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

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

Health Insurance

The Physicians' Working Group for Single-Payer National Health

Insurance*

JAMA. 2003;290:798-805.

The United States spends more than twice as much on health care as the

average of other developed nations, all of which boast universal

coverage. Yet more than 41 million Americans have no health insurance.

Many more are underinsured. Confronted by the rising costs and

capabilities of modern medicine, other nations have chosen national

health insurance (NHI). The United States alone treats health care as a

commodity distributed according to the ability to pay, rather than as a

social service to be distributed according to medical need. In this

market-driven system, insurers and providers compete not so much by

increasing quality or lowering costs, but by avoiding unprofitable

patients and shifting costs back to patients or to other payers. This

creates the paradox of a health care system based on avoiding the sick.

It generates huge administrative costs that, along with profits, divert

resources from clinical care to the demands of business. In addition,

burgeoning satellite businesses, such as consulting firms and marketing

companies, consume an increasing fraction of the health care dollar. We

endorse a fundamental change in US health care-the creation of an NHI

program. Such a program, which in essence would be an expanded and

improved version of traditional Medicare, would cover every American for

all necessary medical care. An NHI program would save at least $200

billion annually (more than enough to cover all of the uninsured) by

eliminating the high overhead and profits of the private, investor-owned

insurance industry and reducing spending for marketing and other

satellite services. Physicians and hospitals would be freed from the

concomitant burdens and expenses of paperwork created by having to deal

with multiple insurers with different rules, often designed to avoid

payment. National health insurance would make it possible to set and

enforce overall spending limits for the health care system, slowing cost

growth over the long run. An NHI program is the only affordable option

for universal, comprehensive coverage.

*Authors: The writing committee for the Physicians' Working Group for

Single-Payer National Health Insurance included Steffie Woolhandler, MD,

MPH (Department of Medicine, Cambridge Hospital/Harvard Medical School,

Cambridge, Mass), U. Himmelstein, MD (Department of Medicine,

Cambridge Hospital/Harvard Medical School, Cambridge, Mass), Marcia

Angell, MD (Department of Social Medicine, Harvard Medical School,

Boston, Mass), and Quentin D. Young, MD (Physicians for a National

Health Program, Chicago, Ill).

http://jama.ama-assn.org/cgi/content/abstract/290/6/798

I'll tell you where to go!

Mayo Clinic in Rochester

http://www.mayoclinic.org/rochester

s Hopkins Medicine

http://www.hopkinsmedicine.org