PNHP

Watch your medFICO score!

Watch your medFICO score!

How healthy is your medical credit score?

System being designed to help hospitals figure out whether you’ll pay them

By Jason Roberson
The Dallas Morning News
December 12, 2007

Mortgage lenders aren’t the only ones showing more interest in your credit score these days Ć¢ā‚¬ā€œ the health industry is creating its own score to judge your ability to pay.

The new medFICO score, being designed with the help of credit industry giant Fair Isaac Corp., could debut as early as this summer in some hospitals.

Healthcare Analytics, a Waltham, Mass., health technology firm, is developing the score. It is backed by funding from Fair Isaac, of Minneapolis; Dallas-based Tenet Healthcare Corp.; and venture capital firm North Bridge Venture Partners, also based in Waltham. Each kicked in $10 million for the project.

The score is already raising questions from consumer advocacy groups that fear it will be checked before patients are treated. People with low medical credit scores could receive lower-quality care than those with a healthy medFICO, they argue.

(Steve Mooney, Tenet’s senior vice president of patient financial services) says the hospital business has changed over the past 30 years to take on characteristics of the retail industry. With patients expected to pay a larger share and do more comparison shopping, they soon will be able to purchase health care much like an automobile, he said.

Pamela Dixon, executive director of the World Privacy Forum, a consumer advocacy group, isn’t impressed. “I don’t like it; I don’t like it at all. These are people’s lives we’re talking about. This isn’t some car.”

http://www.dallasnews.com/sharedcontent/dws/bus/stories/121207dnbushealthcredit.299ccc0.html#

Comment:

By Don McCanne, MD

You can get an idea of the magnitude of the growth in the market of inadequate underinsurance products when the industry has identified yet another administrative service that they can sell us: a medical FICO score to determine the creditworthiness of patients who have significant out-of-pocket expenses as a result of today’s higher cost-sharing requirements.

And soon we’ll be purchasing health care much like an automobile? Does that mean that we’ll have to negotiate with the health care salesman who will have to obtain the approval of the health sales manager (after checking our medFICO score) before we can drive away with our health care?

Anything to keep the government out of our health care.

Obama's views on single payer national health insurance

(excerpted from USA Today, Dec. 11, 2007)

(In 1996) Obama said he would support a single-payer health plan for Illinois “in principal” [sic], “although such a program will probably have to be instituted at a federal level; the long-term objective would be a universal care system that does not differentiate between the unemployed, the disabled, and so on.” The campaign says Obama has consistently supported single payer health care in principle.

Under single-payer health care, a government system would replace private health insurance. Obama’s campaign said he has always supported the idea in concept, but thinks it is not currently practical because of the existing health care infrastructure.

In a statement, a campaign spokeswoman said, “Obama never saw or approved” the document, and the health care, capital punishment and gun control answers weren’t consistent with his stances, then or now.

Full article: http://www.usatoday.com/news/politics/election2008/2007-12-11-obama-views_N.htm

Health Care Reform

The New York Times
Letter
Published: December 12, 2007

Paul Krugman’s repeated focus on the Democratic presidential candidates’ opinions regarding mandates to buy health insurance is distracting (“The Mandate Muddle,” column, Dec. 7).

The true policy difference on health care reform within the Democratic Party is between those who support incremental reform within our current financing system (represented by Hillary Rodham Clinton, John Edwards and Barack Obama) and those who support reforming our current financing system into a single-payer system (represented by Dennis Kucinich).

Mr. Krugman has devoted many columns to extolling the benefits of a single-payer system, so I am not sure why he is repeating politicians’ talking points about minor differences rather than asking why the three leading Democrats aren’t supporting the best reform policy.

Jeremiah Schuur
Cambridge, Mass., Dec. 7, 2007

The writer is an emergency physician.

Obama’s views on single payer national health insurance

(excerpted from USA Today, Dec. 11, 2007)

(In 1996) Obama said he would support a single-payer health plan for Illinois “in principal” [sic], “although such a program will probably have to be instituted at a federal level; the long-term objective would be a universal care system that does not differentiate between the unemployed, the disabled, and so on.” The campaign says Obama has consistently supported single payer health care in principle.

