EMAIL SIGN UP!
Most Popular This Week
Popular content
Today's Top News
American College of Physicians Endorse Single-Payer
The Philadelphia-based American College of Physicians - the nation's second-largest physician group - endorsed a single-payer health-care system yesterday.
But the organization stopped short of saying that a single-payer system like Medicare, in which the government would get and pay most bills, is the best way to achieve universal health coverage.
The group said the country also could do that through expansion of the current mix of private insurance and government coverage. Under the proposal, people would be required to get health insurance.
While some physicians have formed organizations that push for single-payer, David Dale, president of the ACP, said his was the largest general-interest doctor group to support the controversial idea.
The group said change was necessary because access to health care had deteriorated.
The largest physician group in the United States, the American Medical Association, does not support single-payer. Earlier this year, it released a proposal to expand insurance coverage, primarily through tax incentives and changes in insurance regulations.
The ACP's membership includes 124,000 internal-medicine physicians and related specialists.
After analyzing health care in the United States and 12 other industrialized countries, the group concluded that universal coverage had been successfully achieved elsewhere through single-payer and pluralistic systems.
Either could work here, the report said. The pluralistic system gives consumers more choice, but also leads to higher administrative costs and inequalities. Because it is what the United States already has, it is less of a political challenge. "It's like remodeling your house to make it better for your whole family," Dale said.
Single-payer has lower administrative costs, but is not politically popular, he said. "I'm not a political analyst. I'm just a doctor," Dale said. "But I think there will probably be resistance to that. That's why we don't have it now." He said his group added it to its proposal to "heighten the debate."
Thomas E. Getzen, a professor of insurance and health management at Temple University, said doctors had long resisted single-payer systems for fear it would give the government more control over them.
Because much of the growth in expense in the current system is in procedures performed by specialists or in increased use of technology like MRIs, doctors who work in those areas have the most to fear from a single-payer system, Getzen said. Internists, who serve as primary-care doctors for many people, have less to fear.
The ACP also called for better payments for primary-care doctors to help avert a shortage and for the creation of a uniform billing system and greater use of electronic health records to reduce administrative costs.
Dale said that some U.S. doctors and hospitals were better than their counterparts in other nations, but that this country's health system compares poorly. "Part of our call is, 'Look around, guys, and see how other people are doing,' " he said, "and they're doing better than us."
© 2007 The Philadelphia Inquirer
Comments
Note: Disqus 2012 is best viewed on an up to date browser. Click here for information. Instructions for how to sign up to comment can be viewed here. Our Comment Policy can be viewed here. Please follow the guidelines. Note to Readers: Spam Filter May Capture Legitimate Comments...
64 Comments so far
Show AllI am glad that the American College of Physicians endorses single payer, about time, but am concerned that a mix of private and public insurance is endorsed as well.
This article contains many myths that you see every day with articles regarding the health care crisis.
First that single payer is politically unpopular. But unpopular among whom? A recent CNN study showed that 2/3rds of Americans support nationally funded health care even if it would increase taxes. Politically unpopular among the insurance and pharmaceutical industry.
The people want single payer.
Second the article mentions that single payer would reduce administrative costs and that is why doctors like it, very true, but
they don't say how much cost. An estimated 30% of health care is administrative waste, and a conservative estimate of savings with single payer would be 10% or over $200 billion dollars a year, with out sacrificing quality.
They make a point that high technology is driving health care costs too high -- everyone tends to blame the doctors (too many tests) or the patients (too many demands) for the high cost of health care. Not true. Insurance industry, insurance industry, insurance industry -- lets blame them for the high cost. That said there may be minimal waste in high technology, but focus on the real problem.
Anyhow, it is good to get single payer discussion on the table. Thank you ACP!
John C Stockton wrote:
"I'm 72 years old and see the erosion of Medicare as an insult to all Americans."
Last winter, my sister had a stroke and was in rehab for 6 weeks to re-learn how to walk, talk, and swallow. She's 76, had been very healthy and had supplemental insurance.
The Medicare manual says that Medicare covers 100 days of rehab. Not so. They say they are supposed to cover the first 20 days. After that, they partially cover it. Also, this means only the stay at the rehab facility. It doesn't talk about the various therapies. They are separate.
