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