‘We need fundamental changes’: US doctors call for universal healthcare

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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 Canada’s, 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 can’t afford care and don’t have access to the care they need, while the system is ever more wasteful, throwing away money on bureaucratic expenses and absurd prices from the drug companies,” said David Himmelstein, a professor 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 leave them vulnerable to ruinous medical bills”. Despite the current high healthcare spending levels in the US, healthcare outcomes are worse than in comparable well-funded countries.

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 financial barriers to seeking care, which would lead to greater utilization of the system and improved health outcomes, Himmelstein argues.

The additional funds would be made up by modest tax 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 said. 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 medication would be negotiated with pharmaceutical companies the same way other countries with single-payer systems already negotiate for lower cost medications. Currently, US drug prices are some of the highest in the world.

While Himmelstein acknowledges that the physicians’ proposal would meet with political and business interest opposition, and he can’t 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.

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, who is also a physician. The Colorado proposal would be financed by a payroll tax 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 can’t be done state by state. The physicians’ plan depends in part on cost containment through having a single payer with the power to negotiate drug pricing with pharmaceutical companies as well as eliminating 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 regarding evaluating health reform proposals, which states in part that: “Unfair concentration of market power of payers is detrimental to patients and physicians, if patient freedom of choice or physician ability to select mode of practice is limited or denied. Single-payer systems clearly fall within such a definition and, consequently, should continue to be opposed by the AMA.”

But Himmelstein sees change around the corner. “I think the AMA and its member organizations 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 the other writers 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 extraordinarily well campaigning on this issue,” said Himmelstein, who is confident that if enough American people demand a single-payer system, Congress will eventually have no choice but to change their minds and support it. But what the American people really think of a single-payer system is a lot murkier. While in some polls show majority supportfor 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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12 COMMENTS

  1. RE “foolish claims” about mammograms:

    Solid research data had demonstrated many years ago that the lowest possible level of ionizing radiation causes cancer, specifically breast cancer (read “The Mammogram Myth” by Rolf).

    But for nearly a century, the biggest profiteers of the use of this highly toxic material, such as the medical establishment, the nuclear energy industry, or the military industry, have been denying, discounting, or obfuscating the real toxicity and the magnitude of injuries and fatalities from their many interventions and accidents to avoid culpability the massacres they’re responsible for.

    For decades, and continuing to current times, the medical authorities have “taught” (=hoodwinked) the people a bunch of plausible-sounding fairy tales and lies (eg, it’s like flying in an airplane or spending a day in the sun) to convince them it is safe and nothing to worry about (see The Mammogram Myth). Mammography is a certified “scientific” scam of allopathic medicine.

  2. Steps must be taken to rise above the rockefeller mess,it can be done by those who dare to take to the next level armed with all the secrets that have been hidden away . Don’t fear the single payer it will answer our prayers to salvage the ACA cause it’s failing no one is signing up because it’s a hydra.

  3. No increase in taxes is needed for the single-payer system, just reduce the bloated military budget and corporate welfare. But why hasn’t the single-payer option ever passed, though everyone has talked about it for half a century? Ted Kennedy had a long senatorial career and was a powerful force in the Senate. He said a national health care system was the ultimate goal of his political life, yet he never accomplished it. It’s because the insurance companies are too rich and powerful

  4. Words matter, as the last link “some polls” in the last paragraph above shows. When asked if they support Medicare-for-all, 63% of respondents were in favor. When asked if they support Socialized Medicine, only 38% were in favor.

    What we have now in the US is a class system of health care, an extremely immoral, patchwork system, with Haves and Have-nots. The Haves are the elderly who have Medicare, the indigents and the undocumented illegal immigrants who have Medicaid, our Politburo politicians who have their own gold-plated plan that we pay for, the armed forces as a benefit of their jobs, the Indian Health Service for American Indians on reservations, and veterans who have the VA (these last 2 health bureaucracies aren’t great).

    The Have-nots are the 20% of the population who still can’t afford healthcare (especially in Dixie), the 20% of the insured who can’t pay their portion of the medical bills, the unemployed, etc. It breeds resentment. And we ALL pay too much, because of the multiple systems. In Canada next door, everyone is covered, at a per capita cost that is cheaper than the US system. And their outcomes are much better, for life expectancy for example.

  5. My insurance won’t touch psychiatric treatment. Costs me $160 a month. I have to pay 100% until I meet a $2000 yearly deductible. Then they only pay 50%.

    But they’ll pay 100% of primary care physician. I need that care so rarely, what’s the point?

    This is a big problem in this country. Lack of psychiatric care. And people with insurance usually don’t get it paid for so they go without it. Which is bad for everyone.

  6. Capitalist make terrible doctors. No test to see if you need a vaccination, No holding your own lifetime health records. No official record of vaccinations so everyone’s shot record is even valid. Children all have different records, some hand written and initialed it is a mess.

  7. Nonsense! USA physicians would not eradicate the current salary base that enticed them to enter academics in medicine. Insurance is an inherited mafia racket where 90% of healthy people financially support 10% of unhealthy people who could have prevented their chronic diseases and dementias. In addition, each race is predisposed with genetic defects. In the USA, there are at least five (5) major races and each is troubled with genetic time bombs if folks don’t promote lifestyle behaviors of health and wellness.

    If US taxpayers VOTE for national healthcare, then US taxpayers should pay insurance premiums based on their genetic racial background … meaning, a whole race financially supports its own race instead of all races. When people recognize their racial genetics predispose them for specific chronic diseases and dementias and the illnesses each race brings as consequences for negative lifestyle choices, the each race will hold itself responsible for their choices … a check-and-balance by themselves, not the whole of the USA society.

    • Isn’t everyone hurt by negative lifestyle choices? Why would you create racial divisions because of that?

  8. Coming from a country that gives world class medical treatment to everyone, The U.S system is just filthy.

  9. You are right Wjabbe, oh so right, but if everyone is going to live a healthy life style, where is the business then for the Medical Mafia?

    Oh and about cancer: that is man made! I got in a fight about that with a dentist, who later admitted to me that I was right in my thinking. But she threw me out anyway. Who cares!

    Regina

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