[rad-green] Second Largest Physicians Group in US Has New Prescription: It's Medicare for All

*https://www.commondreams.org/news/2020/01/20/historic-shift-second-largest-physicians-group-us-has-new-prescription-its-medicare
<https://www.commondreams.org/news/2020/01/20/historic-shift-second-largest-physicians-group-us-has-new-prescription-its-medicare>Common
Dreams          January 20, 2020In Historic Shift, Second Largest
Physicians Group in US Has New Prescription: It's Medicare for All"Major
changes are needed," declares the 159,000-member American College of
Physicians, "to a system that costs too much, leaves too many behind, and
delivers too little."by Jon Queally, staff writer*

[image: More than two thousand physicians published an open letter to the
American public, prescribing single-payer Medicare for All, in a full-page
ad in The New York Times that will run in the print edition on Tuesday,
January 21, 2020. On Monday, in a separate but related move, the American
College of Physicians (ACP), a national organization representing 159,000
internists, officially endorsed single-payer Medicare for All reform. The
ACP is the largest medical specialty society and second-largest physician
gro]

*More than 2,000 physicians announced an open letter to the American
public, prescribing single-payer Medicare for All, in a full-page ad in
the New York Times that will run in the print edition on Tuesday, January
21, 2020. On Monday, in a separate but related move, the American College
of Physicians (ACP), a national organization representing 159,000
internists, officially endorsed single-payer Medicare for All reform. The
ACP is the largest medical specialty society and second-largest physician
group in the country after the American Medical Association (AMA). (Photo:
PNHP)*

The fight for Medicare for All received a two-handed boost from tens of
thousands of doctors on Monday when the American College of Physicians—in a
move described as a "seachange for the medical professions"—officially
endorsed a single-payer system as among only one of two possible ways to
improve the nation's healthcare woes.

Representing 159,000 doctors of internal medicine nationwide, the ACP is
the largest medical specialty society and second-largest physician group in
the country overall after the American Medical Association (AMA).

"All over this country, a growing number of doctors are sick and tired of
the enormous waste and bureaucracy that exists in our cruel and
dysfunctional healthcare system."
—Sen. Bernie Sanders (I-Vt.)The ACP delivered its case in a 43-page
position paper—titled "Envisioning a Better U.S. Health Care System for
All: Coverage and Cost of Care
<https://annals.org/aim/fullarticle/2759528/envisioning-better-u-s-health-care-system-all-call-action>"—published
in the *Annals of Internal Medicine* <https://annals.org/aim> on Monday.
According to the paper:

Although the United States leads the world in health care spending, it
fares far worse than its peers on coverage and most dimensions of value.
Cost and coverage are intertwined. Many Americans cannot affford health
insurance, and even those with insurance face substantial cost-related
barriers to care. Employer-sponsored insurance is less prevalent and more
expensive than in the past, and in response, deductibles have grown and
benefits have been cut. The long-term solvency of U.S. public insurance
programs is a perennial concern. The United States spends far more on
healthcare administration than peer countries. Administrative barriers
divert time from patient care and frustrate patients, clinicians, and
policymakers. Major changes are needed to a system that costs too much,
leaves too many behind, and delivers too little.

Sen. Bernie Sanders (I-Vt.), a leading candidate for the 2020 Democratic
presidential nomination and the author of the The Medical for All Act of
2019 now in the U.S. Senate, welcomed the development.

"I am delighted that the American College of Physicians has come out in
support of a Medicare for All, single-payer healthcare system," Sanders
said in a statement emailed to Common Dreams.

"All over this country, a growing number of doctors are sick and tired of
the enormous waste and bureaucracy that exists in our cruel and
dysfunctional healthcare system," Sanders added. "They are sick and tired
of spending time filling out reams of paperwork and arguing with insurance
companies. Medicare for All will give doctors the freedom to focus on
making their patients healthy, not making health insurance executives
wealthy."

"Major changes are needed to a system that costs too much, leaves too many
behind, and delivers too little."
—The American College of Physicians (ACP)The ACP's detailed review of the
current for-profit system—even with some of the improvements resulting from
the Affordable Care Act (ACA)—found that "too many Americans are uninsured
or underinsured" and that current spending is "high and
unsustainable"—especially as other developed nations show their ability to
achieve better or similar outcomes for less while offering universal,
government-guaranteed coverage to all.

While it did not say that Medicare for All was the only way to achieve a
more equitable, accessible, and sustainable healthcare system, the ACP laid
out four key recommendations for achieving universal coverage in the United
States. They are:

1. The American College of Physicians recommends that the United States
transition to a system that achieves universal coverage with essential
benefits and lower administrative costs.

