The muscle of the health industry lobby — pharma, health plans, doctors, and hospitals — is gathering to stop single payer.
The Hill’s Peter Sullivan had the report on Friday morning. The industry’s influence can’t be underestimated: It stopped Clintoncare. And, for better or worse, it was a boon for passing Obamacare that the industry mostly supported the legislation.
The industry’s disparate interests fight over a lot of issues, but Medicare-for-all unites them. That is going to be a factor if we get to 2021 with a Democratic Congress and president, and they decide to pursue single-payer health care.
That moment really might come. A sign times are changing: A Republican health care lobbyist called me recently to ask whether all-payer rate setting would be a better alternative to single payer, by causing less disruption. (I quibbled that you would need some kind of coverage component, given the moral urgency that is animating the left on health care.)
Still, a Republican almost endorsing price controls. That is a pretty strong indicator of where our health care debate seems to be heading.
Payment cuts for health care providers, if we eliminate private insurance and move everybody to Medicare rates, are going to come up a lot in this debate.
Those cuts are an easy thing for industry lobbyists to target and for Republicans to run ads on. Cuts could be overstated, depending on how much legitimate waste single payer can actually eliminate by consolidating the administration of health care, but the projections for Medicare for All plans are going to anticipate big cuts.
That explains the industry’s lobbying position. But reality on the ground is more complicated than that. There are absolutely health care providers who support single payer. Quite a few of them sent me emails after I asked for their thoughts last week.
Here are some of the most interesting responses. From a registered Republican working at a next-gen gene sequencing company:
From a retired neurosurgeon, who had also thought of himself as a Republican:
From a radiation oncologist of more than 20 years, in Chicago and for the military:
From a Texas oncologist still early in their career:
On the other side, from an anesthesiologist intern in Chicago, fiscally liberal but socially conservative, who has some concerns about how single payer would handle Catholic hospitals:
This story appears in VoxCare, a newsletter from Vox on the latest twists and turns in America’s health care debate. Sign up to get VoxCare in your inbox along with more health care stats and news.
For more newsletters, check out our newsletters page.
Join the conversation
Are you interested in more discussions around health care policy? Join our Facebook community for conversation and updates.