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'Health Care for All,' the path forward

The Partnership for America’s Health Care Future was recently launched to fight growing public and political support for a national health insurance plan. This is a massive coalition of over 30 major health care lobbying organizations, including America’s Health Insurance Plans (AHIP), the Pharmaceutical Research and Manufacturers of America (PhRMA) and the Federation of American Hospitals. Although they claim otherwise, this group is pushing for profits rather than the best interests of patients.

And that’s why we — physicians, politicians and the public — must join in our own alliance to push back and advocate for what many know as “Medicare for All” or “single payer,” but I prefer to call “Health Care for All.” While a public or quasi-public agency would oversee health care financing, the delivery of care would still be left to private practitioners. I’ve been advocating for this for years, though the idea has gained traction since Bernie Sanders made it a centerpiece of his presidential campaign in 2015.

Congressional and administrative encroachments — spurred by big business — on the ambitious, but flawed, Affordable Care Act have made health care through private insurance less available and more expensive for many Americans. It is increasingly clear that health care reform must overcome that commoditization.

Many doctors, especially the younger cohort, support the Health Care for All idea. Dr. Steven Schroeder at UCSF, quoted in Kaiser Health News, says “Students [today] come in saying, ‘We want to make a difference through social justice. That’s why we’re here.’” Student delegates to the American Medical Association last year proposed a resolution to delete the AMA policy against single payer.

A Merritt-Hawkins poll also found that, overall, 56 percent of doctors are now somewhat or strongly supportive of a single payer health system, a large increase over 2008. And Physicians for a National Health Program, which advocates “Improved Medicare for All,” has grown in recent years to 23,000 members (including me).

Still, Health Care for All will be fought by vested interests making excessive profits, and it will require strong public and professional pressure to overcome such obstacles and achieve reform. We can start by dispelling some myths:

Will it cost more?

On the contrary, the recent meticulous report from the Political Economy Research Institute at the University of Massachusetts, Amherst, not only confirms other predictions that individuals will not pay more, it concludes that "Medicare for All could reduce total health care spending in the U.S. by nearly 10 percent, to $2.93 trillion, while creating stable access to good care for all U.S. residents." Cost for Health Care for All is often predicted from our present costs, expanded to cover everyone. But that does not recognize the inefficiency of our expensive, chaotic, less effective health care now. A national system can save us money.

Is Health Care for All politically impossible?

No. Over half of U.S. health care already comes through government programs funded by taxes; it is hardly a stretch to go the rest of the way.

Will it limit our choice of doctors or insurance plans?

Nope. It will include all doctors and all patients, with no insurance chaos to confuse and restrict care. And Health Care for All removes the limitations for workers as well as for employers by not requiring employer contributions to health care insurance.

What if we don't want government-controlled health care?

That is not how it will be if doctors get on board and help. My great fear is that not enough doctors will grasp the vision for a politically independent, professional board using national data to decide what health care options are right for doctors to provide their patients.

This, then, is how the U.S. public can help strengthen its natural alliance with American doctors to best serve patients. Take a page from the legalistic parody of concern that ends many pharmaceutical ads, urging viewers to “Ask Your Doctor.”

At your next medical visit, ask your doctor about single-payer Health Care for All, and urge him or her to get behind it.

Dr. James F. Burdick is a professor of surgery at Johns Hopkins Medicine and author of the book, "Talking About "Single Payer." His email is jburdic1@yahoo.com.

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