Under single-payer health care, a government system would replace private health insurance. Obama’s campaign said he has always supported the idea in concept, but thinks it is not currently practical because of the existing health care infrastructure.

In a statement, a campaign spokeswoman said, “Obama never saw or approved” the document, and the health care, capital punishment and gun control answers weren’t consistent with his stances, then or now.

Full article: http://www.usatoday.com/news/politics/election2008/2007-12-11-obama-views_N.htm

Australia learns wrong lesson from U.S.

BUPA Australia Bids To Be Largest Health Insurer Down Under

By Vivian Wai-yin Kwok
Forbes.com
December 7, 2007

BUPA Australia confirmed Friday that it had sweetened its bid to take over MBF for 2.41 billion Australian dollars (U.S.$2.1 billion), stepping up its plan to become the biggest health insurer in the country.

MBF is Australia’s second-largest health insurance concern, currently serving 2 million people, representing approximately a 20% share of the country’s health insurance market. BUPA Australia, a subsidiary of British United Provident Association, which made landfall in Australia in 2002, has accumulated more than 1 million customers, for a 10.13% national market share.

“Together MBF and BUPA Australia would create the country’s leading health fund, which would be in a stronger position to provide affordable health insurance, greater efficiencies and improved services for members,” BUPA Australia’s Managing Director Richard Bowden said.

The integration of BUPA Australia and MBF would significantly challenge the state-owned Medibank Private, which has a 29% share of the country’s health insurance market.

BUPA’s revised proposal involves a cash payment of A$2.41 billion to be distributed among all the contributors to MBF, a mutual insurer, which provides policyholders with certain ownership rights.

MBF has been developing a proposal for demutualization and a listing early next year. “The Board is actively considering the BUPA proposal and preliminary informal consultations have been held with the MBF Council. The Board expects to make a decision in the near future as to whether to recommend this proposal formally to the MBF Council and contributors or continue with the demutualisation proposal.”

BUPA Australia first approached to MBF in August with an A$2 billion ($1.8 billion) takeover proposal. However, MBF turned down the initial bid and said it would follow the route taken by NIB Holdings, the country’s sixth-largest health insurer, and transform itself into a listed company.

NIB Holdings, with about 7% of the national market, floated its shares on the Australian Stock Exchange last month, marking the first time a private health insurer went public. NIB’s stock surged 29% on the first day, pushing up the company’s market capitalization to A$570 million ($499 million).

http://www.forbes.com/markets/2007/12/07/bupa-australia-mbf-markets-equity-cx_vk_1207markets02.html

And…

Revealed: highest-earning woman executive in Britain

By Fiona Macgregor
Scotsman.com
June 27, 2005

The head of the private medical firm Bupa has become Britain’s highest-earning woman executive.

Valerie Gooding, 54, was paid more than £1.4 million in salary and bonuses last year in her role as chief executive. That equates to £815 an hour.

She will receive a further £967,000 under an incentive plan and her pension pot grew from £2.7 million to £3.9 million, according to Bupa’s annual report.

http://business.scotsman.com/topics.cfm?tid=343&id=705382005

Comment:

By Don McCanne, MD

It is often said that private insurers in other nations with less expensive, universal health care systems are very different from those in the United States. They are highly regulated, non-profit entities that serve patients well. But is that always true? Step back and take a look at what is happening in Australia.

The private, for-profit British mega-insurer, BUPA, has moved into Australia big time in an effort to take over the financing of their health care system. Australia’s second largest insurer, MBF, is a mutual company owned by those insured. BUPA is competing with the management of MBF in offering a payout to the insured, opening the way for them to convert to a listed company on the Australian Stock Exchange.

Just as we heard in the United States, this conversion, they claim, would enable BUPA to provide “affordable health insurance, greater efficiencies and improved services for members.” But what we got in the United States was unaffordable premiums, financial barriers to care, greater administrative waste, and greater numbers of uninsured and underinsured.

Anyone paying attention then knew who would benefit: the board members and executives of the insurance companies and their friends on Wall Street who have enabled greed to become a major driving force in the American economy. Wealth moves up while more and more of us suffer financial hardship when medical needs arise.

