Health Care

WomenMatter will continuously post updates on all this and other issues as we monitor the continuing philosophical and practical debates nationwide. Please check back often for updates. Past updates are available for reference on the Healthcare Archives page.

MD Outcry: Doctors Propose Universal Healthcare

How possible would it be for the government to provide healthcare to everybody? According to almost 8,000 doctors, universal healthcare is not only possible, but also necessary.

The United States spends 14% of its gross domestic product on healthcare. That’s more than any other country in the world. Yet, 43 million Americans go without health insurance. Each year, 102,000 Americans die because they don’t have access to healthcare, and the number-one cause of personal bankruptcy is unpaid medical bills.

According to Marcia Angell (who was editor of the New England Journal of Medicine and now lectures at Harvard Medical School), a single-payer health care system is the answer to the United States’ healthcare woes.

Doctors in disagreement

Thousands of doctors agree with Angell. Together they have published a proposal for universal coverage in the Journal of the American Medical Association (JAMA). In the proposal, the doctors claim that a single-payer system would cover all Americans and save billions of dollars.

However, the American Medical Association is opposed to a single-payer system. The AMA’s president, Donald Palmisano, claims that a single-payer system would create new problems. He says that patients would have long waits for healthcare services, new technologies would be slow to be adopted, and facilities would not be as well maintained. Palmisano also warns that a single-payer system would create a huge bureaucracy, which would limit the authority of physicians.

What is a single-payer system?

The single-payer healthcare system proposed in JAMA equals the expansion of government-provided healthcare. Currently, Medicare and Medicaid provide coverage to the elderly, the disabled, and the poor. A single-payer system would expand that coverage to everyone, replacing Health Management Organizations (HMOs). “Single-payer" basically means universal healthcare, in which the government is the single payer. Tax dollars would fund the enterprise.

There are other routes to universal healthcare.

Expanding government health programs is not the only way to achieve universal healthcare. Legislators could create laws that require employers to provide coverage to all employees. Or, Congress could provide substantial subsidies to businesses that extend coverage to part-time workers; they could also withhold tax deductions or government contracts from employers that don’t give all employees health insurance. Many of America’s uninsured would gain coverage if government encouraged businesses to cover all of their workers. However, when health coverage is linked to employment, the unemployed often go without. Many unemployed workers are eligible for Medicaid but do not enroll because they are unaware of the program or are unwilling to accept government aid.

Americans in favor of universal care

Many Americans are in favor of a universal healthcare system. However, most politicians are afraid to mention universal healthcare because of its huge price tag. President Clinton’s national health plan was killed in Congress and no representative has dared to attempt universal coverage since.

Drug firms, the managed care industry, and some doctors are opposed to universal coverage. They claim that switching to a single-payer system would cause the quality of care to go down because the competition among HMOs and PPOs ensures high quality services and low(er) prices.

Economists remind us that healthcare industry prices inflate at a much faster rate than other markets, regardless of competition. There are many reasons for this. One of them is that patients’ and doctors’ financial interests are not aligned. Doctors and hospitals sometimes administer unnecessary tests or perform unneeded procedures in order to maximize billing. These practices inflate the cost of care. Many economists say that healthcare inflation needs to be controlled for any healthcare system to work.

WomenMatter continues to raise the question about “what’s the question?" Is it how to get quality or how to hold down costs? How do Americans wish to share the risk of getting sick?

Which of these is your priority? Quality or cost? How willing are you to share the risk with people who may be sicker and older than you in order to get both? To chat with other WomenMatter readers about your ideas [click here]. To contact your representatives, click here. To learn more about our healthcare system, [click here].

Posted on: 8/18/2003

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