“Major changes are needed to a system that costs too much, leaves too many behind, and delivers too little.”
By Jon Queally
Common Dreams (1/21/22)
The fight for Medicare for All received a two-handed boost from tens of thousands of doctors on Monday when the American College of Physicians—in a move described as a “seachange for the medical professions”—officially endorsed a single-payer system as among only one of two possible ways to improve the nation’s healthcare woes.
Representing 159,000 doctors of internal medicine nationwide, the ACP is the largest medical specialty society and second-largest physician group in the country overall after the American Medical Association (AMA).
The ACP delivered its case in a 43-page position paper—titled “Envisioning a Better U.S. Health Care System for All: Coverage and Cost of Care“—published in the Annals of Internal Medicine on Monday. According to the paper:
“Although the United States leads the world in health care spending, it fares far worse than its peers on coverage and most dimensions of value. Cost and coverage are intertwined. Many Americans cannot affford health insurance, and even those with insurance face substantial cost-related barriers to care. Employer-sponsored insurance is less prevalent and more expensive than in the past, and in response, deductibles have grown and benefits have been cut. The long-term solvency of U.S. public insurance programs is a perennial concern. The United States spends far more on healthcare administration than peer countries. Administrative barriers divert time from patient care and frustrate patients, clinicians, and policymakers. Major changes are needed to a system that costs too much, leaves too many behind, and delivers too little.”
Sen. Bernie Sanders (I-Vt.), a leading candidate for the 2020 Democratic presidential nomination and the author of the The Medicare for All Act of 2019 now in the U.S. Senate, welcomed the development.
“I am delighted that the American College of Physicians has come out in support of a Medicare for All, single-payer healthcare system,” Sanders said in a statement emailed to Common Dreams.
“All over this country, a growing number of doctors are sick and tired of the enormous waste and bureaucracy that exists in our cruel and dysfunctional healthcare system,” Sanders added. “They are sick and tired of spending time filling out reams of paperwork and arguing with insurance companies. Medicare for All will give doctors the freedom to focus on making their patients healthy, not making health insurance executives wealthy.”
The ACP’s detailed review of the current for-profit system—even with some of the improvements resulting from the Affordable Care Act (ACA)—found that “too many Americans are uninsured or underinsured” and that current spending is “high and unsustainable”—especially as other developed nations show their ability to achieve better or similar outcomes for less while offering universal, government-guaranteed coverage to all.
Four key recommendations for real reform
While it did not say that Medicare for All was the only way to achieve a more equitable, accessible, and sustainable healthcare system, the ACP laid out four key recommendations for achieving universal coverage in the United States. They are:
1. The American College of Physicians recommends that the United States transition to a system that achieves universal coverage with essential benefits and lower administrative costs.
2. Coverage should not be dependent on a person’s place of residence, employment, health status, or income.
3. Coverage should ensure sufficient access to clinicians, hospitals, and other sources of care.
4. Two options could achieve these objectives: a single-payer financing approach, or a publicly financed coverage option to be offered along with regulated private insurance.
While acknowledging that a transition to Medicare for All could be “highly disruptive” to the healthcare system, the ACP said “single-payer financing approach could achieve [its] vision of a system where everyone will have coverage for and access to the care they need, at a cost they and the country can afford. It also could achieve our vision of a system where spending will have been redirected from health care administration to funding coverage, research, public health, and interventions to address social determinants of health.”
Medicare for All, the paper continued, could also “achieve other key policy objectives, including portability, lower administrative costs and complexity, lower premiums and cost sharing, lower overall health care system costs, better access to care, and better health outcomes, depending on how it is designed and implemented.” …