BUPA was the subject of a previous Quote of the Day, when they pulled out of the insurance market in Ireland. They had been successful in insuring the healthy while leaving high-cost patients to be covered by the state-run program. They left in protest over the demand to adhere to their prior agreement that risk pool transfers would be made to correct for adverse selection. They thought that they should be allowed to keep the excess profits resulting from their devious scheme to market selectively to the healthy.

Someone in Australia should ask Valerie Gooding just how much frickin’ money does she really need. Now she is going to siphon off funds that should be going to patients and those who provide their care.

What she really needs is new quarters as luxurious as those that Sir Conrad Black will soon occupy. At least he didn’t stoop to taking money needed for others’ health care.

Experts pick apart Bill Clinton's medical bankruptcy comment

Jennifer Jacobs
Des Moines Register Staff Writer
December 10, 2007

A fact check is in order on a comment about medical bankruptcies that Bill Clinton and other leading Democrats keep making, two dueling experts say.

“Over half of all the bankruptcies in this decade can be tied to personal health emergencies,” the former president said Monday at a Hillary Clinton campaign rally in Ames.

And he’s said it before while stumping for his wife’s health care reform plan, which would require all Americans to carry health insurance either through the government or a private insurer.

“He’s wrong,” said Michael Millenson, a visiting scholar at Northwestern University’s Kellogg School of Management. “Well, it’s not that Bill Clinton is wrong, it’s that he’s quoting a piece of research which is wrong.”

Clinton’s reference was to a Harvard University study of medical bankruptcy that is widely quoted, including by Democratic presidential candidates John Edwards and Barack Obama.

Harvard professors David Himmelstein and Elizabeth Warren interviewed more than 1,700 families that were in bankruptcy courts across the country. About half of all families filing for bankruptcy did so in the aftermath of a serious medical problem, according to the findings, released in 2005.

But that figure was disputed by Millenson and Northwestern University professor David Dranove, who re-examined the study at the behest of the insurance industry. They said medical bills were a contributing factor in just 17 percent of the bankruptcies. And the Harvard researchers didn’t rule out other factors, such as job loss, college loans or housing costs, they found.

“Using their numbers is both factually inaccurate and politically unfortunate,” Millenson, an Obama supporter and volunteer, said in an interview Monday. “President Clinton and Hillary Clinton have a wonderful track record for trying to cover the uninsured. But when you go beyond the facts allowed, you give ammunition to those who are trying to minimize the problem of the uninsured.”

Hillary Clinton’s Iowa spokesman, Mo Elleithee, pointed out that the Clinton, Obama and Edwards campaigns have all cited this fact, and that it came from “a well-respected Harvard study.”

“I find it hard to believe that anyone would quarrel with the fact that skyrocketing health care costs have caused financial hardship for many American families,” Elleithee said. “That’s why Hillary Clinton has a plan to reduce health care costs while increasing both quality and access to all Americans.”

Himmelstein, reached by phone Monday at Harvard, said the study is accurate. The Northwestern academics misrepresented and manipulated the data, he said.

“President Clinton is correct,” Himmelstein said. “But he’s wrong in saying his wife’s plan would do something about it.”

Himmelstein is a passionate advocate for a system where the government insures everyone.

“I think Clinton’s plan is just an absolute fraud, and so is Edwards’ and Obama’s,” he said.

The “Swiss cheese coverage” of private insurance would still leave some Americans saddled with enormous bills, and those who lose their jobs would be particularly vulnerable to medical bankruptcy, he said.

Skip the back-and-forth, and these academics agree on some points. About 46 million Americans have no health insurance. And for the 250 million with insurance, high co-payments, deductibles and exclusions from coverage can harm their finances.

But the number of bankruptcies due to medical bills is unknown, said Millenson, who described himself and Dranove as “militant political moderates.”

Dranove recently started a year-long study on the issue, this time with a grant from the Robert Wood Johnson Foundation.

Health Care System's Future Splits Views in U.S.

Angus Reid Global Monitor
Polls & Research
December 11, 2007

(Angus Reid Global Monitor) – Adults in the United States are divided on the way their medical services should operate, according to a poll by YouGov/Polimetrix released by The Economist. 42 per cent of respondents would prefer a plan that replaces the current health care system with a “single-payer” program where all health care costs are paid by the government, while 41 per cent would choose a plan that maintains the current system where most health care costs are paid by individuals or employers.

