This article is more than 5 years old. Information may no longer be current.

Physicians call for universal, single-payer health care system

In an editorial published in the American Journal of Public Health, researchers outlined a proposal to overhaul the nation’s current health care system and replace it with a government-backed, single-payer structure that provides coverage for everyone.

“Our nation is at a crossroads,” Adam Gaffney, MD, lead author of the study and fellow in pulmonary and critical care medicine at Massachusetts General Hospital and Harvard Medical School, said in a press release. “Despite the passage of the Affordable Care Act 6 years ago, 30 million Americans remain uninsured, an even greater are underinsured, financial barriers to care like copays and deductibles are rising, bureaucracy is growing, provider networks are narrowing, and medical costs are continuing to climb.”

In 2015, the Supreme Court upheld the legality of the Affordable Care Act subsidies. But even after full implementation of the Affordable Care Act (ACA), 27 million people will be uninsured by 2026, according to the Congressional Budget Office. To ensure that everyone receives health care, Gaffney and colleagues have proposed a government-funded, single-payer system, which so far has been endorsed by 2,200 physicians.

The researchers’ proposed system would provide coverage to everyone in the country. In addition, it would provide dental care, long-term care and prescription drugs to everyone.

To provide this added coverage, the proposed system would lower administrative health care costs and decrease the incentives that lead to the corruption seen in health maintenance organizations. If administrative costs were lowered to Canadian levels, 15% of national health spending would be eliminated and $500 billion would be saved each year, according to the authors, who cited data from a study published in the New England Journal of Medicine. In addition, the proposed system would save money by negotiating with drug companies over prices, similar to universal health care programs in other countries.

To lower administrative costs, the proposed system would pay hospitals for their operating costs through global budgets, similar to how cities fund fire departments. This would eliminate per-patient billing. In addition, hospitals’ operating funds will be removed from advertising or other capital investments aimed only at profit. To advance hospitals, the proposed system will use capital grants targeted toward community needs.

In addition, the proposed system would preserve patient and doctor relationships by using one large network that would allow free choice of hospital and clinician and prevent turnover.

“We can continue down this harmful path — or even worse, take an alternative ‘free market’ route that would compound our problems — or we can embrace the long-overdue remedy that we know will work: The creation of a publically financed, nonprofit, single-payer system that covers everybody,” Steffie Woolhandler, MD, MPH, co-author of the study and professor at City University of New York School of Public Health at Hunter College, said in the release. “Today we’re saying we must quickly make that shift. Lives are literally at stake.” – by Will Offit

Disclosure: The researchers report no relevant financial disclosures.