Doctors have historically been the watchdogs of the U.S. medical system, with the American Medical Association scaring New Dealers into dropping national health coverage from the Social Security Act and then the AMA shredding Harry Truman's reform efforts in the late 1940s. But a new poll and other significant indicators suggest that doctors are turning against the health-insurance firms that increasingly dominate American health care.
The latest sign is a poll published recently in the Annals of Health Research showing that 59 percent of U.S. doctors support a "single payer" plan that essentially eliminates the central role of private insurers. Most industrial societies -- including nations as diverse as Taiwan, France, and Canada -- have adopted universal health systems that provide health care to all citizens and permit them free choice of their doctors and hospitals. These plans are typically funded by a mix of general tax revenues and payroll taxes, and essential health-care is administered by nonprofit government agencies rather than private insurers.
The new poll, conducted by Indiana University's Center for Health Policy and Professionalism Research, shows a sharp 10 percent spike in the number of doctors supporting national insurance: 59 percent in 2007 compared to 49 percent five years earlier. This indicates that more physicians are eager for systematic changes, said Toledo physician Dr. Johnathon Ross, past president of Physicians for a National Health Program.
"What this means is the usual bloc of anti-reform is breaking up," he told The Toledo Blade. "These doctors are looking in the eyes of sick [uninsured] patients every day."
The poll results underscore mounting signs that doctors are resenting the increasingly short leash on which they are held by insurers and large hospital chains, the current masters of American medicine. And, increasingly, doctors seem to be showing support for a single-payer system that would essentially eliminate for-profit insurers and curb the power of big provider chains.
The ever-accelerating corporatization of health care is producing a seismic shift in the way that doctors look at universal health care. Doctors are experiencing an extreme and relatively sudden loss of control at the hands of insurers and hospital networks, while being snowed under by paperwork and bureaucratic battles with insurance companies over authorizations and payments…
The statistics indeed suggest a major breakdown: Premiums have climbed 87 percent since 2000, and workers' meager pay raises have been far outstripped by major increases in their share of the premiums. While the U.S. ranks 37th on a variety of quality measurements used by the World Health Organization, per-capita spending in the U.S. is twice as high as any other nation. For example, the U.S. spent $6,697 per person in 2005 compared with $3,326 in Canada. Meanwhile, the sharply escalating costs in the U.S. are leading to shrinkage of insurance coverage provided by employers. Some 47 million Americans are uninsured, with the present economic downturn certain to significantly increase those numbers…
State-level polls reinforce the just-released national survey from Indiana's Center for Health Policy. A remarkable 64 percent of the Minnesota doctors surveyed in 2006 expressed support for a Canadian-style single-payer system that would drive insurers from their commanding role in the health system, reported Minnesota Medicine. The Minnesota poll aligned closely with a Massachusetts survey of doctors in 2004, which reflected 61 percent backing for single-payer, according to the Archives of Internal Medicine. Doctors' views seem to be coming into closer alignment with those of the general public, of which 67 percent explicitly support a system like Canada's or Britain's…
Meanwhile, members of the American College of Physicians -- the nation's second-largest doctors' organization with 124,000 internal-medicine physicians and related specialists -- voted in December 2007 to endorse the single-payer idea. The vote followed an analysis of health care in the United States and 12 other industrialized countries, after which the ACP concluded that universal coverage had been successfully attained elsewhere through single-payer or mixed public/private systems...
Roger Bybee is a Milwaukee-based writer and progressive activist, who formerly edited the official labor weekly Racine Labor. He has written for a number of state and national publications and websites on issues such as health care reform and corporate globalization.
http://www.prospect.org/cs/articles?article=the_doctors_revolt
Tuesday, July 8, 2008
COMPRENSIVE HEALTH COVERAGE
John F. Wasik July 2, 2008
Healthcare will become one of the most onerous personal-finance issues in coming years unless the system is changed to ensure universal access, cost control, and long-term financing.
US families now pay more than $12,000 a year for health coverage, according to the Kaiser Family Foundation. Yet why doesn't any presidential candidate fully endorse a comprehensive national plan?
What would make healthcare available to more than 47 million who don't have coverage and the majority of American families whose premiums have risen 78 percent since 2001? Massive buying power through consolidation of separate programs and a public-private partnership.
