With Covid-19 changing the way healthcare operates, not only in the U.S. but also around the world, there’s a lot more talk about universal healthcare, also known as Medicare for All, but what could it mean for patients and providers? While the debate around Universal healthcare has been front and center for years, the growing healthcare needs of a country affected by a global pandemic has brought the topic to the forefront once again.
What is universal healthcare? How will it work? What would it mean for a medical practice? Here’s a closer look at a few things you may need to know.
Problems with the Healthcare System Today
Currently, the United States faces some difficult problems in the healthcare system. The current network includes multiple payers, which consists of both government and private health insurance options. That creates a very complicated network that is difficult for everyone involved to navigate. According to Harvard, while the U.S. spends more healthcare dollars than comparable countries, we still have the lowest life expectancy and perform relatively poorly on various health outcomes. High administrative costs and a lack of price control make the complex network of insurance plans more wasteful.
The United States is also the only developed country that doesn’t offer universal healthcare. Although the Affordable Care Act did make some headway in expanding and improving health insurance coverage in some areas, the act was not designed to offer universal healthcare or move the U.S. to a Universal Healthcare system.
How Does a Universal (or Single) Payer System Work?
With a universal payer healthcare system, instead of having multiple insurance companies that compete with one another, one public or quasi-public agency has the responsibility of financing healthcare for everyone. All residents have health insurance under a single insurance plan and are provided with access to required services, such as hospitals, doctors, prescription medicines, vision are, dentists, and long-term care. Since it would operate much like Medicare does, in the U.S., it’s often termed “Medicare-for-all.”
According to advocates of a universal payer system, multiple problems within the U.S. healthcare system would be addressed. It would offer more equality for underinsured and uninsured Americans. Proponents believe that wasteful spending and overall healthcare expenses could be controlled better via lower administrative costs and cost control strategies.
Of course, one must also consider the possible tradeoffs that would come with a Universal healthcare. Restricted availability of some healthcare services and lengthy wait times could quickly become a reality. And while it offers advantages, it wouldn’t instantly ease the ongoing tension that comes with balancing quality, cost, and access within healthcare.
What Would a Universal Healthcare Mean for Your Practice?
If the U.S. did turn to a Universal healthcare in the future, what would that mean for your medical practice? While we don’t entirely know what a universal payer system would mean for the country and the healthcare industry, some of the few things we can infer include:
- Employer-Based Insurance Likely Wouldn’t Exist – Today, most Americans get health insurance through an employer. That system would change significantly with a universal payer system, although no one is quite sure how drastically. It is possible that a combination of employer and employee taxes would pay for a single-payer healthcare system. The key is not to elevate the tax burden so much that it hurts the middle class, which means that hospitals and medical practices may need to find other ways to bring down costs to avoid overburdening the middle class with taxes.
- Billing and Coding Become Easier – One of the critical benefits of a Universal healthcare for medical practices is that billing and coding become much more manageable. With a universal payer, the administrative end of your medical practice gets immediately streamlined. Although there will always be some controversies that arise from coding and insures requiring additional information, it would likely be dramatically reduced with a Universal healthcare. Instead of dealing with multiple insurance companies that haggle for different prices and have other coverages, practices would deal with one entity. This would allow medical practices to reduce administrative costs due to a more streamlined approach to billing and coding.
- Private Insurance Remains but Changes – Although the market will undoubtedly change with a universal payer system, private insurance likely remains. You may have a plan as we do today in education – private and public schools coexist. Individuals would opt into public options unless they choose to go with private insurance. Some providers may wish to cater to individuals with private insurance, resulting in the complex responsibility of the government to ensure everyone gets the same level of care. Of course, that opens the question of where the line is drawn between an individual’s right to care and the threshold of “premium” care other individuals may pay extra money to receive? But that’s another topic.
Despite an increasing call for a universal payer system, particularly with the challenges that have faced the healthcare system during Covid-19, a Universal healthcare is still in the distance. But it could change in the next couple of years, and medical practices need to prepare for this possible eventuality and what it will mean for their operations. At M-Scribe.com, we provide quality billing and coding services for providers across the country with an eye to the future. Contact M-Scribe.com today to learn more about how we can help your practice.