Key Features of Single-Payer
Universal, Comprehensive Coverage
Only such coverage ensures access, avoids a two-class system, and minimizes expense
No out-of-pocket payments
Co-payments and deductibles are barriers to access, administratively unwieldy, and unnecessary for cost containment
A single insurance plan in each region, administered by a public or quasi-public agency
A fragmentary payment system that entrusts private firms with administration ensures the waste of billions of dollars on useless paper pushing and profits. Private insurance duplicating public coverage fosters two-class care and drives up costs; such duplication should be prohibited
Global operating budgets for hospitals, nursing homes, allowed group and staff model HMOs and other providers with separate allocation of capital funds
Billing on a per-patient basis creates unnecessary administrative complexity and expense. A budget separate from operating expenses will be allowed for capital improvements
Free Choice of Providers
Patients should be free to seek care from any licensed health care provider, without financial incentives or penalties
Public Accountability, Not Corporate Dictates
The public has an absolute right to democratically set overall health policies and priorities, but medical decisions must be made by patients and providers rather than dictated from afar. Market mechanisms principally empower employers and insurance bureaucrats pursuing narrow financial interests
Ban on For-Profit Health Care Providers
Profit seeking inevitably distorts care and diverts resources from patients to investors
Protection of the rights of health care and insurance workers
A single-payer national health program would eliminate the jobs of hundreds of thousands of people who currently perform billing, advertising, eligibility determination, and other superfluous tasks. These workers must be guaranteed retraining and placement in meaningful jobs.
from the American Journal of Public Health January 2003, Vol 93, No.1
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Yesterday the prestigious American College of Physicians (ACP), the nation's second largest medical association (124,000 members), endorsed single payer national health insurance as "one pathway" to universal coverage. This is the first time the group has endorsed single payer and represents a huge step forward in the movement for fundamental health care reform.
The ACP's decision followed a careful evaluation of lessons from other nations' health systems. The central lesson, they said in an article in the Annals of Internal Medicine, is the need for the United States to provide universal health insurance coverage. While the ACP's own proposal is based on a "pluralistic" model, they urged lawmakers to seriously consider a single payer system as one way to provide universal access to health care. They noted that single payer systems have the advantage of being "more equitable, have lower administrative costs, have lower per capita health care expenditures, have higher levels of patient satisfaction, and have higher performance on measures of quality and access than systems using private health insurance."
In our estimation, this development changes the terms of engagement within the medical profession and in the larger public debate. The steady "legitimation" of our single payer national health insurance alternative takes a giant step forward with this declaration from the ACP. It is incumbent on PNHP to make this heartening development part of the public discourse as soon and as loudly as possible!
PNHP'ers in internal medicine are advised to call their state's ACP governor to express their approval, and send letters of congratulations of ACP's endorsement to the President and Executive Director,
Dr. David Dale, President
Dr. John Tooker, Executive Vice President and CEO
American College of Physicians
2011 Pennsylvania Avenue, NW Suite 800
Washington, DC 20006
The essence is Medicare-For-All is that it would save huge amounts of money: on private insurer advertising, commissions, profits, unconscionable executive pay as well as tremendous savings by physicians, hospitals, clinics and labs on their non-benefit costs for processing billions of billings from thousands of insurers under many more thousands of plans."
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