Singlepayer accelerates the healthcare shortage to dangerous heights

Projecting a dramatic 40 percent reduction in provider reimbursement relative to private insurance, Charles Blahous, a former Medicare trustee, observes, "The cuts in the Sanders M4A bill would sharply reduce provider reimbursements for treatments now covered by private insurance, which represent a substantially greater (more than 50 percent larger) share of national health spending than does Medicare."

True, American physicians are among the most highly paid medical professionals in the world. Overall, in 2018 the average American primary care physician earned $223,000, while specialists earned $329,000. In 2018, American staff nurses earned $73,287 on average, clinical nurse specialists earned $88,271, and nurse anesthetists earned $150,833.

Of course, liberals in Congress could cut American medical workforce compensation to "single payer" levels. Examining comparative 2016 data – including compensation in "single payer" Britain and Canada – researchers writing in the Journal of the American Medical Association found that American general physicians earn an average annual salary of $218,173. The comparable compensation for Canadian generalists was $146,286, while British generalists received just $134,671.

Medicine is, however, a tough and often stressful profession, and medical students routinely incur large personal debts. In 2018, according to the American Association of Medical Colleges, the median medical school debt amounted to $195,000.

Punitive payment cuts would surely be costly. By 2030, Americans already face a serious and potentially dangerous physician shortage, ranging between 15,800 and 49,300 primary-care doctors, and between 33,800 and 72,700 non-primary care doctors. Accelerated retirements, job-based burnout and growing demoralization fuel that shortfall.

Combining a mammoth pay cut with the abolition of private-sector alternatives would not only hurt morale. It would accelerate the shrinkage of the medical workforce.

Patients will suffer.

Blahous's Mercatus study of the Senate bill – projecting a 40 percent reduction in provider reimbursement – is thus far the only such estimate of its impact on medical compensation. The House bill – creating a global budget for American health spending and government fee systems for doctors and other providers – is yet to be subject to a similar econometric analysis.

There is an obvious candidate to undertake such an analysis: The Office of the Actuary at the Center for Medicare and Medicaid Services. The Actuary has regularly estimated the impact of Obamacare's scheduled Medicare payment reductions.

Congress and the Trump administration should ask the Actuary to conduct a similar analysis of the "Medicare for All" bills, not only assessing their impact on America's doctors and hospitals, but also Americans' access to high quality medical care.

Congress must secure the best and most authoritative estimates of the impact of the House and Senate bills. Silly political promises won't cut it. American doctors and patients – that is, all of us – deserve an honest prognosis.