If a national heath plan were adopted over the next few years, 19 per cent of respondents expect better care than they currently have, 26 per cent think it would be the same, and 32 per cent predict it will be worse.

When asked whether the U.S. government should guarantee health insurance for all citizens–even if it means raising taxes–48 per cent of respondents agree with the rationale, while 36 per cent disagree.

Health care in the U.S. is based on a system of benefits provided by employers, as well as the Medicare and Medicaid programs which allocate health insurance for the elderly, disabled and poor. Around 47 million Americans are uninsured.

Texas congressman Ron Paul, who is running for the Republican PartyĆ¢ā‚¬ā„¢s presidential nomination in 2008, decried the idea of a government-administered system on his website, writing, “The federal government will not suddenly become efficient managers if universal health care is instituted. Government health care only means long waiting periods, lack of choice, poor quality and frustration. Socialized medicine will not magically work here.”

Polling Data

Would you prefer a plan that replaces the current health care system with a “single-payer” program where all health care costs are paid by the government or a plan that maintains the current system where most health care costs are paid by individuals or employers?

42% Prefer to have government pay all costs

41% Prefer to have individuals and employers pay more costs

16% Not sure

If a national health care plan is adopted in the next few years, do you think you personally would receive better or worse care than you receive now?

19% Better with a national health care plan

36% About the same

32% Worse with a national health care plan

13% Not sure

Should the U.S. government guarantee health insurance for all citizens, even if it means raising taxes?

48% Yes

36% No

16% Not sure

Source: YouGov/Polimetrix / The Economist
Methodology: Online interviews with 1,000 American adults, conducted on Dec. 3 and Dec. 4, 2007. No margin of error was provided.

Nation's Largest Medical Specialty Group Endorses Single Payer Health Reform

Says U.S. should learn from other nations' health systems

For Immediate Release:
December 11, 2007

Contacts:
Quentin Young, MD, MACP 312-782-6006
John Geyman, MD 360-378-6264
Don McCanne, MD 949-493-3714

After careful evaluation of the health systems of 12 other nations, the American College of Physicians (ACP), the nation’s largest medical specialty society and second largest medical association (124,000 members), endorsed single payer national health insurance as “one pathway” to universal coverage. The ACP represents specialists in internal medicine.

“This new proposal by the ACP brings single payer into the mainstream,” said Dr. C. Anderson Hedberg, President Emeritus of the ACP. “It’s the logical next step.”

Although ACP has advocated universal coverage since 1990, and had their own proposal for reform since 2002 based on a “pluralistic” model, this is the first time they have endorsed single payer national health insurance.

“There’s really only one choice for universal health care at a cost we can afford, and that’s single payer, Medicare for All,” said Dr. Marcia Angell, former editor-in-chief of the New England Journal of Medicine. “There is simply no way to cover everyone in a pluralistic system and control costs.”

“This changes the political landscape for the presidential candidates, who now will need to take a fresh look at single payer. It recognizes the political feasibility of single payer as well as its importance as a leading option for health care reform” said Dr. Quentin Young, a “Master” in the ACP and National Coordinator of Physicians for a National Health Program (PNHP).

PNHP is a 15,000 member organization headquartered in Chicago that has advocated for single payer national health insurance since 1986. The group’s peer-reviewed research and reform proposals in support of single payer are on-line at www.pnhp.org.

The ACP said their recommendation is based on a large and growing body of evidence that the U.S. health system is performing poorly compared to nations with single payer national health insurance:

“Single-payer systems generally have the advantage of being more equitable, with lower administrative costs than systems using private health insurance, lower per capita health care expenditures, high levels of consumer and patient satisfaction, and high performance on measures of quality and access.” (ACP Position Paper, Annals of Internal Medicine, 12/07)

“The ACP endorsement of single payer is an important step forward for the medical profession,” said Dr. John Geyman, author of “The Corrosion of Medicine: Can the Profession Reclaim its Moral Legacy” and Past President of PNHP. “Instead of ideology and unbridled self-interest, they are putting patients’ needs first.”

