By DAVID MCLANAHAN and DONALD MITCHELL
April 30, 2008
The need for meaningful health care reform remains one of the hottest topics in the public as we approach our national election. An important new study, in the prestigious Annals of Internal Medicine, reveals a growing consensus among practicing physicians that our broken health care system would be best fixed by legislation establishing national health insurance (NHI).
Researchers at Indiana University, in a study of randomly chosen physicians representing the total population of U.S. physicians across all specialties, found a shift in the thinking over the past five years. Now a solid majority of doctors, almost 60 percent, support government legislation to establish NHI — a 10 percent increase in support since 2002.
In another indication that doctors’ attitudes are changing, in December 2007 the nation’s largest medical specialty group, the 124,000-member American College of Physicians, endorsed a single-payer NHI program for the first time.
NHI plans typically involve a single-payer federally administered social insurance fund that guarantees health care coverage for everyone, much like Medicare provides for seniors. Such plans allow patients to go to the doctors and hospitals of their choice, but eliminate or substantially reduce the role of private insurance companies in the health care financing system.
This growing consensus is one more indication that physicians are increasingly rejecting the “marketplace medicine” that has eroded the American value of caring for and supporting one another and that has frustrated our traditional professional ethics. It is in no doubt connected to the daily witnessing of the suffering caused by inequities in health care delivery as well as the waste and inefficiency associated with a private insurance industry that consumes 31 percent of every U.S. health care dollar on bureaucratic paperwork and overhead.
As doctors, we see more and more of our patients experiencing a deterioration in the quality of their employer-based coverage, or losing such coverage altogether, often leading to their financial ruin. Families USA now estimates that one working-age Washingtonian dies each day because of lack of health insurance. In Washington we waste $5.2 billion on excess administrative expenses, more than enough to cover our 746,000 uninsured. Surely we can and must do better.
The Washington Legislature recently took a step forward in passing the Health Working Group legislation, which authorizes a comparative economic/quality analysis of four state health care reform proposals, including a single-payer plan. Washingtonians will have an opportunity to study the results and express themselves in public forums around the state. Unfortunately, the working group timeline delays any meaningful legislation based on its work until the 2010 legislative session.
It is now time for those seeking political office to confront the elephant in the room — the private health insurance industry — and the obstacles it poses to delivering quality health care at an affordable cost to everyone who needs it.
Although both Sens. Hillary Clinton and Barack Obama have said they could support single-payer NHI, neither seems prepared to advocate for it. This new survey of the nation’s doctors, coupled with the findings in an AP/Yahoo public opinion poll last December that 65 percent of Americans favor a similar approach, demonstrate substantial public support for national health insurance. Clearly the physicians and the public are pointing the way forward for meaningful political action.
David McLanahan, M.D., and Donald Mitchell, M.D., are members of Physicians for a National Health Program, Western Washington Chapter. Contributing to this column was Hugh Foy, M.D., also a chapter member.