America’s doctors are starting to warm up to the idea of a single-payer health care system, aka Medicare for All. This week, the American College of Physicians announced its support for universal health care coverage, either through single payer or a public option in combination with private insurance.
The American College of Physicians, the second-largest doctors group in the U.S., had previously endorsed the concept of universal health care coverage as well as a public option, where the government offers its own insurance plan that exists alongside private insurance plans. But in a series of position papers published Tuesday in the Annals of Internal Medicine, which the group owns, the ACP for the first time laid out its arguments for a single payer system—one where all essential health insurance coverage is provided through the government.
“There is a clear case that the U.S. health care system requires systematic reform,” members of the ACP’s Health and Public Policy Committee and Medical Practice and Quality Committee wrote in one paper.
For one, the ACP authors noted, the U.S. is spending far more than similarly developed countries (including those with single payer) on health care per person, in part due to much larger administrative costs. But compared to these other countries, Americans on average actually have worse health outcomes, while millions remain uninsured, despite the modest reforms put in place by the Affordable Care Act. Tens of thousands of Americans are estimated to die every year as a result of being uninsured, and people with insurance face rising out-of-pocket costs that threaten to bankrupt them in the event of serious illness or even a child’s birth. Others avoid seeing doctors altogether.
“The U.S. health care system is like a chronically ill patient, and ACP is proposing a new prescription,” the authors of another paper wrote. “Simple market solutions have been unsuccessful elsewhere, and we do not believe that health care is a commodity.”
Over the decades, there have been numerous attempts to overhaul the American health care system—none perhaps more popular than the Medicare for All movement currently most championed by presidential candidate and Vermont senator Bernie Sanders. On Twitter, Sanders lauded the ACP for its support for a single payer system, saying, “A growing number of doctors are sick and tired of the enormous waste and bureaucracy in our cruel and dysfunctional health care system.”
While the ACP doesn’t reference Sanders or the current political debate over Medicare for All specifically, it nonetheless stated that the ACP “rejects the view that the status quo is acceptable, or that it is too politically difficult to achieve needed change.”
What makes the ACP’s new position on single payer especially noteworthy is that it represents a break from the medical establishment’s historic resistance to such a policy. The American Medical Association, which now represents around 15 percent of all U.S. doctors, has lobbied against single payer for close to a century. However, last June, a faction of AMA members narrowly lost a vote to eliminate the organization’s stated disapproval of single payer, 47 percent to 53 percent. That same year, the AMA pulled its support and money from the Partnership for America’s Health Care Future, a lobbying group funded by private insurers, hospital executives, and pharmaceutical companies that was created to oppose single payer or a public option.
Also this week, the Physicians for a National Health Program, a group of doctors supporting single payer, bought a full-page ad in the New York Times explicitly backing Medicare for All. The ad includes an open letter, which has been signed by over 2,000 doctors and medical students.
“We witness daily the inhumanity and irrationality of the current health care system,” the letter reads. “It is time to transform the way we pay for care—to embrace improved Medicare for All.”
Last week, a new study found evidence that Medicare for All would likely save money for Americans compared to the current system, undermining another common talking point made by critics.