"Doctors Push National Health Insurance"

By THE ASSOCIATED PRESS

Filed at 5:25 p.m. ET
WASHINGTON (AP) -- Nearly 8,000 U.S. physicians are calling for government-financed national health insurance, which they say would cover every American while saving billions of dollars.

Ten years after President Clinton's national health plan died in Congress, tangled in complexity and under fierce assault from the medical, insurance and pharmaceutical industries, the doctors argue that private sector solutions have failed.

They contend that work in Congress to enact a prescription drug benefit for the elderly and disabled would shift more government money to private companies while offering little value to consumers.

The doctors would put in place a single-payer system -- essentially an upgraded and expanded version of Medicare, the government health care program for the elderly and disabled.

``HMOs, launched as health care's bright hope, have raised Medicare costs by billions and fallen to the basement of public esteem. Investor-owned hospital chains, born of the promise of efficiency, have been wracked by scandal,'' the doctors write. ``And drug firms, which have secured the highest profits and lowest taxes of any industry, price drugs out of reach of those who need them most.''

Their proposal was published in Wednesday's Journal of the American Medical Association.

The group of 7,782 physicians is led by Marcia Angell, former editor of the New England Journal of Medicine, and former Surgeons General Julius Richmond and David Satcher.

``The system cannot continue much longer the way it is,'' Angell, a Harvard Medical School lecturer, said in an interview. ``It is clearly imploding. It isn't that single-payer is the best choice. It's the only choice.''

The American Medical Association remains opposed to a single-payer health care system, Dr. Donald Palmisano, AMA's president, said in a statement.

``By implementing a single-payer system, the U.S. would be trading one problem for a whole set of others,'' Palmisano said. ``Long waits for health care services, a slowness to adopt new technologies and maintain facilities, and development of a large bureaucracy that can cause a decline in the authority of patients and their physicians over clinical decision-making are all hallmarks of the single-payer system.''

The American Association of Health Plans, the lobbying arm of the managed care industry, also said it opposed the doctors' proposal, which would eliminate for-profit hospitals and health maintenance organizations.

The physicians signing onto the article account for less than 1 percent of the 813,770 physicians in the United States as of 2000, according to the AMA.

But Richmond said it is significant that a large number of doctors, traditionally opposed to government health programs, would endorse national health insurance. ``Physicians have realized that there is something very fundamentally wrong with the system,'' said Richmond, who served as surgeon general in the Carter administration.

The doctors said they hope to spark a debate over national health insurance that essentially ended with the death of the Clinton health plan.

Of the Democratic presidential candidates, only Rep. Dennis Kucinich is advocating a single-payer system.
Americans spend $1.6 trillion on health care, which the doctors say is more than enough money to cover every American. The doctors contend that there will be at least $200 billion in administrative savings in a single-payer, national insurance plan.
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On the Net:
JAMA:    http://jama.ama-assn.org/cgi/content/abstract/290/6/798

"Proposal of the Physicians' Working Group for Single-Payer National Health Insurance",
The Physicians' Working Group for Single-Payer National Health Insurance,
JAMA. vol. 290, no.6, pp. 798-805 (August 13, 2003).