2. Coverage should not be dependent on a person's place of residence,
employment, health status, or income.

3. Coverage should ensure sufficient access to clinicians, hospitals, and
other sources of care.

4. Two options could achieve these objectives: a single-payer financing
approach, or a publicly financed coverage option to be offered along with
regulated private insurance.

While acknowledging that a transition to Medicare for All could be "highly
disruptive" to the healthcare system, the ACP said "single-payer financing
approach could achieve [its] vision of a system where everyone will have
coverage for and access to the care they need, at a cost they and the
country can afford. It also could achieve our vision of a system where
spending will have been redirected from health care administration to
funding coverage, research, public health, and interventions to address
social determinants of health."

Medicare for All, the paper continued, could also "achieve other key policy
objectives, including portability, lower administrative costs and
complexity, lower premiums and cost sharing, lower overall health care
system costs, better access to care, and better health outcomes, depending
on how it is designed and implemented."

"As physicians, we see daily the harm that our fragmented,
private-insurance based system does to our patients."
—Dr. Adam Gaffney, PNHP

While the ACP in its backing of a single-payer approach also co-endorsed
the more incremental step of creating a federally-administered "public
option" as a pathway to universal coverage, Drs. Steffie Himmelstein and
David Woolhandler, co-founders of Physician for a National Health Program
(PNHP), argue the latter would be an inferior avenue if the aim is to cover
everyone while reducing overall costs.

According to an op-ed by Woolhandler and Himmelstein, also published in the
*Annals* alongside the ACP's new position paper, "Achieving universal
coverage would be costlier under the "public choice" model the ACP
co-endorses along with single payer."

Unlike a public-private mix of coverage that the public option would
represent, the pair write, a single-payer Medicare for All  would allow
hospitals and doctors to "save billions on billing-related costs" each
year, and those savings could be re-purposed "to expand care" to millions
for less cost than the status quo.

[image: screen_shot_2020-01-20_at_5.02.50_pm.png]
<https://pnhp.salsalabs.org/signonletterdecember42019/index.html>In a
separate but related move to the ACP's announcement, more than two thousand
physicians on Monday announced an open letter
<https://pnhp.org/physicians-prescribe-medicare-for-all/> to the American
public, prescribing single-payer Medicare for All, in a full-page ad in *The
New York Times* that will run in the print edition on Tuesday, January 21,
2020.

Among the doctors "prescribing" Medicare for All as the only serious
solution to the nation's healthcare crisis, said PNHP—which helped organize
the effort—"are towering figures in American medicine" and include Dr.
Marcia Angell, former editor-in-chief of the* New England Journal of
Medicine*; Dr. Bernard Lown, developer of the defibrillator; Dr. Paul
Farmer, infectious disease expert and founder of Partners in Health; and
Dr. Mary Bassett, former New York City Health Commissioner.

The full text of the open letter follows:

*We are doctors from across the spectrum of our profession. We serve
patients rich and poor, in hospitals and clinics, private offices and
public agencies.*

*We witness daily the inhumanity and irrationality of the current health
care system. America funds health care more generously than any other
nation, and our hospitals and medical workforce are second to none. Yet
despite an abundance of medical resources, care is too often meager.*

*For the thirty million who remain uninsured and millions more whose
insurance is inadequate to their needs, life-saving treatment is often out
of reach, deepening health disparities. Oppressive costs and the fear of
financial ruin amplify the suffering of illness. Meanwhile, doctors and
nurses struggle to provide good care in a bad system. We waste countless
hours complying with arcane billing requirements and, along with our
patients, imploring insurers to fulfill their promises of coverage.*

*It is time to transform the way we pay for care — to embrace improved
Medicare for All.*

*Medicare for All would curb soaring drug prices and dismantle the wasteful
bureaucracy of private insurance companies, freeing up hundreds of billions
of dollars to expand and improve care — while ensuring free choice of
doctor and hospital.*

*Vested interests who profit from the current broken system raise false
alarms of dislocation and disruption to incite fear of change. They are
wrong. Improved Medicare for All would bring welcome relief to patients,
lower costs for families and communities, and allow doctors and nurses to
focus on what matters most: caring for our patients.*

"As physicians, we see daily the harm that our fragmented,
private-insurance based system does to our patients," noted Dr. Adam
Gaffney, president of PNHP and a pulmonary and critical care physician at
Harvard Medical School and the Cambridge Health Alliance. "Patients go
without the care they need, and physicians squander time and resources on
wasteful billing and clerical tasks. Medicare for All would be a much
better way — for patients and doctors both."

As physicians, the signatories of the letter said, the answer is obvious:
"we prescribe Medicare for All."

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