[nradov]

The focus on "Medicare for All" or single payer healthcare in general is so misguided. Commercial insurers are like the smallest problem in the whole messed up US healthcare system. Putting everyone on Medicare wouldn't solve any of the more fundamental problems.

https://www.sensible-med.com/p/the-entire-healthcare-system-...

[HDThoreaun]

One of the most fundamental problems with the US healthcare system is the fee for service payment system. Another closely realted one is the abundance of bureaucrats and administrators. Obamacare created a pilot program to move medicare off fee for service and toward fee per patient, and m4a would likely expand that program. Combined with some sort of pharma reform and 3 of the biggest problems healthcare face could be solved. Then congress needed to expand residency funding and the next biggest problem(lack of physicians, they currently make 9% of healthcare spending in the US) would be easily solved as well.

[nradov]

Commercial insurers are also moving from fee-for-service to value-based care payment models (with capitation being one approach). That isn't something unique to Medicare.

Increasing residency funding is a good idea, but I'm skeptical that it would reduce overall costs. With an aging population, demand for healthcare services is effectively infinite. The shortage of physicians is, paradoxically, one of the factors holding costs down today. If you can't see your doctor because appointments are backlogged for months then no insurance claim will be generated.