On a busy Tuesday clinic morning, I saw a patient with sky-high blood pressure and chest pain who should
have gone straight to the emergency department. Instead, he sat on my exam table, quietly panicking
about something else: the bill.
“Doc, I can’t afford another ER visit,” he whispered. “Can’t you just give me something here?”
Moments like this are why I, like a growing number of physicians, support Medicare for All. Not because
I enjoy new acronyms or 1,000-page policy documents (I don’t). But because I’m tired of watching
patients make medical decisions based on their wallets instead of their health.
In this article, I’ll walk through what “Medicare for All” actually means, why many doctors are warming
to the idea, what worries people about it, and whyafter years in exam rooms, emergency departments,
and hospital hallwaysI believe a universal, single-payer system is the most humane, efficient next
step for the U.S. health care system.
What “Medicare for All” Really Means (Without the Jargon)
First, a quick translation. “Medicare for All” is shorthand for a single-payer, universal health
care system. In practical terms, that means:
- Everyone living in the United States has health coverage, automatically, as a basic right.
- The main payer for medical bills is a public program (an expanded version of Medicare), instead of
a patchwork of private insurance, employer plans, and separate government programs. - Care is still largely delivered by the same hospitals, clinics, and doctors you see nowjust paid
through one streamlined system.
Think of it as replacing a tangled bowl of insurance spaghetti with one clear, transparent plate. You
still go to your doctor; you just don’t have to solve a billing puzzle every time.
Different proposals use slightly different blueprints: some envision a full single-payer system that
covers almost all services with no premiums or co-pays; others consider strong public options layered on
top of private plans. But the heart of Medicare for All is simple: everyone in, nobody out, and
one primary payer to simplify the money side of care.
Why Our Current System Is Failing Patients and Physicians
I don’t support Medicare for All because it’s perfect. I support it because I see, every day, how badly
our current system is failing.
Coverage gaps and underinsurance
We still have millions of uninsured Americans and many more who are technically “insured” but saddled
with deductibles so high that they avoid care unless they’re in crisis. Financial barriers lead to
delays in cancer screenings, skipped insulin doses, and untreated depressionproblems that become
medically worse and financially more expensive over time.
Administrative chaos and burnout
From the physician’s side of the exam table, the chaos is staggering. My colleagues and I routinely
spend hours every week fighting with multiple insurers over prior authorizations, coverage denials, and
billing codes. Studies have shown that administrative complexity is a major driver of physician burnout
and a huge source of wasted health care dollars.
I did not go to medical school to become an unpaid customer service representative for half a dozen
insurance companiesbut on many days, that’s exactly what it feels like.
High costs, mediocre outcomes
The U.S. spends far more per person on health care than other wealthy countries, yet we don’t get
better overall results. We lag behind in areas like life expectancy and rates of preventable chronic
disease, even as families and employers shoulder enormous premiums and out-of-pocket costs.
When you’re inside the system, it’s obvious: our problem isn’t a lack of spending. It’s where
the money goesand how hard it is for patients to actually access care when they need it.
Why Many Physicians Are Shifting Toward Medicare for All
Physicians used to be seen as a solidly skeptical bloc when it came to single-payer health care. That’s
changing.
Recent surveys show a sizable share of U.S. physicians now view a single-payer or Medicare for All
system as one of the better directions for health care reform. In one national survey, about 40%
of doctors rated a single-payer system as the best or next-best path forward. Other polling has
found that support for single-payer among physicians has risen into the majority over the past decade,
as more of us see how fragmented coverage harms patients and adds red tape to our work.
Major professional groups have also shifted. The American College of Physiciansone of the largest
physician organizations in the countryhas endorsed single-payer reform or a strong public option as a
preferred path to universal coverage, emphasizing that payments must be adequate and equitable to
ensure access and address persistent disparities.
When you talk to physicians who support Medicare for All, common themes emerge:
- Less time on billing, more time with patients.
