California Medical Association
House of Delegates
March 13-15, 2004
The delegates adopted a health care financing reform policy (Report B-1-04)…
Report B-1-04
CMA Health Care Financing Reform Policy
Recommendation 7:
That in order for CMA to consider supporting a single payer health reform proposal, the following criteria must be in place:
1. Physicians must be permitted to balance bill their usual and customary rates.
2. A scientific, apolitical body must make benefit/coverage decisions.
3. Pluralistic delivery system options must be retained (e.g., pre-paid
group practices, FFS).
4. A mechanism for addressing fraud.
5. Patients allowed to “buy up” – to purchase additional coverage outside the ‘single’ plan.
6. A mechanism to address capital investment and infrastructure building.
7. Medically appropriate co-payments on a sliding scale must be incorporated
to discourage excessive utilization.
http://www.calphys.org/html/bb522.asp
Comment: Single payer advocates certainly would have problems with some of
the qualifying criteria listed, including balance billing, financial penalties for accessing beneficial services, and the suggestion that buying to the front of the queue might be permitted through “buy up” coverage. But we must recognize that it is truly remarkable that the California Medical Association has officially advanced its position on single payer to one of considering support.
We should work within organized medicine to be certain that single payer continues to be included in the evaluation of all options for reform. As the
general concepts for reform are better understood, we can continue to work
to improve the policy details.