To understand what a pervasive problem medical spending is, you need to digest some numbers. Health expenditures consume about 16 percent of US gross domestic product. Translated to an individual family, medical insurance claims 20 percent of median income. That's compared with 8 percent in 1987, according to the nonpartisan New America Foundation. Life expectancy is directly connected to medical coverage. Uninsured and underinsured (an additional 25 million) Americans visit doctors less frequently, pay more for care, and have the highest rate of preventable deaths before age 75, according to the Institute of Medicine.
Employers who do offer coverage are less competitive in a global marketplace. Workers who don't have policies end up in emergency rooms demanding costly care that taxpayers will ultimately finance.
Unless the growing bite of health costs is addressed, related spending will double by 2017 from 2007 levels, consuming one out of every five dollars produced in the United States, according to the Center for Medicaid and Medicare Services.
How do you save the best of US healthcare while providing it to everyone at a reasonable cost? Creating one new, entirely government-run public program may be untenable and politically unacceptable. The road to a solution can merge both private and public interests. What would such a hybrid look like? It would:
1) Outsource cost controlling. That means hiring audit firms to see where costs can be cut. The government could act like a huge accounts-payable department; a private firm would police billing and implement best practices.
2) Negotiate the best price. Maybe Wal-Mart's purchasing practices could be the model.
3) End fees for service. Medical expenses should be based on performance and outcomes, not on number of procedures.
4) Make technology a big part of the system. A major overhaul focusing on efficient technology use is in order.
The healthcare picture of the future isn't cloudy. There will be devastating financial consequences if we don't hunker down and prepare for a much more severe fiscal storm.
John F. Wasik is a Bloomberg News columnist. He can be reached at jwasik@bloomberg.net. Copyright 2008 Globe Newspaper Company.
http://www.boston.com/business/healthcare/articles/2008/07/02/healthcare_costs _must_be_brought_under_control_or_the_economy_will_surely_suffer/
Healthcare will become one of the most onerous personal-finance issues in coming years unless the system is changed to ensure universal access, cost control, and long-term financing.
US families now pay more than $12,000 a year for health coverage, according to the Kaiser Family Foundation. Yet why doesn't any presidential candidate fully endorse a comprehensive national plan?
What would make healthcare available to more than 47 million who don't have coverage and the majority of American families whose premiums have risen 78 percent since 2001? Massive buying power through consolidation of separate programs and a public-private partnership.
To understand what a pervasive problem medical spending is, you need to digest some numbers. Health expenditures consume about 16 percent of US gross domestic product. Translated to an individual family, medical insurance claims 20 percent of median income. That's compared with 8 percent in 1987, according to the nonpartisan New America Foundation. Life expectancy is directly connected to medical coverage. Uninsured and underinsured (an additional 25 million) Americans visit doctors less frequently, pay more for care, and have the highest rate of preventable deaths before age 75, according to the Institute of Medicine.
Employers who do offer coverage are less competitive in a global marketplace. Workers who don't have policies end up in emergency rooms demanding costly care that taxpayers will ultimately finance.
Unless the growing bite of health costs is addressed, related spending will double by 2017 from 2007 levels, consuming one out of every five dollars produced in the United States, according to the Center for Medicaid and Medicare Services.
How do you save the best of US healthcare while providing it to everyone at a reasonable cost? Creating one new, entirely government-run public program may be untenable and politically unacceptable. The road to a solution can merge both private and public interests. What would such a hybrid look like? It would:
1) Outsource cost controlling. That means hiring audit firms to see where costs can be cut. The government could act like a huge accounts-payable department; a private firm would police billing and implement best practices.
2) Negotiate the best price. Maybe Wal-Mart's purchasing practices could be the model.
3) End fees for service. Medical expenses should be based on performance and outcomes, not on number of procedures.
4) Make technology a big part of the system. A major overhaul focusing on efficient technology use is in order.
The healthcare picture of the future isn't cloudy. There will be devastating financial consequences if we don't hunker down and prepare for a much more severe fiscal storm.
John F. Wasik is a Bloomberg News columnist. He can be reached at jwasik@bloomberg.net. Copyright 2008 Globe Newspaper Company.
http://www.boston.com/business/healthcare/articles/2008/07/02/healthcare_costs _must_be_brought_under_control_or_the_economy_will_surely_suffer/
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