Six years after the adoption of the Affordable Care Act, a physicians' group says corporate interests are pushing aside the concerns of doctors and the needs of patients.
An editorial calling for the United States to move from the Affordable Care Act to a single-payer system, which was President Barack Obama’s first choice in 2008, appearing in the American Journal of Public Health, suggests that at least a segment of the nation’s doctors feel that the ACA did not go far enough.
Physicians for A National Health Program called for replacing the ACA with a publicly financed system “to fully cover medical care for all Americans, while lowering costs by eliminating the profit-driven private insurance industry with its massive overhead.”
The proposal, which is linked to the editorial, was crafted by a 39-member working group and has so far been signed by than 2280 doctors and 168 medical students, according to the group.
“Our nation is at a crossroads,” said Adam Gaffney, MD, a pulmonologist at Massachusetts General Hospital and the editorial’s lead author. “Despite the passage of the Affordable Care Act six years ago, 30 million Americans remain uninsured, and even greater numbers 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.”
He added, “Caring relationships are increasingly taking a seat to the financial perogatives of insurance firms, corporate providers and Big Pharma. Our patients are suffering and our profession is being degraded and disfigured by these mercenary interests.”
In calling the effective elimination of the health insurance industry, the group did not say how many jobs would be lost or what the net effect would be on the economy.
Recent results in the Kaiser Health Tracking Poll suggest that while Democrats still strongly support the ACA overall, some cracks have begun to show as Senator Bernie Sanders campaigns on the principle that Americans can do more, under the banner, “Medicare for all.” Concerns about cost-sharing and especially the high cost of prescription drugs are uniting voters from across party lines.
The PNHP program calls for the following:
· Patients should get to choose to go to any doctor and hospital. Most providers would get funding from a National Health Program, or NHP, and remain privately owned. Physicians could practice on a fee-for-service basis or receive a salary.
· NHP would be paid through a mix of government health sources into a single fund, augmented by what the physicians said would be “modest new taxes,” offset by reductions in premium and out-of-pocket spending.
· Co-payments and deductibles would end.
· Single-payer healthcare would save $500 billion a year, the doctors claim, by eliminating the overhead and profits of insurers, and the “massive paperwork they inflict on hospitals and doctors.”
· The physicians claim this elimination of waste would more than offset the cost of caring for the uninsured and would lead to better care for everyone else, including improved public health services.
Gaffney A, Woolhandler S, Angell M, Himmelstein DU. Moving forward from the Affordable Care Act to a single-payer system [published online May 5, 2016]. Am J Pub Health. 2016; doi: 10.2105/AJPH.2015.303157.