As a family physician who has recently retired after 40 years in practice (29 years in Northampton), I was glad to see the article in the Gazette by Alexander MacDougall highlighting the critical shortage of primary care practitioners in Massachusetts, particularly in rural western Mass. [“Primary care in crisis: Doctor shortage continues,” July 26].

It is true that burdensome, mainly computer-based administrative requirements for doctors play a major role in causing physician burnout that leads to worsening shortages. It is important to highlight that many of these burdensome and time-consuming procedures, particularly one known as a “prior authorization,” are inflicted on physicians by private insurance corporations as a way of delaying and denying medical care that has already been deemed necessary by the physician and patient.

In some insurance plans, particularly a privatized form of Medicare known as Medicare Advantage (Medicare part C), this procedure has been shown to delay and even prevent potentially lifesaving care, particularly for people diagnosed with cancer, who have significantly lower survival rates when enrolled in these plans. These plans also only pay for care within a limited geographic network, further limiting access to care.

This causes added stress to doctors, who care about their patients and know this is not good for them. Despite the time-consuming and added stressful “gatekeeping” functions required of primary care physicians, they earn significantly less than specialists.

The consideration of a primary care task force would be welcome, to further shine light on the many factors contributing to our physician shortage, since legislative bills such as S750 (PC4you) would have resulted in a Band-Aid approach that would only have been relevant to those patients enrolled in private commercial insurance plans, excluding Medicare, MassHealth and also those without any insurance. It would not have reined in the extremely high health care costs (close to $15,000 per person per year in Massachusetts) that are siphoned off by private insurance companies due to their high administration costs (up to 30%) and profit, without any resultant improvement in health metrics.

Transitioning to a single-payer health system such as Medicare for All, as mentioned in the article, is an option that in my view and many others is long overdue. Eighty-eight percent of Northampton voters polled voted in favor of single payer in a 2018 ballot referendum. The main reason that Medicare for All, a bill that has been introduced in the Massachusetts Legislature by Sen. James Eldridge and Rep. Lindsey Sabadosa, has not yet passed, is due to the greed and lobbying power of insurance companies and Big Pharma.

A single-payer system would decrease administrative tasks for primary care and other doctors, as well as provide better care for lower cost by eliminating the profit seekers. I hope this happens in my lifetime.

Dr. Shelly Berkowitz is a recently retired family physician who lives in Northampton.