In my sister's case, they screwed up even that and paid for only 14 days. Although she had what she thought was good supplemental insurance, she ended up paying between $2000 and $3000. This was not a luxury rehab place. The therapy was good but the facility, food, etc. was barely passable.
After she came back home, the Home Healthcare people came by for several weeks. That's it. I look after her. What happens now?
I'm 71 and pay over $2000 a year in supplemental. How much care will I get if I get sick?
Frosty Bunny--Your post rings so true to me because I had a similar experience with a primary care physician who quit the HMO (after they got to the point when they asked him to fill out an elaborate form for every perscription he wrote!) and instead went on to become a medical missionary to Africa. My loss (he too was a great doctor) turned out to be Africa's gain.
Moonflower6--Thanks for your expert perspective on "the system" and i hope your mom recovers soon--sounds like she will if you have anything to say about it.
it nice to get expert confirmation that Michael Moore was 100% correct and right on in SICKO.
I'm sitting in a hospital room watching my mother snooze as I post this comment. Two weeks ago she entered the hospital for thyroid surgery. Not a small town hospital. A large, a major medical center in a Florida metropolis. But by the Grace of God, she is still alive.
As a nursing instrutor, I know the standards of care and have seen them violated no less than 30 times a day here, every day. I know better than to ever leave her alone here for more than an hour at a time. If I were not a nurse, I have no doubt my mother would not have survived this hospital stay. I really feel for any one in who does not have a nurse in the family to advocate for them when they are at the mercy of this broken system.
American hospitals are some of the most dangerous places on earth if you value your life.... Even the best nurses are stretched beyond their limits by poor staffing ratios. Corporate America cuts nursing care at the bedside to reap profits for their ceo's and stockholders. Every single one of my mother's grave complications might have been prevented with good nuring care.
Those of you who think we have the best "health care system in the world", take it from someone with twenty five years in health care, you are very sadly mistaken, and it could very easily cost you your life.
The corporate media rigs the discussion of health care coverage and the presidential campaign. A perfect example came out this morning in the Wall Street Journal. The article is critical of the "Democrats" for not really having a plan for universal health care coverage. And THEN they proceed to compare Clinton/Edwards/Obama on this issue (the corporate candidates) criticizing their lack of complete coverage of 47 million uninsured people in the US, and failed to mention the one candidate who HAS a plan for universal coverage: Kucinch. The bias could not be more clear, under the guise of "leading candidates." The corporate media excludes any candidate who seeks progressive policies towards a new progressive regime or era.
http://online.wsj.com/article/SB119681696156513818.html?mod=googlenews_wsj
Single-payer has lower administrative costs, but is not politically popular, he said. "I'm not a political analyst. I'm just a doctor," Dale said. "But I think there will probably be resistance to that. That's why we don't have it now." He said his group added it to its proposal to "heighten the debate."
Not politically popular?...not if your an insurance company or pharmecuetical company, but otherwise--single payor is very politically popular. Great responses in here--unionguy and the nurse come to mind especially. I haven't read them all.
This should eventually build critical mass. The medical profession will benefit from more patients, businesses will benefit from paying less in health care costs, and mostly, people will have overall better access to health care. The only losers are the HMOs and specifically the fat cats that run them which are a minuscule minority.
They're a powerful lobby, but they're way too out numbered to keep this up indefinitely.
That small factor is one of the only reasons why we'll be the last to enter this social system.
Doesn't stand a chance! The medical corporations are more powerful and meaner than the Mafia not to mention they have 98% of the politicians in their back pockets!
The only way this could ever come about (universal, non-profit health care) is if we had an informed public. Somehow I don't think FOX, CNN or NBC is up to the challenge.
Doctors will now increasingly be viewed in the same light as ambulance chasing lawyers as the medical professions continue to bankrupt ordinary Americans.
Jaded Prole: Don't forget that the Green Party has consistently supported single-payer and whomever the Green presidential and congressional candidates are, they will undoubtedly do the same. That's just one more reason to look outside the corporatist party box for solutions and better ideas.
