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Doctors prescribe single-payer national health plan

More than 2,200 physicians are calling for a break from the private insurance model of financing medical care and the creation of a publicly financed, single-payer national system.

“Despite the passage of the Affordable Care Act six years ago, 30 million Americans remain uninsured, an even greater number are underinsured, financial barriers to care like co-pays and deductibles are rising, bureaucracy is growing, provider networks are narrowing and medical costs are continuing to climb,” said Dr. Adam Gaffney, a Boston-based pulmonary disease and critical care specialist.

Gaffney co-chaired a working group of more than 2,000 physicians. The group endorsed a single-payer plan — sometimes called Medicare for All or universal care — in a proposal in the American Journal of Public Health.

Doctors in the District of Columbia and 48 states, including Wisconsin, signed on to the proposal, which calls for a national health program providing for:

• Patients to choose to go to any doctor or hospital and for most hospitals and clinics to remain privately owned and operated. Physicians would continue to practice on a fee-for-service basis or receive salaries from group practices, hospitals or clinics.

• Financing of the national health program would be from current sources of government health spending put into a single fund, with new taxes that would be offset by reductions in premiums and out-of-pocket spending. Co-pays would be eliminated, as would deductibles.

• A single-payer system that would save about $500 billion annually by eliminating the overhead of insurance firms and the paperwork they inflict on hospitals and doctors.

• An administrative savings from a streamlined system that would offset the costs of covering the uninsured and upgraded coverage for others, including full coverage of prescription drugs, dental care and long-term care. Savings would be redirected to underfunded health priorities, particularly public health.

“Caring relationships are increasingly taking a back seat to the financial prerogatives of insurance firms, corporate providers and Big Pharma,” said Gaffney. “Our patients are suffering and our profession is being degraded and disfigured by these mercenary interests.”

The physicians’ working group cited a 2008 survey showing 59 percent of Americans supported legislation to establish a national health plan, an increase of 10 percentage points from 2003.

More recently, surveys of Democrats show even higher support for a single-payer plan or an expansion of the Affordable Care Act.

Creating a national health program is a prominent and popular plank in presidential candidate Bernie Sanders’ platform, but the physicians’ group emphasized non-partisanship.

“Our nation is at a crossroads,” Gaffney said.

Dr. Steffie Woolhandler, a co-author of the proposal and a professor of public health at City University at New York’s Hunter College, said, “We can continue down this harmful path — or even worse take an alternative free-market route that would compound our problems — or we can embrace the long-overdue remedy that we know will work: the creation of a publicly financed, nonprofit, single-payer system that covers everybody.”

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