American College of Emergency Physicians: It's Time for Single-Payer

[eridani]

http://www.acepnews.com/index.php?id=2049&type=98&tx_ttnews[tt_news]=1564&cHash=da03e20e36

Winston Churchill’s iconic remark, reportedly issued at the dawn of America’s entry into World War II, is equally applicable to the present American health care debate and the crisis that spawned it. Regardless of whether you are elated or disappointed with June’s historic Supreme Court decision upholding the constitutionality of the Affordable Care Act, it is certainly no panacea for the problems facing U.S. health care. Even with the law intact, and despite its best intentions, it will still leave some 25 million uninsured, underinsure millions more, expand the corporatization of health care, and do little to control the escalating costs of care over the long term. So it’s clear we need to do the right thing: the creation of a national, universal, publicly funded health care system, free of the corrupting power of profit-oriented health insurance, and at the same time capable of passing constitutional muster. In short, the right thing is an expanded and improved Medicare-for-All program, otherwise known as single-payer.

Don’t be so shocked. For the last 30 years, we have tried all the alternatives, and none of them have worked. We have experimented with HMOs, PPOs, high-deductible health plans, health savings accounts, pay-for-performance, capitation, and disease management. These ideas have been promoted in various iterations, often with great fanfare, by public and private payers alike, yet none of them have shown long-term success at bending the cost curve. And the promise of the latest reforms du jour, such as Accountable Care Organizations and Patient-Centered Medical Homes, is speculative at best. American health care is unique among the world’s democracies in that it was never planned in terms of enabling legislation or explicit constitutional authority. As others have stated, our employer-based insurance system, which now covers about 160 million Americans, was an accident of history. Its lineage can be traced to FDR’s wage and price control policies during World War II, where employers were permitted to offer workers health insurance in lieu of higher wages as a job inducement. This benefit has evolved piecemeal into the Rube Goldberg complexity that is contemporary employer-sponsored health insurance, with some 1,200 private plans each doing the same things – medical underwriting, coordination of benefits, claims adjudication and denial, marketing, public relations, lobbying, litigating, and paying shareholder dividends and inflated CEO salaries while forcing individuals to pay a higher share of premiums, increased deductibles, expanded copays, or a combination of all three. Taken as a whole, private insurers’ activities are duplicative, inefficient, wasteful of scarce health care resources, conducive of job lock, and completely misdirected in supporting the 21st-century health care agenda that America needs and deserves.

[jenw2]

1. Exactly, if people are not allowed to pay for their own healthcare...

it will finally become fair here like it has in several other countries.

[DemoTex]

2. Absolutely!

It MUST happen.

[marions ghost]

3. 'Medicare for all" or Single Payer

has a profound and powerful effect on quality of life.

I've lived in a country that has it. Just a whole different attitude towards investing in the health of a population. Lower stress. Greater ability to fight disease. Reduction of too many problems to list here.

[mikki35]

4. AMEN!

ER docs are, more than any other docs I know, pragmatic to the nth degree. They are on the front lines, so to speak, every day they work. They are forced, by circumstance and brutish reality, to make the decisions, to tell the unvarnished truth, to lay it out in whole, not piecemeal. They do not suffer fools gladly, and they have just about zero tolerance for political BS. Actually FINDING one that is capable and/or willing to take on the thankless task of being a director is a herculean task, just by itself. So, this attitude and conclusion does not surprise me one iota. Unfortunately, there are many, many other types of docs that will fight such a change to the death.

[limpyhobbler]

5. good...

I couldn't get that link to work because it had some special characters in it but this one worked for me at least:

http://www.acepnews.com/index.php?id=495&cHash=071010&tx_ttnews%5Btt_news%5D=1564

[Viva_La_Revolution]

6. link didn't work for me

found it here http://pnhp.org/blog/

[eridani]

7. Sorry--I linked to print format. It's also on the ACEP website n/t