I am sorry, but I use the health care system in France and Switzerland and prefer both of them to anything the US has to offer.
Good news. On a related note, a highly placed hosptial offical in my area recently announced retirement lamenting that medicine has become an increasingly meanspiritied business. He said that while he had thought differnetly in the past, he now supported a single payer system.
The only candidate that has and will support such a system is Dennis Kucinich.
My doctor consistently has one complaint: the insurance companies she must deal with.
She says: Knowing what she knows now about the insurance industry if she had to choose a career all over again she would not become a doctor.
(And she's a great doctor.)
Single payer? If the U.S. Government is the single payer then, finally, we will get some teath in the EPA. Corporate poisoning of the American taxpayer will cost congress far more than they can ever recover from corporate bribes.
I'm all for it. The way it stands we pay twice as much as those other countries and still have almost 50 million people without health care. Many of us just have catastrophic that doesn't pay anything most of the time.
It has a lot to do with the extra layers of bureaucracy and lobbying efforts of drug companies and the insurance industry.
The food we eat destroys us and once ill the drugs are supposed to take over for the chemicals your body is designed to provide naturally.
Remember when he says "not politically popular" that means it's not popular with our ruling class. The people, on the other hand, would go for it- of course, if it were explained coherently and consistently.
I have the impression that with a true universal-single-payer-health-insurance that competition and profit among doctors and hospitals moves from the current milking of insurance dollars and denial of claims, to competetion based on service. How else would hospitals make money if everyone paid the same?
I smell socialism.
Next thing you know, we'll have socialized defense.
Democrats will never enact single-payer health care, even if they held every seat in Congress.
You want peace and single payer health care? Vote Green Party, www.GP.org
Most doctors don't want to waste their time playing Mother May I with insurance companies. They would rather spend their working hours healing patients.
saywhat, all I've been smelling is the stench of fascism for the last eight years. Thos that scream "socialism" over something as basic as single payer healthcare only show thier ignorance of terminology.
bildad -- I'm far from locked into the delusional box of corporate politics. Kucinich is at present the best candidate. We know the whole system is rigged and prescripted and that the "deciders" will not choose anyone as unowned as Kucinich as a final candidate. I am all for alternative candidates and will vote for one rather than a corporate candidate like Clinton or Obama.
By the way, anyone see this?
I am constantly amazed at US corporations on this. You would think that adoption of a single-payer system would be to their benefit! Immediate lower costs would enable them to compete more evenly with corporations from the other 29 of the top 30 industrialized nations with single-payer.
Everyone I now in countries with this do not mind the increased taxes because they know that they will have lifetime health care and retirement. Mainly because the governments cannot take away funds set aside for this - unlike all administrations, beginning with Nixon who have stolen funds from SS and Medicare to use for general fund purposes or have used for other purposes than intended.
If ever in Philly check out the Mutter Museum of medical oddities at the College.
Anyone else wondering what kind of salaries Doctors pull under single-payer and 'competing' systems?
(AMA members; like your current terms?)
saywhat: "I smell socialism"
I sure as hell hope so!!! Capitalism and it's destruction to this country can be seen everywhere you look. But BE SURE to look UP to the 1% up top!
There was an ad in the paper today to get health insurance through Blue Cross Blue Shield.
I called to get a quote. For my age (about 55) and because I have no been insured for the last year, and even though I have no pre-existing conditions or take any medications (which could be proven through a physical), they said I'd have to pay $400/mo. for a YEAR before any coverage would start!
There would be a $1500 deductible with no medications covered on a yearly basis.
Groups like the one mentioned in the article, and Hillary Clinton and states like Massachusetts can DEMAND that people get health insurance, but when someone like me is told to fork over $400/mo., forget it.
I'd rather die than give the rotten insurance company money every month I simply cannot afford. And shame on them for not being willing to cover me for a year!
A disgusting state of affairs.
There is no need trying to talk to anybody who can't see that health care for profit is immoral.
"I smell socialism"
God--I hope so!
Because of the overwhelming stink coming from the moral rot that is capitalism.
