The proposal would keep hospitals and clinics private, allow physicians to bill under a fee-for-service model, and be funded by combining current sources of government health spending into a single fund with modest new taxes.
By Jeff Lagasse
Healthcare IT News, May 9, 2016
More than 2,000 doctors backed a single-payer healthcare system in an article published by the American Journal of Public Health.
While Presidential candidate Vermont Sen. Bernie Sanders is running on a Medicare for all platform, the proposal authors called their recommendation strictly non-partisan and described a single-payer system as publicly financed and covering all Americans for medically necessary care.
Under the national health program outlined by the physicians, patients could choose to go to any doctor or hospital of their preference. Most hospitals and clinics would remain privately owned and operated, receiving a budget from the program to cover all operating costs. Physicians could continue to practice on a fee-for-service basis, or receive salaries from group practices, hospitals or clinics.
The program would be paid for by combining current sources of government health spending into a single fund with modest new taxes they claim would be fully offset by reductions in premiums and out-of-pocket spending. Co-pays and deductibles would be eliminated.
The single-payer program, they said, would save about $500 billion annually by eliminating the high overhead and profits of insurance firms, and the “massive paperwork” they inflict on hospitals and doctors.
The physicians also argued that the administrative savings of the streamlined system would fully offset the costs of covering the uninsured, as well as upgraded coverage for everyone else, including full coverage of prescription drugs, dental care and long-term care. Savings would also be redirected to what the group cites as “underfunded health priorities,” particularly public health.
The study also claims the “single payer” would be in a strong position to negotiate lower prices for medications and other medical supplies, yielding additional savings and reining in costs.
Adam Gaffney, a Boston-based pulmonary disease and critical care specialist who was co-chair of the working group that produced the proposal, said in a statement that the nation was at a crossroads.
“Despite the passage of the Affordable Care Act six years ago, 30 million Americans remain uninsured, an even greater number are underinsured, financial barriers to care like co-pays and deductibles are rising, bureaucracy is growing, provider networks are narrowing, and medical costs are continuing to climb,” he said. “Caring relationships are increasingly taking a back seat to the financial prerogatives of insurance firms, corporate providers, and Big Pharma. Our patients are suffering and our profession is being degraded and disfigured by these mercenary interests.”
Marcia Angell, a co-author of the proposal and member of the faculty of global health and social medicine at Harvard Medical School, said in a statement that the country “can no longer afford to waste the vast resources we do on the administrative costs, executive salaries, and profiteering of the private insurance system. We get too little for our money. It’s time to put those resources into real health care for everyone.”
Surveys show support for single-payer national health insurance may be rising among physicians. A 2008 survey of physicians found that 59 percent supported “legislation to establish national health insurance,” up from 49 percent five years earlier.