At least one Healthcare Provider Org is seeing the light!

Universal access to healthcare in this country has been hampered partly because provider organizations have been against if for many years.  Now at least one Provider Org,
The American College of Physicians, is now singing a different tune for some reason.  If universal access to care is going to ever come about, gettting the buy in of providers for system reforms is important.

Universal healthcare in this country has gone down to defeat over the last 50 years with the help and blessing of the AMA.

The AMA and the Defeat of Government Insurance before 1960

By the 1960s, the system of private health insurance in the United States was well established. In 1958, nearly 75 percent of Americans had some form of private health insurance coverage. By helping to implement a successful system of voluntary health insurance plans, the medical profession had staved off the government intervention and nationalized insurance that it had feared since the 1910s. In addition to ensuring that private citizens had access to voluntary coverage, the AMA also was a vocal opponent of any nationalized health insurance programs, suggesting that such proposals were socialistic and would interfere with physician income and the doctor-patient relationship. The AMA had played a significant role in defeating proposals for nationalized health insurance in 1935 (under the Social Security Act) and later in defeating the proposed Murray-Wagner-Dingell (MWD) bill in 1949. The MWD bill would have provided comprehensive nationalized health insurance to all Americans. To ensure the defeat of the proposal, the AMA charged every physician who was a member $25 for their lobbying efforts (Marmor 2000).

But now:

Washington -- The American College of Physicians has endorsed the concept of a single-payer health care system for the first time.

In a new position paper, the organization, which represents 124,000 physicians in internal medicine and related subspecialties, identified a system in which the federal government is the sole third-party payer as one of two reform vehicles to achieve universal coverage. The other is a public-private system that includes a legal guarantee that everyone has access to coverage and that offers health care subsidies to low-income residents.

So we have a bit of competition between two provider groups.  Hopefully The American College of Physicians will take the lead from now on.  Other recommendations concerning reform made by the group are:

ACP reform plan
In a recent position paper, the American College of Physicians endorsed eight health reform recommendations, including two methods of achieving universal health care -- a single-payer system or a pluralistic system. Other recommendations include:

Providing basic health care benefits that aren't dependent on residence or employment status. The benefits should not have unreasonable financial barriers and should include preventive care; primary care, including chronic disease management; and protection from catastrophic expenses.
Controlling health care costs by offering patients better health information and incentives -- but not punishments -- to adopt healthy lifestyles.
Focusing federal work-force policy on ensuring an adequate supply of primary care doctors.
Redirecting federal health care policy to support the patient-centered medical home concept.
Creating a hybrid payment system that still covers services provided but also pays for care coordination and rewards physicians who meet evidence-based care standards.
Reducing administrative burdens by creating uniform billing and credentialing systems for all payers.
Supporting with federal funds an interoperable health information technology infrastructure.

I hope these new positions are not some sort of front or scam for short-term advantage, but are a sign of a real epiphany for this group and organized medicine in general about the mission of the American health care system and how to meet that mission.  Come 2009 as the new leaders of this country come to grips with this healthcare problem, I do hope this group continues its enlightened stance, and maybe it can supplant the AMA as the provider lead org for the betterment of this country!

•  Just saw this announcement . . .

  ten minutes ago. A little good news in a sea of despair.

  by nyceve on Tue Dec 18, 2007 at 05:56:33 PM PDT

•  I see many physician colleagues

  in favor of universal health care and even single payor insurance, so I am not surprised by this.  I think things have gotten bad enough that many feel there is no other option.  At this point, it is mainly the insurance companies that benefit from our current system--it is miserable for physicians, who have to beg for services their patients need, and patients alike.  

  by EJP in Maine on Tue Dec 18, 2007 at 05:57:25 PM PDT

•  The doctors woke up to a simple fact:

  If no one can afford to pay them, they are out of a job.  Self-interest, pure and simple.  Don't ascribe to them any generous impulse.

  I have been saying this for a long time:  When the doctors can't keep their big incomes, they will start requesting single payer healthcare. The Republicans will have a constituency that wants it, and then we can all be bipartisan and get single payer.  But the right people--the rich people--have to be suffering first.

  As usual, the elite don't really care about us unwashed masses.  Only when it impacts their bottom line.

  by Dar Nirron on Tue Dec 18, 2007 at 06:08:32 PM PDT

  •  I love being reduced to a stereotype.

    You generalize a bit much.

    Please check out the Physicians for a National Health Plan web site. http://www.pnhp.org/

    by madaprn on Tue Dec 18, 2007 at 06:12:58 PM PDT

    •  I don't know about that

      You generalize a bit much.

