is failing.” A majority of both surveyed doctors and the general public appear to agree. A 2009 survey of physicians indicated that 9% favored the current health care system. This result mirrored public sentiment at the time: only 18% of people were satisfied with the quality of health care, and 9% were satisfied with the cost of health care in the United States.

Additionally, research has shown that administrative burden greatly contributes to physicians’ dissatisfaction with the current system, and doctors believe it impedes their ability to care for patients.1,8, A 1994 study surveying physicians in Washington showed that 89% of respondents identified reduced administrative burden as most likely to improve the current health care system. Ten years later, a survey of Massachusetts physicians showed similar attitudes towards administrative obligations, with 67% agreeing that they would be amenable to a 10% reduction in compensation in exchange for significantly less paperwork.7 As hospitals in the United States devote 25% of their budget to administration, a reduction in administrative burden could bring about greater satisfaction and decreased costs related to health care.12 The implementation of the ACA in 2010 by President Obama sought to improve aspects of earlier health care systems by expanding Medicaid coverage, preventing lack of coverage due to pre-existing conditions, and creating the individual mandate. Additionally, the ACA provided subsidies for insurance premiums to low income patients and families. Since its implementation, an estimated 17.6 million people have gained health insurance. However, while the ACA gave millions more Americans access to health insurance, there have also been reports of significant problems. While many Americans were able to gain insurance through the ACA, almost 6 million lost health insurance, and those above 400% of the Federal Poverty Level (FPL) faced reduced coverage and substantial increases in their premiums and out-of-pocket costs. The American Health Care Act (AHCA) has been offered as an alternative to the ACA. The AHCA differs from the ACA in various ways. First, the AHCA repeals the individual health care mandate and instead utilizes a late enrollment penalty for people that have not had continuous health insurance coverage for a 63-day period. The AHCA also proposes to reduce Medicaid coverage, and would replace the income-based tax credits provided by the ACA with a flat tax credit adjusted for age.16 The Congressional Budget Office (CBO) report on the AHCA estimated that while it would save $337 billion over the next ten years, some 24 million more people would be uninsured by 2026.,

Single payer health care is an alternative system, and is defined by Albers et al. (2007) as an insurance plan “administered by a governmental body or publicly accountable commission, guaranteeing coverage and access to necessary medical treatment.” Physicians and hospitals could still be privately employed and owned under single payer.