If you get to Medicare, you will.

Yes, absolutely political, but still interesting to see change in thought over the years.

Has the sky fallen? Big reversal.

Of course providers hate insurance -- all those FORMS, to say nothing of the 'second guessing'.

Could single payer ever happen in follow-the-money America? Maybe I should say in unlimited-election-campaign America.

Let's do a two-fer: Single Payer health care and Six-Month-Limit election campaigning -- with caps!

This reads as if it were a Trojan horse - the intent may be merely to express opposition to AHCA (the first item cited in the summary) but it's cloaked in the appearance of being something different, to provide a bit of misdirection.

Maybe I'm being too cynical. Or maybe not.

Not one of my doctors (all in academic medicine) want single payer. They have enough trouble already dealing with Medicare's "One Size Fits All" policies.

Interesting, Anglophilia, as my friends in academia (Cook County, Loyola, Northwestern, Rush, UIC, UofC) were the first to express support for a single payer system. I now hear it from friends working in non-academic settings.

More and more physicians (as a percentage) work in group practices of various kinds. Many medical schools have large and growing group practices. Of course physician mdln knows the difference, but from a patient's perspective, it can be hard to see the difference between a doc who's in a traditional faculty slot and sees patients only a few days a week versus those who are working in "the school's" group practice and are practicing physicians like any other. Some may do a few hours a month as a clinical adjunct, if that's what they want to do, but doing so can't hardly be viewed as being part of the mainstream faculty.

Insurance company and Medicare billings are mostly electronic and (I don't believe) involves many if any "forms". Docs need to know and understand procedure codes and the subtle differences between them but as far as dealing with insurance companies, etc., that's what the admin people do and that's one of several reasons why so few docs practice under their own roofs these days.

The forms and codes are WHY doctors are forced into conglomerates. Single payer would eliminate having to know how to fill out every insurance company's dance card.

No. ACA is why hospitals are becoming entire networks. The government requires it. They thought it would consolidate personnel and supplies. It's not a bad idea.

Doctors are forced into conglomerates primarily because they can't afford the malpractice rates. Simple as that. All the codes and forms are in the computer software. They just click on (for example) office visit, lab test, blood work, flu shot, annual physical and it's done.

The days of the small town doctor going door to door with the black bag and lollipops are basically only a fond memory. Everyone wants to sue the doctor or the hospital because they didn't get coco puffs for breakfast or they didn't like the band-aid color after the shot.

Put me in charge of the judicial system and frivilous lawsuits would at least be cut way down, or eliminated. That would help in a lot of ways.

And for many if not most on Medicare it's not single payer. Many/most? have supplemental coverage so hardly single payer. And sorting through the different policies is ridiculous.

This whole thing of politicizing health care is a joke. What we have isn't perfect but you'd be far ahead to work on it rather than try to scrap it and start over. Except I'm still waiting for the "death panels" that the Bimbo from Nowhere promised us over and over. I WANT THOSE DEATH PANELS! I'll be the first volunteer to be on the panel.

"ACA is why hospitals are becoming entire networks."

Maybe in your area, rob, not in mine. The growth of several of the large local "group" practices that are unaffiliated with the local medical school (which is another group) has been going on for decades. One dates from before WWII. I'm not including Kaiser, which is also huge and over 60 years old.

The government requires it? I don't think so.

"Doctors are forced into conglomerates primarily because they can't afford the malpractice rates."

Maybe in your state, not in mine. A law was enacted that placed a statutory limit on malpractice damage awards. With that one action the malpractice insurance and frivolous suit landscape changed forever. Insurance rates plummeted. Many but not all states have similar caps.

For several decades now, more young docs are as interested or more interested in their lifestyles than in making a fortune. They want to spend their time treating patients, not interviewing for receptionists or signing rent checks. THAT and the complexities of billing and running a business are among the reasons why, in my experience, docs are drawn to group practices.

Sorry, it's nationwide. I'll let y'all do the footwork since you're so certain.

I'll let y'all do more footwork - do you have an objective source for your comment? This was an opinion piece. As you surely know, magazines and newspapers have reporting and editorial sections, they're separate. Only the reporting side is "supposed" to be not subjective. That isn't where this piece was published.

This author is affiliated with the Cato Institute, a libertarian activist organization. This is a political piece, not an objective report.

As I said, what you describe isn't what I observe in my area nor have gleaned from talking to docs I know. Mergers and consolidations happen in all industries, in in all markets. Neither the speculation of policy wonks (I did read the cited article) nor others drawing an anecdotal inference is particularly convincing for me, maybe it is for you.

Since you won't acknowledge what the piece is based on, THE FACT FROM THE ANNALS OF INTERNAL MEDICINE, I'll post it here. Deny all you want, but I happen to be in the innerworkings of it. It's reality, whether you observe it or not. I really don't care if you believe me, but don't go around misleading others.

The central planners behind the Affordable Care Act – also known as
Obamacare – were convinced that consolidation in health care would lead
to decreased health care spending by eliminating duplication,
standardizing treatment protocols and incentivizing better utilization.
As three of Obamacare's primary authors wrote
in The Annals of Internal Medicine in 2010, the law was designed to
"unleash forces that favor integration across the continuum of care." No
part of health care was supposed to be spared – doctors, hospitals,
insurers, pharmaceutical companies and others were given regulatory and
financial incentives to merge.

Did you notice the term "central planners" in your quote and elsewhere in that piece? It's used three times. It's a libertarian contemptuous curse, used to evoke comparison to central planning typical of communist and other totalitarian regimes. Typical of the propaganda put out by the Cato Institute. They're anti-ACA and as with the so-called survey that started the thread, these are meant to be persuasive political pieces, not objective assessments.

Maybe you talk like that too. Maybe you don't recognize these two pieces as dueling wonkery, propaganda for each extreme side. I think what I'm trying to point out in reply isn't subtle at all. There's nothing objective in either piece, no conclusions to be drawn.

"I happen to be in the innerworkings of it"

I thought you worked for a researcher? If so, research and care delivery are two very different things.

You think the Annals of Internal Medicine, a peer reviewed journal, is a leftist propaganda machine. That explains a lot.

There's nothing to learn from wonky blabbering from either side. The second item is a political/opinion piece in Annals, not research findings and absolutely not peer reviewed. You need to understand your "sources" and what you're reading.

Your presumption about my political leanings couldn't be more wrong but I can smell the difference between objective assessments and opinion pieces. No matter who's spewing the BS and double talk, and no matter which positions they're trying to advance, it isn't worth anyone's time to read or listen to stuff like that.