Proposal of the Physicians' Working Group for Single-Payer National Health

[Cleita]

This is the medical plan or extension and improvement on Medicare that should be extended to all Americans. It will take a strong grass roots movement to accomplish this as the for profit health care industry fights this proposal with the ferocity of a jihad. Their operatives are everywhere spreading disinformation anytime something like this has a chance of being debated in Congress.

I recommend that considering the illigitmate government in Washington these days that we try to do this more locally at a state or even county level. Once the movement spreads then there is a good chance that the federal government is going to have to take the reins as they have the money and the bureacracy to do this.

http://www.physiciansproposal.org/

Introduction

U.S. health care is rich in resources. Hospitals and sophisticated equipment abound; even many rural areas boast well-equipped facilities. Most physicians and nurses are superbly trained; dedication to patients the norm. Our research output is prodigious. And we fund health care far more generously than any other nation.

Yet despite medical abundance, care is too often meager because of the irrationality of the present health care system. Over 39 million Americans have no health insurance whatsoever, including 33% of Hispanics, 21% of African-Americans and Asians, and 11% of non-Hispanic Whites. Many more - perhaps most of us - are underinsured. The world's richest health care system is unable to assure such basics as prenatal care and immunizations, and we trail most of the developed world on such indicators as infant mortality and life expectancy. Even the well-insured may find care compromised when HMOs deny them expensive medications and therapies. For patients, fear of financial ruin often amplifies the misfortune of illness.

For physicians, the gratifications of healing give way to anger and alienation in a system that treats sick people as commodities and doctors as investors' tools. In private practice we waste countless hours on billing and bureaucracy. For the uninsured, we avoid procedures, consultations, and costly medications. In HMOs we walk a tightrope between thrift and penuriousness, under the surveillance of bureaucrats who prod us to abdicate allegiance to patients, and to avoid the sickest, who may be unprofitable. In academia, we watch as the scholarly traditions of openness and collaboration give way to secrecy and assertions of private ownership of vital ideas; the search for knowledge displaced by a search for intellectual property.

For seven decades, opponents have blocked proposals for national health insurance, touting private sector solutions. Their reforms over the past quarter century have emphasized market mechanisms, endorsed the central role of private insurers, and nourished investor-ownership of care. But vows of greater efficiency, cost control, and consumer responsiveness are unfulfilled; meanwhile the ranks of the uninsured have swelled. HMOs, launched as health care's bright hope, have raised Medicare costs by billions, and fallen to the basement of public esteem. Investor-owned hospital chains, born of the promise of efficiency, have been wracked by scandal; their costs high, their quality low. And drug firms, which have secured the highest profits and lowest taxes of any industry, price drugs out of reach of those who need them most.

Many in today's political climate propose pushing on with the marketization of health care. They would shift more public money to private insurers; funnel Medicare through private managed care; and further fray the threadbare safety net of Medicaid, public hospitals and community clinics. These steps would fortify investors' control of care, squander additional billions on useless paperwork, and raise barriers to care still higher.

It is time to change fundamentally the trajectory of America's health care - to develop a comprehensive National Health Insurance (NHI) program for the United States.

Four principles shape our vision of reform.

1. Access to comprehensive health care is a human right. It is the responsibility of society, through its government, to assure this right. Coverage should not be tied to employment. Private insurance firms' past record disqualifies them from a central role in managing health care.

2. The right to choose and change one's physician is fundamental to patient autonomy. Patients should be free to seek care from any licensed health care professional.

3. Pursuit of corporate profit and personal fortune have no place in caregiving and they create enormous waste. The U.S. already spends enough to provide comprehensive health care to all Americans with no increase in total costs. However, the vast health care resources now squandered on bureaucracy (mostly due to efforts to divert costs to other payers or onto patients themselves), profits, marketing, and useless or even harmful medical interventions must be shifted to needed care.

4. In a democracy, the public should set overall health policies. Personal medical decisions must be made by patients with their caregivers, not by corporate or government bureaucrats.

We envision a national health insurance program (NHI) that builds upon the strengths of the current Medicare system. Coverage would be extended to all age groups, and expanded to include prescription medications and long term care. Payment mechanisms would be structured to improve efficiency and assure prompt reimbursement, while reducing bureaucracy and cost shifting. Health planning would be enhanced to improve the availability of resources and minimize wasteful duplication. Finally, investor-owned facilities would be phased out. In each section we present a key feature of the proposal followed by the rationale for our approach. More…

Here is the link to the original article in the JAMA that has the references listed.

http://www.physiciansproposal.org/proposal/Physicians%20ProposalJAMA.pdf

I know there often isn't much interest in health care issues here at DU, so I would appreciate help in keeping this kicked. It is an issue that affects each and every one of us.