Optimizing Physician Payment for a Single-Payer Healthcare System.

The article focuses on proposing a "Fee-for-Time" physician payment model as an alternative to current U.S. systems, particularly within a single-payer health care framework. This model would compensate independent physicians based on an hourly rate determined by years of training and time spent on clinical services, including documentation and care coordination, aiming to be simpler, fairer, and less administratively burdensome than existing fee-for-service payments using the Resource-Based Relative Value Scale (RBRVS) or value-based payments (VBP). The proposal emphasizes equitable payment across specialties, elimination of incentives to over-document or avoid complex patients, and collective bargaining to set standardized rates with regional cost-of-living adjustments. The authors argue that this approach could reduce disparities, administrative costs, and gaming of the system while aligning physician incentives with patient care quality under a universal single-payer system.