Experts pick apart Bill Clinton’s medical bankruptcy comment

Jennifer Jacobs
Des Moines Register Staff Writer
December 10, 2007

A fact check is in order on a comment about medical bankruptcies that Bill Clinton and other leading Democrats keep making, two dueling experts say.

“Over half of all the bankruptcies in this decade can be tied to personal health emergencies,” the former president said Monday at a Hillary Clinton campaign rally in Ames.

And he’s said it before while stumping for his wife’s health care reform plan, which would require all Americans to carry health insurance either through the government or a private insurer.

“He’s wrong,” said Michael Millenson, a visiting scholar at Northwestern University’s Kellogg School of Management. “Well, it’s not that Bill Clinton is wrong, it’s that he’s quoting a piece of research which is wrong.”

Clinton’s reference was to a Harvard University study of medical bankruptcy that is widely quoted, including by Democratic presidential candidates John Edwards and Barack Obama.

Harvard professors David Himmelstein and Elizabeth Warren interviewed more than 1,700 families that were in bankruptcy courts across the country. About half of all families filing for bankruptcy did so in the aftermath of a serious medical problem, according to the findings, released in 2005.

But that figure was disputed by Millenson and Northwestern University professor David Dranove, who re-examined the study at the behest of the insurance industry. They said medical bills were a contributing factor in just 17 percent of the bankruptcies. And the Harvard researchers didn’t rule out other factors, such as job loss, college loans or housing costs, they found.

“Using their numbers is both factually inaccurate and politically unfortunate,” Millenson, an Obama supporter and volunteer, said in an interview Monday. “President Clinton and Hillary Clinton have a wonderful track record for trying to cover the uninsured. But when you go beyond the facts allowed, you give ammunition to those who are trying to minimize the problem of the uninsured.”

Hillary Clinton’s Iowa spokesman, Mo Elleithee, pointed out that the Clinton, Obama and Edwards campaigns have all cited this fact, and that it came from “a well-respected Harvard study.”

“I find it hard to believe that anyone would quarrel with the fact that skyrocketing health care costs have caused financial hardship for many American families,” Elleithee said. “That’s why Hillary Clinton has a plan to reduce health care costs while increasing both quality and access to all Americans.”

Himmelstein, reached by phone Monday at Harvard, said the study is accurate. The Northwestern academics misrepresented and manipulated the data, he said.

“President Clinton is correct,” Himmelstein said. “But he’s wrong in saying his wife’s plan would do something about it.”

Himmelstein is a passionate advocate for a system where the government insures everyone.

“I think Clinton’s plan is just an absolute fraud, and so is Edwards’ and Obama’s,” he said.

The “Swiss cheese coverage” of private insurance would still leave some Americans saddled with enormous bills, and those who lose their jobs would be particularly vulnerable to medical bankruptcy, he said.

Skip the back-and-forth, and these academics agree on some points. About 46 million Americans have no health insurance. And for the 250 million with insurance, high co-payments, deductibles and exclusions from coverage can harm their finances.

But the number of bankruptcies due to medical bills is unknown, said Millenson, who described himself and Dranove as “militant political moderates.”

Dranove recently started a year-long study on the issue, this time with a grant from the Robert Wood Johnson Foundation.

Health Care System’s Future Splits Views in U.S.

Angus Reid Global Monitor
Polls & Research
December 11, 2007

(Angus Reid Global Monitor) – Adults in the United States are divided on the way their medical services should operate, according to a poll by YouGov/Polimetrix released by The Economist. 42 per cent of respondents would prefer a plan that replaces the current health care system with a “single-payer” program where all health care costs are paid by the government, while 41 per cent would choose a plan that maintains the current system where most health care costs are paid by individuals or employers.

If a national heath plan were adopted over the next few years, 19 per cent of respondents expect better care than they currently have, 26 per cent think it would be the same, and 32 per cent predict it will be worse.

When asked whether the U.S. government should guarantee health insurance for all citizens–even if it means raising taxes–48 per cent of respondents agree with the rationale, while 36 per cent disagree.

Health care in the U.S. is based on a system of benefits provided by employers, as well as the Medicare and Medicaid programs which allocate health insurance for the elderly, disabled and poor. Around 47 million Americans are uninsured.