- Simpler coverage rules. No more trying to remember 20 different formularies.
- Fewer heartbreaking “I can’t afford that” conversations.
- Alignment with our professional ethics. We’re trained to treat people based on need,
not income.
It’s not that doctors suddenly became policy wonks; it’s that the day-to-day friction of our current
system finally pushed many of us to say: “There has to be a better way.”
Would Medicare for All Be Too Expensive?
One of the most common questions I hear is: “Doc, this all sounds nice, but how are we going to pay for
it?”
Fair question. The short answer is that we are already paying enormous amounts for health carejust in
a fragmented, inefficient way through premiums, deductibles, co-pays, and employer contributions.
Several economic analyses suggest that a well-designed Medicare for All plan could reduce
overall national health spending while expanding coverage. A widely cited study from Yale
researchers estimated that moving to a single-payer, universal system could save around 13% in national
health expenditureshundreds of billions of dollars a yearlargely by cutting administrative overhead
and negotiating better prices for drugs and services.
That doesn’t mean no trade-offs. Taxes would almost certainly rise. But for many households and
employers, those taxes could be offset (or more than offset) by eliminating premiums, deductibles,
surprise bills, and the constant uncertainty of job-based insurance.
As a clinician, I’m less interested in how we label the dollarstaxes, premiums, contributionsand more
interested in whether patients can get care when they need it, without facing financial ruin. Medicare
for All is one of the few proposals that takes that goal seriously at a system-wide level.
Addressing Common Concerns About Medicare for All
“Will I have to wait forever for care?”
People often point to wait times in other countries with universal coverage. The reality is nuanced.
Some nations with single-payer systems do struggle with waits for certain elective procedures, but they
also generally provide faster access to primary and preventive care, and no one is left completely out
because they can’t pay. Many of the capacity issueshow many doctors, nurses, and hospital beds we
haveare problems we already face in the U.S., regardless of who pays the bill.
A well-designed Medicare for All plan would have to invest in primary care and workforce capacity, not
just flip the payment switch and hope for the best.
“Will I lose my doctor?”
Under most Medicare for All proposals, you would actually have more freedom to choose
your doctor, not less. Today, patients are often locked into narrow networks and forced to switch
physicians when their employer changes plans. Single-payer systems typically allow broad choice of
providers, because the main restriction is clinical capacity, not network contracts.
“Will this hurt medical innovation?”
Innovation depends on funding, but also on how that funding is structured. Many nations with more
universal systems still produce cutting-edge drugs, devices, and surgical techniques. The question isn’t
“innovation or access,” it’s how to balance fair prices with ongoing investment. Medicare for All
proposals generally focus on negotiating better prices and reducing waste, not slashing all research
budgets.
Beyond the Exam Room: Economic and Social Benefits
As a physician, my primary focus is health. But the ripple effects of Medicare for All go beyond the
clinic.
Less “job lock,” more freedom
Tying health insurance to employment traps many people in jobs they don’t want, just to keep their
coverage. Analyses suggest that universal, portable health coverage could reduce this “job lock,”
encourage small business creation, and let people make career choices based on their skills and goals,
not their insurance card.
Fewer medical bankruptcies
In a wealthy country, no one should go bankrupt because they got sick, had a high-risk pregnancy, or
were hit by a drunk driver. Universal coverage with robust financial protection is one of the most direct
ways to reduce medical debt, which weighs heavily on families and communities.
Aligning policy with medical ethics
Physicians are taught a simple principle: treat the person in front of you. Medicare for All moves our
policy architecture closer to that ethical standardcare based on need, not income, employment status,
or zip code.
Why This Physician Spoke Up
For years, I tried to stay “above” health policy debates. I told myself I was too busy, or that this was
the job of think tanks and politicians, not clinicians.
Then I started counting how many times a week I heard some version of:
- “I can’t afford that test.”
- “I lost my insurance when I got divorced.”
- “I’m rationing my meds to make them last.”
