Over 5,000 U.S. physicians have signed an open letter calling on the candidates for president and Congress "to stand up for the health of the American people and implement a nonprofit, single-payer national health insurance system."

Staff Writers

WASHINGTON - Noting that the nation's private-insurance-based model is failing by denying needed medical care to millions, wasting resources and driving up costs, the doctors say that a publicly financed system is "the sole hope for affordable, comprehensive coverage."

"A single-payer health system could realize administrative savings of more than $300 billion annually -- enough to cover the uninsured and to eliminate co-payments and deductibles for all Americans," they write, adding that it would also slow cost increases.

Dr. Oliver Fein, a professor of clinical medicine and public health at Weill Cornell Medical College in New York and a signer of the letter, said today, "With the sudden economic downturn, more people than ever before are worried about how to pay for health care. A single-payer system -- an improved Medicare for all -- would lift those worries, provide care to all who need it and require no new money. It's the only morally and fiscally responsible approach to take."

In their letter, the physicians express disappointment that most U.S. political leaders still cling to the private health insurance industry model of financing care and "seem intent on reprising failed schemes from the past" like mandates or tax incentives.

"The incremental changes suggested by most Democrats cannot solve our problems; further pursuit of market-based strategies, as advocated by Republicans, will exacerbate them," they say. "What needs to be changed is the system itself."

The letter is being circulated by Physicians for a National Health Program [1], a single-payer advocacy group. Fein is the group's president-elect. Excerpts from the appeal are being published in full-page advertisements in the Oct. 13 editions of The New Yorker and The Nation magazines, which arrive on newsstands this week.

Signers of the letter include some of the most prominent figures in U.S. medicine, including leaders of professional societies in internal medicine, pediatrics, family medicine, psychiatry and public health. Among them are Marcia Angell, M.D., senior lecturer at Harvard Medical School and past editor-in-chief of the New England Journal of Medicine, and Bernard Lown, M.D., professor of cardiology emeritus at Harvard and Nobel laureate.

Dr. Steffie Woolhandler, an associate professor of medicine at Harvard Medical School and a co-author of the letter, said, "Physicians have a responsibility to get to the root of a patient's medical complaint, to make a diagnosis based on evidence. Only then can we confidently prescribe a cure, rather than offer a consoling placebo.

"Given the repeated failure of incremental reforms like the one under way in Massachusetts, which is already facing cost overruns and leaving many residents uncovered, and given the increasingly obvious failure of unfettered markets, it's clear that neither of these traditional prescriptions for reform will work," she said. "What's needed instead is the only treatment that has proven its effectiveness -- a single-payer plan." (Woolhandler co-wrote a piece published late last year in the New York Times that scrutinized "mandate" proposals like those currently backed by Obama: LINK [2].)

The letter's release follows a survey in the Annals of Internal Medicine this spring that shows 59 percent of U.S. physicians support national health insurance, a jump of 10 percentage points from five years ago

Single-payer plans typically involve a single, publicly administered social insurance fund that guarantees health care coverage for everyone, much like Medicare presently does for seniors. Patients go the doctors and hospitals of their choice; health care providers largely remain private. Private health insurers are eliminated or their role is substantially reduced.

A bill in Congress, the U.S. National Health Insurance Act, H.R. 676 [3], embodies the single-payer model. Sponsored by Rep. John Conyers Jr. (D-Mich.), it currently has over 90 co-sponsors, more than any other health reform proposal.

Related Link
The full text and initiating signers "Open Letter to the Candidates on Single Payer Health Reform" - www.pnhp.org/letter [4].
Complete list of signers - www.pnhp.org/letter/signers [5].
PDF of the full-page, four-color ad - www.pnhp.org/ad [6]