      The fact that providers are now choosing the lesser of two evils (from their historical point of view)  does not excuse their obstruction of universal coverage for the last 60+ years.  Now that providers are getting squeezed by the aberrant system they help create, they are indeed changing their tune just like the poster said!

      by truthbetold on Tue Dec 18, 2007 at 06:23:16 PM PDT

      •  again

        The AMA has been the major physican-based obstacle to radical change of health care delivery in the US. The membership of the AMA constitutes only about 8% of all physicians in the US, with heavy representation of specialists, not primary care. The AMA, thus, hardly speaks for most physicians in this country and does not speak at all for nonphysician health care providers, public health experts or consumers.

        Plenty, I repeat, plenty of health care providers in the US have been in favor of universal coverage for decades.

        by madaprn on Wed Dec 19, 2007 at 06:42:09 AM PDT

    •  madaprn, I may owe YOU an apology, but

      I am in a very angry place regarding doctors right now.

      My family pays twice as much each month for insurance with a high deductible than we pay for our mortgage.  And our family income has decreased by 20-25% at the same time that insurance costs are rising.

      My husband had his foot operated on and it cost thousands of dollars.  Then he got an infection which the doctor treated with PAINKILLERS.  Finally, my husband lanced the incision himself and got approximately one tablespoon of pus from the wound, packed it with OTC antibiotic ointment, and it eventually got better.

      There's more, but this doctor lives in a million dollar home while my family can't afford to fix the cracks in the foundation of ours.

      by Dar Nirron on Wed Dec 19, 2007 at 08:23:09 AM PDT

      •  sounds like your husband received shitty followup

        Really shitty follow up. I assure you that not every health care provider lives in a mansion nor is focused solely on the bottom line.

        by madaprn on Thu Dec 20, 2007 at 07:35:20 PM PDT

  •  a lot of doctors support single payer

    Going into medicine is a huge commitment, and most people go into it because they have a genuine desire to... well... practice medicine. My GP spends about 30% of his time and office resources dealing with insurance companies, paperwork, and permissions. The combination of enormous regulatory burdens, bureaucrats restricting doctors from preferred treatments, and more and more patients being driven out of health insurance has a lot of doctors disgusted.

    Ironically, the move to for-profit health insurance companies may be the thing that's ultimately responsible for creating socialized medicine in this country.

    At least, I hope so. I want to believe that 20 years of increasingly poor health insurance options at the very moment we were going through an amazing revolution in medical technology will at least yield something positive.

    by Swordsmith on Tue Dec 18, 2007 at 08:11:25 PM PDT

•  The American College of Physicians

  has a history of supporting national health insurance so I believe this is legitimate and sincere.  
  Physicians used to be the main barrier to any sort of health care reform (as per your description of the AMA).  But the new generation of doctors differs greatly from the previous one:

  1.  they no longer are as likely to be in it for the money.  If you want to make a lot of money, going to school for 7 or more years after graduating from college, working your tail off and incurring huge debts is not the way to do it.  The pay is only really high for certain subspecialties.  Primary docs simply do not get rich.  

  2.  the insurance companies have successfully sucked all the profit out of the system -- the ones getting wealthy off health care are the insurance company and profit-making HMO CEOs.  Many doctors have to struggle to maintain their practices if they accept insurance payments.  So physicians are no longer enamored of private health insurance.  Being screwed over tends to make you pretty angry.

  3.  there are far more women physicians than there used to be.  Research shows that women physicians are more likely to choose work arrangements that allow them to protect their family time, and that income is a much lower priority.  (I know this because I did some of the research!).  They really don't care who pays them and they're happy with a comfortable income, e.g. like in the Canadian system, and are not looking for great wealth.

  4. the boogey man of government bureaucrats making medical decisions and doctors being overwhelmed by government red tape no longer scares physicians as much as the reality of insurance clerks making medical decisions and insurance companies' overwhelming paper work requirements.

  by Tamar on Tue Dec 18, 2007 at 06:08:38 PM PDT

  •  very well put

    asdf

    by Swordsmith on Tue Dec 18, 2007 at 08:12:43 PM PDT

•  This is good news, and perhaps a growing wave of

  support that our new president will be able to ride.

  Though none of our front-runners has proposed single-payer, I'll bet any of them would gladly change their tune if they felt there was serious support for it.

  by Happy Days on Tue Dec 18, 2007 at 06:10:54 PM PDT