It was no longer abstract. It was tens of real people, every week, whose health decisions were boxed in
by coverage gaps and billing nightmares. At some point, silence started to feel less like neutrality and
more like complicity.
Supporting Medicare for All doesn’t mean you believe any single bill in Congress is flawless. It doesn’t
mean ignoring concerns about implementation, taxes, or transition. It simply means believing that
health care is a right, that our current system is deeply broken, and that a universal,
single-payer model is a credible, evidence-supported way to make things better.
From the Front Lines: Experiences That Shaped My View
Numbers and policy briefs are important, but my support for Medicare for All is ultimately rooted in
lived experiencemine and my patients’. Here are a few of the moments that changed my mind.
The young man with the “too expensive” inhaler
A few years ago, a young man in his early 30s came to clinic with a nasty respiratory infection, gasping
between sentences. His asthma was clearly out of control. When I asked about his controller inhaler, he
stared at the floor and admitted he hadn’t picked up a refill in months. His high-deductible plan meant
he would pay hundreds of dollars out of pocket.
We patched him up that day, gave samples, called in coupons, and did all the little workarounds doctors
learn to survive in this system. But those hacks rely on luckon which samples are in the closet, which
pharmacy discount applies this month. They are not a health care strategy. They’re a band-aid over a
policy wound.
In a Medicare for All system, that inhaler would be a basic, predictable part of his coverageno
scavenger hunt required.
The “insured” patient who couldn’t use her insurance
Another patient, a middle-aged woman working two part-time jobs, proudly told me she finally had health
insurance through one employer. But when I recommended a colonoscopyan evidence-based screening that
can literally prevent cancershe shook her head.
Her deductible was so high that she would effectively be paying cash for the procedure. She decided to
“wait until next year” and hope for the best. As a physician, I’m trained to think in terms of risk:
cancer risk, heart attack risk, stroke risk. But she was evaluating a different risk entirelythe risk
of not making rent.
Medicare for All doesn’t erase fear, but it removes that particular trade-off: between preventive care
and financial survival.
The admin afternoon that never ended
One day I tracked how much time I spent on administrative tasks. Out of a ten-hour workday, more than
three hours went to insurance forms, prior authorizations, phone calls, and messages about coverage
disputes. That’s almost half a workday lost to navigating rules that differ from insurer to insurer,
plan to plan.
Now multiply that across every physician, nurse practitioner, and clinic in the country. The cost is
enormous, not just in dollars but in missed opportunities to talk to patients about their goals, fears,
and treatment options.
A single-payer system with standardized benefits doesn’t make paperwork disappear, but it dramatically
simplifies it. One set of rules. One main payer. One shared definition of what’s covered. That’s good
for clinicians, and it’s even better for patients who currently get lost in the maze.
The conversation with my medical students
Medical students and residents often ask whether they should support Medicare for All. I don’t tell them
how to think or vote. Instead, I ask them what kind of system they want to practice in for the next 30
or 40 years.
Most say they want a system where their main job is to care for peoplenot to interpret insurance
fine-print, not to decide which patient is “worth” a prior authorization phone call, not to act as
part-time billing specialists. They want to practice medicine, not bureaucracy.
When I look at the options on the table, Medicare for All comes closest to that vision: a health care
system where coverage is universal, the financing is simpler, and clinicians are freed up to do the work
they trained for.
Conclusion: A Doctor’s Case for Medicare for All
No health reform is a magic wand. Medicare for All would require careful design, honest conversations
about financing, and a thoughtful transition. It would not fix every problem in American medicine.
But from where I sitas a physician who has watched too many patients delay care, cut pills, or dodge
tests because of costit’s one of the most promising ways to align our health care system with our
values. Universal coverage. Simpler administration. Greater equity. A focus on care, not paperwork.
That’s why this physician supports Medicare for All: not as a slogan, but as a serious, evidence-backed
blueprint for a healthier, fairer future.