Single-payer healthcare systems allow governments to better regulate costs but have the capacity to extend patient wait times to see surgeons, obtain advanced diagnostic imaging and undergo surgery.
Here, two neurosurgeons discuss the impact a single-payer system would have on spine in the U.S.
Question: Would a single-payer insurance system help or harm spine practice?
Erich Anderer, MD. NYU Langone Hospital – Brooklyn and NYU School of Medicine in New York City: I'd like to think that the practice of spine surgery — and all surgery for that matter — is payer agnostic. Some payers have adopted approval criteria for spine surgery that make it difficult to account for nuances in disease presentation. If these types of processes become the norm via a more centralized insurance system, it could make it even more onerous for people that really need surgery to get approval to have it done.
Thomas Loftus, MD. Austin (Texas) Neurological Institute: Based on single-payer systems that exist in markets in other countries, it seems that single-payer insurance would hurt spine practice. To allow absolute control of healthcare delivery by a single payer restricts patient access to care and severely affects and limits decision making by the actual physician. The small advantage of not having to deal with multiple insurance companies would be greatly offset by the complete disruption of who makes the actual healthcare decisions. It would be bad for patients and bad for their physicians.