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, getting 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!