Medicare for All and the Future of America’s Health Care Workforce

The Medicare for All Proposal being debated across the country would have enormous effects on every aspect of the healthcare industry and would fundamentally reform how Americans receive care, not just its cost. Among these impacts are how lower payments would reduce the number of physicians and nurses providing care.

FTI Consulting’s independent economic analysis indicates that proposals to implement a Medicare for All system, specifically one that relies upon Medicare payment levels, threaten to accelerate the looming healthcare workforce crisis. The resulting effects on access to care stem not from deliberate denials of care under a new system, but instead from the likely diminished capacity of the health care workforce to meet the needs of the population.

Already, the U.S. is facing a health care workforce shortage that could reach 151,000 direct care workers¹ and 121,300 physicians by 2030.² While the underlying causes of projected workforce shortages are varied and complex, most are tied directly to low reimbursement rates and the resulting negative effects on wages and staffing. Particularly for rural and underserved communities, extending Medicare payment systems to a broader population could have a significant negative impact on the adequacy of the country’s health care workforce, access to care, and, ultimately, patient outcomes.

FTI Consulting’s analysis found that Medicare for All would exacerbate the current and project shortages of healthcare professionals. Taken with the increase in demand from an aging population and the reduction of cost-sharing, these amount to a foreseeable yet rarely mentioned unintended consequence of worse care for patients.

FTI Consulting has since continued to research the impact of health policy proposals at both the state and national level, putting out four additional Issue Briefs.

Footnotes:

1. Osterman P. Who Will Care for Us?: Long-Term Care and the Long-Term Workforce. New York, NY: Russell Sage Foundation; 2017.

2. IHS Markit ltd. The Complexities of Physician Supply and Demand: Projections from 2017 to 2032. Association of American Medical Colleges; 2019. https://www.aamc.org/system/files/c/2/31-2019_update_-_the_complexities_of_physician_supply_and_demand_-_projections_from_2017-2032.pdf. Accessed December 10, 2019.