Texas congressman Ron Paul, who is running for the Republican PartyĆ¢ā‚¬™s presidential nomination in 2008, decried the idea of a government-administered system on his website, writing, “The federal government will not suddenly become efficient managers if universal health care is instituted. Government health care only means long waiting periods, lack of choice, poor quality and frustration. Socialized medicine will not magically work here.”

Polling Data

Would you prefer a plan that replaces the current health care system with a “single-payer” program where all health care costs are paid by the government or a plan that maintains the current system where most health care costs are paid by individuals or employers?

42% Prefer to have government pay all costs

41% Prefer to have individuals and employers pay more costs

16% Not sure

If a national health care plan is adopted in the next few years, do you think you personally would receive better or worse care than you receive now?

19% Better with a national health care plan

36% About the same

32% Worse with a national health care plan

13% Not sure

Should the U.S. government guarantee health insurance for all citizens, even if it means raising taxes?

48% Yes

36% No

16% Not sure

Source: YouGov/Polimetrix / The Economist
Methodology: Online interviews with 1,000 American adults, conducted on Dec. 3 and Dec. 4, 2007. No margin of error was provided.

Better morale with no insurance?

Decline in Employer Sponsored Health Insurance Traced to New Small-Business Owners

National Federation of Independent Business (NFIB)
December 4, 2007

The primary reason for the decline in the number of small businesses providing health insurance appears to be that owners of new firms are reluctant to introduce health benefits, according to a National Federation of Independent Business Small-Business Poll released today. The poll on purchasing health insurance found that 52 percent of small-business owners do not offer either employee health insurance or an insurance purchase subsidy.

“It’s much better for employee morale if a small-business owner never offers health benefits, than it is to offer them and then be forced to take it away because it is too expensive to continue,” said William J. Dennis, NFIB’s senior research fellow.

http://www.nfib.com/object/IO_35492.html

NFIB Small Business Poll:
http://www.nfib.com/page/researchFoundation

Comment:

By Don McCanne, MD

You know that we have serious problems with our health care financing system when a policy expert states that it is better for morale if new small business owners never offer their employees health insurance in the first place.

Small business owners are not to blame. The problem is the perpetuation of our health care financing method in which we use individual private plans for which premiums are set based on the actuarial risk of the collective members of the segregated risk pools. This is not only an expensive, administratively burdensome process, it also prevents equitable financing by allowing healthy and wealthy individuals to to escape into their own low cost pools, thereby relieving them of paying their full equitable share of pools that include those with greater health care needs.

Health care is now so expensive that most smaller start-up businesses can no longer afford to include health benefit programs for their employees. Just as adequate health insurance has become too expensive to enforce an individual mandate to purchase insurance, neither can an employer mandate be enforced. The amount that an employer or an individual or family pays for private insurance is determined by the full actuarial value of the benefits of the individual/group plan pool plus the high administrative costs that cannot be avoided in a fragmented system of financing health care. That creates a mismatch between the premium charged and the ability to pay for it.

There are those who insist that we could leave in place the private plans and achieve equity through various tax supports designed to match the premiums charged to the ability to pay, even if it does perpetuate the administrative waste. As government tax support increases, compliance improves, but you will never have 100 percent coverage with full participation by those who are healthy until the tax support covers the entire premium and enrollment is automatic (but then why would you continue to tolerate the administrative waste?). Though some would suggest that we could allow individuals to opt out, those supporting mandates to purchase plans realize that the healthy must be included in the collective risk pools for insurance to work.

If really we do want health care to be affordable for individuals and businesses of modest means, we need to do away with the private plan model and replace it with an equitably funded risk pool that covers everyone – a single payer national health program.

Professionals call for Medicare-style health plan

Nurses' ad cites Cheney's heart troubles as evidence of universal need

By Russ Britt
MarketWatch
Last update: 7:24 p.m. EST Dec. 7, 2007

LOS ANGELES (MarketWatch) — While health-care reform may play second fiddle to the war in Iraq among voters this election season, it appears that the domestic issue is taking on new life thanks to medical-industry professionals.

