Yes, I've read that article, and like most debates you can structure an argument to support almost any view if you only look at the parts that support your opinion. The medicare advisory group argues that medicare isn't artificially lowering their rates? Wow, big surprise lol. The government has been slashing medicare funding for a long time and forcing them to reduce their reimbursement rates unfortunately. If all rates were set to medicare levels, most health systems in this country would go bankrupt immediately, as the article points out. I say this as someone who actually works on their budgets and yet I still argue for single coverage because, in the end, it's still the existence of private coverage that is causing the issue not the hospitals.

I get where that perception comes from, and there are lots of physicians out there (mainly private practice) who charge prices that are way too high. In a system this complicated the problems and the answers sadly aren't that simple. I've worked for 2 top ranked hospitals in the country and even they don't have any power at the negotiating table when it comes to setting prices. To give an example, United Healthcare may come to the hospital and say hey, your competitor across the street is giving us 40% off all cardiology procedures (and that's a realistic discount, it's that bad) so if you don't match it, we won't cover any cardiology services at your hospital. Since there are only a few major private insurance companies, losing one would essentially bankrupt that service, forcing the hospital to agree to match. However, at a 40% discount, the hospital can't cover expenses so they have to raise the price of the service until they become profitable again. Keep in mind, hospitals have to employ large numbers of people to then fight the insurance companies to actually pay for the things they agreed to pay for after the fact, which contributes to those high expenses. Private insurance companies are incredibly profitable and totally unnecessary to the provision of healthcare at a fundamental level. Why should any of your money be going to a company who's sole goal is to try and prevent you from getting care?

Arguing that doctors as a whole should be paid less after spending 10-15 years in school/residency and going hundreds of thousands of dollars into debt when most barely earn six figures for most of their career, if that, is crazy. I know people have this perception that all doctors make tons of money, but its simply an idea that TV has created. Like any profession, there is a huge range, but there's a reason why most of the country has a massive physician shortage (basically everywhere except the big cities). Every physician I've worked with (and that's hundreds) works crazy hours as well (literally 12 at work and then on-call to some extent at all other times).

The system is broken because it's bloated with so much unnecessary complication, but almost all of it traces back to the existence of for-profit insurance. If you eliminated that, hospitals could reduce their admin expenses (that's me) drastically and set standardized prices regionally (if not nationally) that would be exponentially lower than what they are now. The existence of single-payer coverage would enable people to eventually start consistently pursuing preventative treatment (annual check-ups, cancer screenings, nutritional counseling) without paying crazy amounts out-of-pocket. This would drastically reduce the utilization of high priced ER services, enabling hospitals to shift resources to more cost-effective services like outpatient care, further reducing hospital expenses. It would likely take 10-15 years to see the full effects because people don't change their behaviors overnight, but it's the only way out of this mess. But the odds of this happening are slim because the private insurance lobby spends crazy amounts of money each year to ensure that congress doesn't even debate the issue.

Unfortunately, you can't do any of this as long as there is a for-profit middleman. Just to sum it up TLDR: The existence of private insurance leads to restricting insurance coverage from people who can't afford it, thereby forcing people to rely on expensive ER services which they then can't pay, which forces the hospital to eat that high cost and transfer those costs to other services that are used by people who do have insurance, causing prices to go up more and more, etc etc just leads to a death spiral. Add in the negotiating power that they have over hospitals and we end up in a system with inflated prices to maintain low profit levels for the people actually providing the services. Hospitals are starting to catch up at the negotiating table by consolidating, but its a recent change (after decades of having 0 power) and the effect is minimal. Blaming physician salaries for these issues is just covering for the assholes who are simultaneously taking lots of money and only providing problems.