I smell socialism, and it smells sweet!! Let's stop paying for gold-plated faucets in the bathrooms of corporate jets! And, let's stop paying for people whose only task is to find ways to deny payments. Recall the woman who held that job,in the movie Sicko, crying uncontrollably at the harm she had done to so many before she quit her job.
Thanks for the link Jaded Prole, that was awesome!!
These issues like the War in Iraq, Immigration, and Health Insurance are all meaningless and pointless in debating. Both Party's Canidates, will keep us in Iraq for 20+ years, with a permanent base of 50-70K troops at least. Both parties will do nothing about Immigration. And both parties will continue to line the coffers of the Health Insurance Industry- even Hillary's and the State of Mass plans are just handing over taxpayer money to the insurance companies.
As far as expansive and unprecedented unconstitutional powers, (civil liberties, privacy, torture issues) don't expect the Dems to change any of that either because they want the same power to spy and harass, be secrative etc that the Republican administration has been using all this time. They all work for the same people, and it's not the American people they work for.
Which is why the best policy is to vote for the canidate who will give us the most laughs over the next 4 years. Im serious. Hillary just makes me cringe. But if we're going to be fucked over anyway by the politicians, we might as well be able to laugh about it. I'm not talking the canidate with the best sense of humor, i'm talking a President who is an utter and complete joke, and mockery of democracy, liberty, and leadership, much like the past two Presidents.
for instance, the phrase "Yesterday's statement was inoperative" had me laughing for days. Or Bill Clintons "Can you define the word 'Is'"
And I am being serious. More and more people need to realize that the current setup of the Government, elections, the media etc... all things politically connected are just a complete sham/propoganda, and laughable at best.
It makes me wonder how much the American people need to be fucked over and ripped off before waking up.
Republicans "We're going to screw you"
Democrats "We'll pretend to be on your side for elections, but we're going to screw you."
jaded, thanks for the link.
i had to stay one night in the hospital after moving to oregon from california...my health insurance through my job did not kick in until four days later... long story short... i've spent 8,000.00 for a one night stay...i'll be paying that off for at least three more years...if it's socialism that will stop this type of discrepency, than bring on the class-less society and utopian future of the working class!!!
also check out Drug Reps, another wrench in the current for profit system.
Whats with the arrogance of the far right conservatives? Why can't they even acknowledge that the corrupt for-profit system is broken, and doesn't work? Why can't they see that's it's not only undemocratic, it's uncapitalistic, and it's certainly not a FREE and FAIR market, and definately doesn't give you choice- unless you like choosing bankruptcy or death.
If you smell socialism, you are mistaken. Socialized medicine, like the Veterans Administration, makes doctors and other providers employees of the government. Single payer means the government is the insurance company with the largest possible risk pool, the entire population. The cost per person therefore drops dramatically, especially when the administrative costs and profits of private insurance are done away with. As it would if we were to socialize health care.
Think of it this way: We have socialized our police and fire protection services and support them fully with a progressive tax system that collects more from those who have more. All of us, from gated communities and ghettos and middle-class neighborhoods, hope we will not need either the police or fire fighters. If we should need either, however, these public employees get to work at once without asking for the name of our Crime Insurance Company or our Fire Insurance Company.
At the next debate each candidate should be asked to evaluate this endorsement: why they do or don't support it.
Oh, I forgot, that would be an actual question. Darn.
In full agreement with curmudgeon99. You'd think that the rest of corporate America would pool their clout to fight the healthcare industry and the oil companies so that they can become competetive and so that people would have some money left over to spend on their products.
Bernice,
Perfect, you hit the nails on the head:
socialized medicine (Vet Admin - drs. work for gov)
universal single payer (medicare - same doctors you now use)
socialized public services (fire/police)
Very well stated. Its to bad the MSM won't make these distinctions.
ed
As a Canadian who has lived under "socialized" medicine for almost all my life, I have nothing but good things to say about the system. Doctors in Canada are still the most highly paid professional people in the country. Yes, there is a present problem with wait times, but once in the system you are well taken care of.
