More than 2,000 physicians want a single-payer system similar to Canadas and say the Affordable Care Act didnt go far enough
A group of more than 2,000 physicians is calling for the establishment of a universal government-run health system in the US, in a newspaper in the American Journal of Public Health.
According to the proposal released Thursday, the Affordable Care Act did not go far enough in removing barriers to healthcare access. The physicians bold plan calls for implementing a single-payer system similar to Canadas, called the National Health Program, that would guarantee all residents healthcare.
The new single-payer system would be funded mostly by existing US government funding. The physicians point out that the US government already pays for two-thirds of all healthcare spending in the US, and a single-payer system would cut down on administrative costs, so a transition to a single-payer system would not require significant additional spending.
Our patients cant afford care and dont have access to the care they need, while the organizations of the system is ever more wasteful, throwing away money on bureaucratic expenditures and absurd costs from the narcotic companies, told David Himmelstein, a prof in the CUNY School of Public Health at Hunter College and lecturer on medicine at Harvard Medical School.
Himmelstein, one of the authors of the plan, said the proposal is meant as a rallying cry for physicians and other healthcare professionals around the cause of a single-payer model. According to the paper, even with the passage of the Affordable Care Act many patients face rising co-payments and deductibles that compromise access to care and left open vulnerable to ruinous medical bills. Despite the present high healthcare spending levels in the US, healthcare outcomes are worse than in comparable well-funded countries.
There has been a conviction that we can approach this incrementally and get there in small steps and one of the advantages of having passed the ACA is that modest steps cant do the job, and in a way make it easier to make arguments that we need more fundamental changes, told Himmelstein.
Under the proposal, all US residents would be able to see any physician of their choosing in the country and be treated at any hospital. With guaranteed coverage and no co-pays, deductibles and premiums, patients would not have fiscal barriers to seeking care, which would lead to greater utilization of the organizations of the system and improved health outcomes, Himmelstein argues.
The additional funds would be made up by modest taxation increases in exchange for abolishing insurance premiums, deductibles and co-pays.
We would have to abolish the insurance companies, there is no way around that, Himmelstein told. The employees at the private insurance companies would be retrained for other jobs, he explains, and receive job placement assistance. The insurance CEOs, who earn multimillion dollar salaries, would not get comparable job placement, Himmelstein said wryly.
Fees for drug would be negotiated with pharmaceutical companies the same style other countries with single-payer systems already negotiate for lower cost medications. Currently, US drug costs are some of the highest in the world.
While Himmelstein acknowledges that the physicians proposal would meet with political and business interest opponent, and he cant say when such a system would realistically have the political backing needed to be implemented, he is hopeful that as more Americans view a single-payer system favorably, pressure will continue to mount on the government.
Proposing a single-payer system in the US is not new. Vermont previously attempted to implement a single-payer system, which passed the legislature but was shut down by the once supportive governor when cost estimates increased beyond what the state was able to afford.
Coloradans will vote this November on whether to institute a single payer system statewide. One of the leaders of the movement in Colorado is state senator Irene Aguilar, “whos also” a physician. The Colorado proposal would be financed by a payroll taxation increase of 7% for employers and 3% for employees. For the self-employed, that would translate into a 10% tax increase.
But Himmelstein said this type of reform cant be done state by state. The physicians scheme depends in part on cost containment through having a single payer with the power to negotiate narcotic pricing with pharmaceutical companies as well as eradicating many levels of bureaucracy in billing and insurance registration.
The American Medical Association( AMA ), which is the largest organization of physicians in the US, has opposed the idea of a single-payer model. When contacted, the AMA pointed to its policy considering assessing health reform proposals, which states in part that: Unjust concentration of market power of payers is detrimental to patients and physicians, if patient freedom of choice or physician ability to select mode of practise is limited or denied. Single-payer systems clearly fell under such a definition and, consequently, should continue to be opposed by the AMA.
But Himmelstein finds change around the corner. I think the AMA and its member organisations are slowly starting to come around and I am confident that they will eventually come around. He points to the passing of resolutions by a few of the state medical associations that make up the AMA membership to study the impact of a single-payer system as indicators of change.
For Himmelstein and another novelists of the editorial, the biggest indicator of change seems to be the talk of a single-payer system in the presidential primaries which has brought attention back to the issue.
Bernie Sanders showed you can do extremely well campaigning on this issue, told Himmelstein, who is confident that if enough American people demand a single-payer system, Congress will eventually have no choice but to change their intellects and subsistence it. But what the American people truly think of a single-payer system is a lot murkier. While in some polls demonstrate majority support for a single-payer system, deeper digging by some polls finds that support dwindles when individuals are asked about giving up their private health insurance and paying additional taxes.
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