By Ken Terry
November 2, 2020

Healthcare for Americans continues to be the subject of debate, derision, and division among presidential candidates — finding a plan that is amenable to Democrats and Republicans, patients and providers, hospitals, insurance companies, and drug manufacturers.

Headlining this discussion is Medicare for All (MFA), which some candidates are touting as a cure-all healthcare plan and which one economist describes as one “giant political issue.”

It’s a complex issue that author Ken Terry, a healthcare writer for 25 years, tackles in great detail in his recently released book, Physician-Led Healthcare Reform: A New Approach to Medicare for All.

As former senior editor for Medical Economics Magazine and the author of two other healthcare books, Terry breaks down the candidates’ proposed healthcare plans and the role of physicians in what Terry considers to be the inevitable passage of some iteration of MFA.

With prior candidates like Bernie Sanders and Elizabeth Warren at the forefront of the conversation, Medicare for All has suddenly become “mainstream,” according to Terry. Whatever its level of public support, however, the deep divide between Democrats and Republicans makes it unlikely that MFA will be adopted anytime soon — at least not until the disparity between escalating insurance costs and slower-growing wages reaches a breaking point for most Americans.

“When enough voters are fed up with the current system and are concerned about their own or their families’ access to healthcare, the dam will break,” Terry writes. “At that point, neither politicians nor healthcare lobbyists will be able to hold back the flood that will carry us to Medicare for All.”

It’s a flood that already comes with its share of questions and concerns.

Among the most serious flaws of MFA is a potentially significant drop in physician income, warns Terry, “and unhappy physicians spell doom for any healthcare reform plan.” It could also doom some of the brightest students from pursuing medical degrees because lower salaries would make it nearly impossible to repay student loans.

One solution, suggests Terry, is a substantial reduction in healthcare waste, an issue that physicians are well-positioned to resolve.

“They’re the only ones, in fact, who know which healthcare services can be safely eliminated without harming patient care,” Terry says. “So, to be successful, any Medicare for All proposal must include provisions to engage doctors in eliminating waste.”

In fact, he says, physicians should play an integral role in whatever plan is eventually adopted.

“Healthcare reform seems to be stuck between a rock and a hard place, but there is a rational way forward,” offers Terry. “This approach, which I call ‘physician-led healthcare reform,’ would engage doctors in building a system that was safe, effective, patient-centered, timely, efficient, and equitable, to use the Institute of Medicine’s set of foundational goals. Primary care physicians, rather than hospitals, would be in charge of the system, and they’d work closely with specialists and other healthcare professionals to produce the best patient outcomes at the lowest cost.”


It’s an idea with considerable merit if politics doesn’t get in the way.



Ken Terry has been writing about health care policy and practice for more than 25-years. As senior editor at Medical Economics Magazine from 1993-2007, he covered all aspects of the medical practice business, focusing on managed care and Health IT.

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