An advertisement, due to appear Monday in Iowa newspapers ahead of upcoming caucuses there, calls for a single-payer, national health-insurance plan similar to Medicare, and cites Vice President Dick Cheney’s chronic heart troubles as evidence of its need. It is sponsored by the Oakland, Calif.-based California Nurses Association/National Nurses Organizing Committee.

At the top of the ad, there’s a news story about a recent visit by Cheney to the hospital for treatment of an irregular heartbeat. Underneath, it says: “If he were anyone else, he’d probably be dead by now.”

The ad goes on to note that under the government health-insurance program that covers Cheney, he is not turned away for preexisting conditions or unable to be treated for what an insurance company might label “experimental treatments.”

“There’s a whole set of barriers that he has never faced,” said Michael Lighty, director of public policy for the nurses’ group.

Welcome to the 2008 elections, where medical professionals are turning up the heat in favor of a universal, single-payer system that represents a radical departure from what most of the major presidential candidates are proposing. They know that such a system is a long shot at this point, but the numbers in their camp are growing.

Other medical professional organizations are calling for similar measures to be enacted, or at least discussed. The American Nurses Association, which represents 2.9 million nurses, is pressing for a national plan, as is a group of 14,000 doctors called the Physicians for a National Health Program.

Dr. Quentin Young, co-founder of the physicians’ group, called alternative proposals from other candidates “patch-quilt failed systems that won’t work.”

“What we have now is the problem, not the solution,” he said.

Also for the first time, the American College of Physicians wants the issue to at least be discussed among other alternatives as the nation moves toward some sorts of changes in health care.

The group, which represents 124,000 internal-medicine physicians, isn’t advocating a Medicare-style plan, but at least wants the subject to be broached — a departure from past practices.

“We’re trying to produce a dialogue,” according to spokesman David Kinsman. “We’re saying that what does not work is the status quo.”

Can these professionals succeed in their quest for a national health program? Medical professionals are contributing in record numbers to candidates’ campaigns, so they’re likely to get the ear of at least some of the candidates. The American Nurses Association said that it plans to sit down with all the candidates to discuss the idea.

‘Outrageous’

The doctors and nurses who propose a single-payer plan say that it will cut red tape, eliminate haggling with insurers over what procedures are necessary and allow them to deliver unfettered health care.

Whether this kind of approach will resonate with voters is unclear, but staffers in Cheney’s office, at least, seem to have little patience for the nurses’ advertising strategy.

“I think it’s outrageous and it doesn’t warrant a response,” commented Megan Mitchell, a spokeswoman for the vice president.

But it appears that candidates for next year’s presidential election are unwilling to lean toward these views — at least for now. Currently, the only one that is calling for the same kind of reform is Rep. Dennis Kucinich, D-Ohio, a dark horse who lags far behind in the polls.

Leading Democratic contenders Sen. Hillary Clinton of New York, Sen. Barack Obama of Illinois and John Edwards, a former senator from North Carolina, all advocate a mix of public and private coverage. Clinton and Edwards propose mandatory coverage for all, along with tax credits for those who can’t afford premiums.

Republicans stray even further from the groups’ goals. GOP candidates largely want to let free-market forces determine the future of health care, with only former New York Mayor Rudolph Giuliani calling for tax credits.

Young, of Physicians for a National Health Program, said that of the three major Democratic candidates, Edwards comes the closest to his organization’s views. But proposals from candidates like Clinton are untenable, he added.

“She is ultimately duplicitous,” he charged. “People are being ripped off, and these liberal Democrats are doing nothing to ease their pain.”

One problem for these stakeholders, though, is that they’re missing a key ally: the powerful American Medical Association.

While some say the AMA has softened its stance in recent years from the Republicans’ free-market approach, it still advocates a mix of public and private programs with tax credits thrown in — much in the vein of the Clinton, Obama and Edwards plans. AMA officials did not return phone calls.

“It is imperative that individuals and families be able to choose what health plan to join,” says an AMA February position paper on health care, posted on the group’s Web site.

Without the AMA’s backing, it will be tough to enact the kind of reform sought by medical professionals. Still, they insist that along with the noise they’re making via the Cheney ads and other efforts, they’re also making progress.

“We’ve moved from being irrelevant to being an undesirable alternative,” according to Young.