American Medical Association opposes Single-payer health system

  1. ama opposes single-payer health system

    august 12, 2003

    reiterating the ama's position on health insurance, ama president donald j. palmisano, md, today said, "a solution to the problem of the uninsured is desperately needed - but a single-payer health care system is not the answer."

    the ama strongly disagrees with an article arguing for a single-payer health care system published in the aug. 13 issue of the journal of the american medical association (jama), which is editorially independent from the ama, and has long-standing policy opposing a single-payer health care system. a jama editorial accompanying the single-payer opinion piece encourages the exploration and discussion of various new solutions.

    in july, ama president-elect john c. nelson, md, testified on capitol hill regarding the newly introduced health insurance certificate act (h.r. 2698), legislation that would provide subsidies to low and low-middle income families for the purchase of health insurance. to be of value, the health insurance certificate program must ensure that lower-income americans can benefit through affordable premiums. "the ama advocates a solution to the uninsured crisis that builds on the strengths of our current system," said dr. palmisano. "by implementing a single-payer system, the united states would be trading one problem for a whole set of others." some of the single-payer problems dr. palmisano cited include: long waits for health care services; a slowness to adopt new technologies and maintain facilities; and the development of a large bureaucracy that could cause a decline in the authority of patients and their physicians regarding clinical decision-making.
  2. 9 Comments

  3. by   fiestynurse
    Doctors Support National Insurance- Boston Globe
    February 10, 2004

    Doctors Support National Insurance
    63% in Mass.Survey Support Single-Payer Care
    By Liz Kowalczyk, Globe Staff,2/10/04

    A majority of Massachusetts doctors support national health insurance, and most said they would be willing to accept a 10 percent cut in fees in return for less paperwork, according to a new study about physicians' attitudes toward health insurance.

    While the four physicians who conducted the survey-all of whom are affiliated withHarvardMedicalSchool-- are members of a nonprofit organization that has long pushed for universal health coverage, their results were published today in a respected medical journal, the Archives of Internal Medicine. The study is part of a growing body of research into physicians' views toward national health insurance that is sparking debate on the topic as the number of uninsured Americans has grown to 41 million.

    A study published three years ago in the New England Journal of Medicine showed a majority of medical school faculty and doctors-in-training believed a "single-payer system"-- where one government entity manages and pays for everyone's medical care-would provide the best care to the most patients for a fixed amount of money. They chose that option over managed care or fee-for-service, in which insurance companies pay doctors and hospitals based on the treatment. Managed care and fee-for-service are the two most common types of private insurance.

    The study published today was based on a survey of 904Massachusettsdoctors and included doctors at teaching hospitals as well as those who see patients in private offices.

    About 63 percent chose single-payer as the best system; 26 percent picked fee-for-service, and just 11 percent favored managed care. About 67 percent of doctors agreed somewhat or agreed strongly that they'd take a 10 percent reduction in fees in return for "a very substantial reduction in my paperwork." And 57 percent said they agreed with a salary system if salaries are "guaranteed to be within 10 percent of their previous incomes."

    Psychiatrists and primary care doctors showed the strongest support for a single-payer system, while surgeons favored it the least. Just 47 percent of surgeons believed a single-payer system would provide the best healthcare to the most patients. Dr. Steffie Woolhandler, one of the authors and a physician at Cambridge Hospital, said surgeons earn 50 to 100 percent more than other doctors. "This may explain their lower support for tinkering with the payment system," she said.

    Robert Blendon, a professor of health policy and political analysis at the Harvard School of Public Health, said the study has a key weakness: The authors did not give doctors enough choices. In other words, the terms "single-payer" could mean different things to different physicians. The authors remarked in their study that they believe most physicians are familiar with the general term as referring to some type of national government health insurance system.

    But a study three months ago published in the Annals of Internal Medicine reported that 49 percent of 1,650 doctors surveyed support government legislation to establish national health insurance. But only 26 percent of the physicians favored a program in which government would pay for all healthcare. Instead, doctors wanted tax credits or employer mandates to achieve universal coverage. Blendon also points out that managed care and a single-payer system are not mutually exclusive. A single-payer system could include a managed care component to tightly manage and control care and costs.

