{"id":656,"date":"2009-03-09T15:32:00","date_gmt":"2009-03-09T19:32:00","guid":{"rendered":"http:\/\/blog.cmhughesmd.com\/?p=656"},"modified":"2009-03-09T15:32:00","modified_gmt":"2009-03-09T19:32:00","slug":"achieving-a-high-performance-health-care-system-with-universal-access-what-the-united-states-can-learn-from-other-countries-american-college-of-physicians-annals-of-internal-medicine","status":"publish","type":"post","link":"http:\/\/blog.cmhughesmd.com\/?p=656","title":{"rendered":"Achieving a High-Performance Health Care System with Universal Access: What the United States Can Learn from Other Countries — American College of Physicians, — Annals of Internal Medicine"},"content":{"rendered":"

Achieving a High-Performance Health Care System with Universal Access: What the United States Can Learn from Other Countries — American College of Physicians,<\/a>:<\/p>\n

When we were talking last week about the lack of single payer advocates at last week’s summit, I didn’t realize that ACP was there. The President of the ACP was there, though I don’t know his persoanl feelings about reform, I did go back and look at the recommendations published by ACP last year.<\/em><\/p>\n

“Paying for Health Care<\/strong><\/p>\n

“Recommendation 1a:<\/i><\/b> Provide universal health insurance coverage <\/sup>to assure that all people within the United States have equitable <\/sup>access to appropriate health care without unreasonable financial <\/sup>barriers. Health insurance coverage and benefits should be continuous <\/sup>and not dependent on place of residence or employment status. <\/sup>The ACP further recommends that the federal and state governments <\/sup>consider adopting one or the other of the following pathways <\/sup>to achieving universal coverage: <\/sup><\/p>\n

“1. Single-payer financing models, in which one government entity <\/sup>is the sole third-party payer of health care costs, can achieve <\/sup>universal access to health care without barriers based on ability <\/sup>to pay. Single-payer systems generally have the advantage of <\/sup>being more equitable, with lower administrative costs than systems <\/sup>using private health insurance, lower per capita health care <\/sup>expenditures, high levels of consumer and patient satisfaction, <\/sup>and high performance on measures of quality and access. They <\/sup>may require a higher tax burden to support and maintain such <\/sup>systems, particularly as demographic changes reduce the number <\/sup>of younger workers paying into the system. Such systems typically <\/sup>rely on global budgets and price negotiation to help restrain <\/sup>health care expenditures, which may result in shortages of services <\/sup>and delays in obtaining elective procedures and limit individuals’ <\/sup>freedom to make their own health care choices. [CMHMD Note: I guess it shows how complicated this all is. ACP considers Japan single payer and France a hybrid sytem, but most consider both single payer. In any case, neither have significant problems with waiting times.] <\/sup><\/em> <\/p>\n

“2. Pluralistic systems, which involve government entities as <\/sup>well as multiple for-profit or not-for-profit private organizations, <\/sup>can assure universal access, while allowing individuals the <\/sup>freedom to purchase private supplemental coverage, but are more <\/sup>likely to result in inequities in coverage and higher administrative <\/sup>costs (Australia and New Zealand). Pluralistic financing models <\/sup>must provide 1) a legal guarantee that all individuals have <\/sup>access to coverage and 2) sufficient government subsidies and <\/sup>funded coverage for those who cannot afford to purchase coverage <\/sup>through the private sector. (See the ACP’s proposal for expanding <\/sup>access to health insurance as an example of how a pluralistic <\/sup>system can achieve universal coverage [69<\/a>].) <\/sup><\/p>\n

“Recommendation 1b:<\/i><\/b> Provide everyone access to affordable coverage\u2014whether <\/sup>provided through a single-payer or pluralistic financing model\u2014that <\/sup>includes coverage for a core package of benefits, including <\/sup>preventive services, primary care services\u2014including but <\/sup>not limited to chronic illness management\u2014and protection <\/sup>from catastrophic health care expenses. <\/sup><\/p>\n

“Recommendation 1c:<\/i><\/b> Until there is political consensus for achieving <\/sup>universal coverage at a federal level, Congress should encourage <\/sup>state innovation by providing dedicated federal funds to support <\/sup>state-based programs with an explicit goal of covering all uninsured <\/sup>persons within the state. (See the ACP position paper, “State <\/sup>Experimentation with Reforms to Expand Access to Health Care” <\/sup>[70<\/a>].) <\/sup><\/p>\n

“[ACP]Comment:<\/i> Universal health care insurance is necessary to ensure <\/sup>that everyone within the United States has access to needed <\/sup>health care services of high quality. The federal government <\/sup>should assure that all persons within the borders of the United <\/sup>States also have access to health care services without undue <\/sup>financial barriers and that health care services provided are <\/sup>adequately reimbursed. The ACP recommends 2 alternatives: a <\/sup>system funded solely or principally by government (federal and <\/sup>state), commonly known as a single-payer system, or a pluralistic <\/sup>system that incorporates existing public and private programs <\/sup>with additional guarantees of coverage and with sufficient subsidies <\/sup>and other protections to assure that coverage is available and <\/sup>affordable for all. The ACP has proposed a step-by-step plan <\/sup>that would achieve universal coverage while maintaining a pluralistic <\/sup>system of mixed public and private sector funding.” <\/sup><\/p>\n

——————————————<\/sup><\/p>\n

SO, ACP advocates either a single payer model, or a social health insurance model (i.e., a hybrid system) as the path to paying for universal health care. This is where I come down as well. I think it would be very useful if we could get a majority of physicians to accept this either\/or approach with the caveat that we vigorously campaign to allow NOTHING LESS than this to be our line in the sand.<\/em> <\/sup><\/p>\n","protected":false},"excerpt":{"rendered":"

Achieving a High-Performance Health Care System with Universal Access: What the United States Can Learn from Other Countries — American College of Physicians,: When we were talking last week about … Continue reading “Achieving a High-Performance Health Care System with Universal Access: What the United States Can Learn from Other Countries — American College of Physicians, — Annals of Internal Medicine”<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"sfsi_plus_gutenberg_text_before_share":"","sfsi_plus_gutenberg_show_text_before_share":"","sfsi_plus_gutenberg_icon_type":"","sfsi_plus_gutenberg_icon_alignemt":"","sfsi_plus_gutenburg_max_per_row":"","footnotes":""},"categories":[93,5,102],"tags":[],"class_list":["post-656","post","type-post","status-publish","format-standard","hentry","category-american-college-of-physicians","category-single-payer-health-care","category-social-health-insurance"],"post_mailing_queue_ids":[],"_links":{"self":[{"href":"http:\/\/blog.cmhughesmd.com\/index.php?rest_route=\/wp\/v2\/posts\/656","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/blog.cmhughesmd.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/blog.cmhughesmd.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/blog.cmhughesmd.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/blog.cmhughesmd.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=656"}],"version-history":[{"count":0,"href":"http:\/\/blog.cmhughesmd.com\/index.php?rest_route=\/wp\/v2\/posts\/656\/revisions"}],"wp:attachment":[{"href":"http:\/\/blog.cmhughesmd.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=656"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/blog.cmhughesmd.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=656"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/blog.cmhughesmd.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=656"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}