This past summer I entered hospital for the first time in my life. I was experiencing chest pains and thought I was having heart problems. I was admitted immediately and spent a full week in the hospital undergoing lab analysis, numerous tests, including a probe into my heart to see if there were issues there. The care I received was excellent! The nurses were great and the doctors were too. At the end of the week I was discharged and told that I had a virus that had affected my heart but all was well. This cost me nothing, not a cent of my own money was spent on all of this.
I have nothing but good things to say about our system, about our nurses, technicians and doctors. I was treated immediately, effectively and respectfully. I shudder to think what all of this would have cost me had I lived in the US.
Fuck it. The Neo-cons and the far fight want to be ripped off, let them be ripped off. They deserve exactly what they get.
"Man wants to be decieved; Decieve him"
Anonymous
And the rest of us who continue to do nothing about it also deserve to be ripped off.
As I was saying about the CEO of Blueshield Bluecross, who took 20 million dollars of company money to build a golf course in his back yard... I don't see any reason why the members of that crooked Insurance company didn't immediately drive over to his mansion/manor with the guilitine ready to go.
This has a lie in it. Single provides full choice of providers. The individual should have known this was wrong. It is the best way to get the job done, and the choices being in play or having better or not having if these people would just be honest about. Also single payer is very politically popular, but big money is coming into play big time.
I'm 72 years old and see the erosion of Medicare as an insult to all Americans. Whatever happened to courage? With the exeption of Kucinich, no politician or organization is ready to take on the Insurance industry! It's a disgrace!
"The largest physician group in the United States, the American Medical Association, does not support single-payer. Earlier this year, it released a proposal to expand insurance coverage, primarily through tax incentives and changes in insurance regulations."
Note: ... "primarily" through tax incentives. As if any tax incentives proposed by Congress would enable all those without health insurance to pay the never-ending increases in premiums in this "deregulated" market. Does the AMA think we're dumb enough to believe Congress will regulate an industry with thousands of lobbyists handing out campaign checks in an effort to support the staus quo?
Hippocratic oath or hypocrisy oath? Lapdogs!!!
Anyone who believes that corporate America, e.g., insurance companies and pharmaceuticals, bouyed up by our puppet politicians, is going to provide health care for and of the people is hopelessly brainwashed. The only thing that is important to them is how many of your dollars they take before you die. We have become sheep on defense spending, so you good republocrats can back into the pole of private health care just as easily.
You get what you can pay for. God help your family if you cant afford the best care outside of your meager catastrophic coverage. If you want the current system as the model for health care, you are truly delusional and have bought the marketing machines story.
Stay well and stay solvent...
Mastershake F*ck a golf course what chutzpah! I'll bring the pitchforks if you bring the torches!
First, like many others, I'd like to thank those that so effectively took on the 'oh no, socialism' comment. The fear of 'socialism,' without any knowledge of what, in fact, socialism is, is exactly why our nation's health care system is in the horrible place it is today. Everytime even the most conservative reforms to this greedy for-profit system have been proposed, a ready made corporate smear campaign is kicked in, with red-baiting as it's main component. Remember, just a couple weeks ago, Republican candidates screamed "socialism" when Hilliary announced her health care reform package, (certainly a far cry from anything approaching 'socialism').
The point is that the huge insurance and pharmisuitical corporations understand that it is, from their point of view, really about dividing and intimidating folks to kill the movement toward health care for all. It was never really about 'socialism,' at least for them.
As well, from our point of view, it really isn't about the horse race, the candidate's personalities or even what they say their own "health care plan" is. In our rigged electoral system, only a Democrat or a Republican has any, any, any chance of becoming president. But even at that, it isn't the president that puts forward or even votes on health care, or any other legislative proposals. It is congress, and congress can be moved by mass movements.
I think that some miss the entire point when they talk of both parties as being the exact same thing. Yes, both are corporate parties, that is true. Yes, the elctoral system at this time is rigged for the wealthy. That also is true! However, to believe that "both are the same," one must have been living someplace other than the nation that I've been living in. This one was taken over by the ultra-right wing Republicans and anything positive that we have tried to do in the past decade has been dead on arrival.
I know damned well that the folks that said that 'both are the same' weren't steelworkers and didn't know any. For us (steelworkers) we saw Bush replace the head of the PBGC and outright steal the pensions that we'd worked our entire lives for. I saw 5 suicides at my local alone! Meanwhile, Sherrod Brown, Dennis Kucinich, Ted Strickland and numerous other progressive Democrats fought like hell for us. These D's were a tremendous help to our fight to win back our pensions.
That's just a short example of why the 'plague on both your houses' is a losing prospect. It isn't about the Dems or the R's. It is about using this electoral process to creat the POSSIBILITY FOR OUR PEOPLE'S MOVEMENT TO WIN VICTORIES!!
With Bush and the ultra-right Republicans controling congress, we have no possibility whatsoever of passing anything on health care. On the other hand, if we elect the Dems, then set back and wait for them to pass natl. health care, we'll likewise be in for a hell of a long wait. However, if we recognize the very real differences between those two parties, even if neither is our perfect choice, we can use the elctions to create more possibilities for our wide people's movement to win. That is how social security, public education, the right to unionize, civil rights laws and other socially positive legislation was brought about. Not by relying on the Democrats, but by relying on our people's movement to mobilize, push and fight for progressive change, and using the Democrats to pass it.
If we make the mistake of standing aside from the political process, and that would include voting Green or some other third party for president, we stand the very strong chance of not just missing out on the best opportunity to fight and win real single-payer health care for all that we've had in a few lifetimes, but also stand a damned good chance of losing those democratic rights and social gains that we still do have.
poeple are traveling in Europe and they see that single payer is ok and what does Bush himself have: he has the Bethesda Naval Hoospital were he gets all his care free just like all other Congressmen.
Jobs at the Canadian border are going lost because companies prefer to situate in Canada and get health insurance for their employees.
There is something CRACKING in the cement: Dana Rohrbacher, arch conservative Congressman gave a lengthy speech in the House that "War on Drugs" is stupid, brutal, counterproductive tec etc.
What we really need is health care in this country that doesn't put profit first. At the Rockridge Institute, we have a campaign to help Americans replace the denial-of-care-so-insurance-companies-can-increase-profits with health care based on compassion, human dignity, and wellness.
Help spread the word by checking it out and passing it along:
http://www.rockridgeinstitute.org/health
Better still, join us by signing up so you can stay informed as we explore how politicians think about education, the environment, the occupation of Iraq, and much more:
http://www.rockridgenation.org/join_form
When the government is financially responsible for all the bills of poisoning someone for life, maybe they'll wise up and not put out the poisons. Maybe that's why Europeans live longer than us.
Furthermore, wherever people themselves are effective at staying healthy, maybe the government will wise up and work with them.
Brush and floss!
The first step to getting a single-payer system is to get a single-party government. As long as Republicans have The White House, or the House, or less than 60 in the Senate, you do not get a bill.
Even with wall-to-wall Democrats, you still do not get a bill without a citizen demand. Democrats believe in subsidizing people and spreading risk. Republicans believe in subsidizing corporations and avoiding risk (aka avoiding coverage for YOUR claim.) But even those are the beliefs of the party members, not necessarily the beliefs of heavily lobbied elected officials.
Elect your Democrats. Then make your demand. There is no other order of events that's going to work (including Dennis, Ralph and the Greens, because they are not getting elected, not in '08, '12, '16, or likely ever.)
If you like your billions spent on TV messages to you from the likes of the AFLAC duck, get a competitive corporate model. That's what your "choices" will be, all vaporous marketing, little to no substance except you keep losing.
I am strongly for single-payer. I know the major DEM candidates do not speak of it, because they can't afford to have the whole med and insurance industries fighting them in a campaign. I also know single-payer is possible, AFTER THEY ARE IN OFFICE. Just do it. You have nothing whatever to lose on health care by electing your Democrats, but your savings are always in peril as long as you do not even have a chance for change because you kept some Republicans in power positions to block any meaningful change.
Thanks, Daniel David!! It's great to hear the voice of realtiy again!
I could not agree with you more. It isn't about the Dems. It's really about OUR using THEM, using OUR PEOPLE'S MOVEMENT, to win this damned thing.
I certainly hope that you are involved in the movement in your home area. You have solid insight!