    "Physicians would like to see people covered, but given a choice how to do it, they might pick other ways," he said. "There's no question, though, that they'd like to get rid of managed care."
  4. by   fiestynurse
    February 9, 2004

    Most Physicians Endorse Single-Payer National Health Insurance
    According to Harvard Study

    Nearly two-thirds (64%) of physicians favor single-payer national health insurance, far more than support managed care (10%) or fee-for-service care (26%) according to a Harvard Medical School study published today in the Archives of Internal Medicine. National health insurance (NHI) received majority support from physicians of virtually every age, gender and medical specialty - even among surgeons, a plurality supported NHI. The breadth of physician support for NHI was highlighted by the fact that even most members of the American Medical Association and the Massachusetts Medical Society favor the single payer approach Despite this high level of support, however, only about half (51.9%) of physicians studied were aware that a majority of their fellow physicians support NHI.

    The researchers surveyed a random sample of 904 Massachusetts physicians drawn from the AMA's Master File of all doctors. The survey included questions about views on health care financing and medical practice issues. Eighty-nine percent believed that it is the responsibility of society, through its government, to provide everyone with good medical care, regardless of their ability to pay. Physicians also favored physician payment under a salary system (56.8%), and would be willing to accept a reduction in fees for a reduction in paperwork (67.1%). Doctors overwhelmingly (70.3%) rejected allowing the insurance industry to continue playing a major role in the delivery of medical care.

    "The perception that physicians oppose national health insurance often serves to reinforce political barriers to health care reform. Our finding that a large majority of physicians actually support single-payer national health insurance could provide the impetus for national health insurance, particularly if physicians began to publicly advocate for their views" said Dr. Danny McCormick, a study author and researcher at Harvard Medical School.

    Dr. David Bor, a study co-author who is an Associate Professor of Medicine at Harvard Medical School and Chair of the Department of Medicine at The Cambridge Health Alliance commented: "At first I was surprised at our results. But when I reflected on my own clinical experience with publicly funded programs like Medicare, I realized that I and many other doctors are convinced that the government can do an excellent job administering health insurance. The plain fact is Medicare works better for patients-and for doctors-than most private insurance plans."

    "Most doctors are fed up with the health care system. It's not just the paperwork and insurance hassles, but knowing that many of our patients can't afford to fill the prescriptions we write for them. And millions of people who are uninsured avoid care altogether until they're desperately ill. That's why more than 10,000 physicians have endorsed a proposal for national health insurance that appeared in the JAMA last August. This survey shows that the overwhelming majority of doctors now support NHI.." said Dr. Steffie Woolhandler, another study co-author and Associate Professor of Medicine at Harvard Medical School.
  5. by   fiestynurse
    The Future Doctors of America are for a National health program.

    Medical Students Commend Study on Universal Health Care
    Study Published in today's issue of New England Journal of Medicine Supports
    Single Payer Health System

    Reston, VA - The American Medical Student Association (AMSA), the nation's largest, independent medical student organization, commends the study, "Costs of Health Care Administration in the US and Canada," published in today's New England Journal of Medicine. The study found that the United States spends $209 billion more than Canada on health care, money that could be used to cover the 40 million uninsured Americans under a single payer system.

    Dr. Steffie Woolhandler and Dr. David Himmelstein, physicians at Cambridge Hospital, compare spending on health-care administration in Canada, a single-payer system, and the United States, which depends on multiple private insurance companies.

    "We currently waste a third of all health care dollars on administration, billing and profit, but the United States remains the only industrialized nation in the world that does not guarantee health insurance to all of its citizens," says Lauren Oshman, M.D., MPH and president of AMSA. "Only by cutting out the waste and embracing a Medicare-for-All system can we repair our broken health-care system. At AMSA, we are educating the medical community about the urgent need for universal health care in this country."

    The American Medical Student Association (AMSA) is the nation's oldest and largest student run organization with approximately 40,000 members and local chapters at every medical school in the United States. Information on AMSA's Universal Health Care initiative can be found at
  6. by   NurseHardee
    Need it really be pointed out, that MDs as a whole are a reatively wealthy and conservative lot who may not have all the best interests of Americans at heart? We could use a lot less MD thought, and a lot more common sense and decency in the delivery of health care world wide, let alone just within the US.

    Nurse Hardee
    Last edit by NurseHardee on Mar 6, '04
  7. by   Alnamvet
    The whole thing is about money and greedy md's...I'll take half of what the feds pay md's for services, donate atleast 20% of my time towards fee free care for woman and children, and I know I can still make out like a bandit.
  8. by   nursebonkers
    Someone who hasn't been employed at the bedside since god knows when, teaching other nurses to take the sh** thats given to them. I dont think so. Thank you very much. :hatparty:
  9. by   fiestynurse
    Nursebonkers - Are you referring to me? I worked 20 years as a hospital bedside nurse and left in 1999 because I was severely burnt-out. I have used my law degree to advocate for nurses. I Picketed the Governor's office for the passing of the nurse-patient ration bill. I don't understand your comment?
  10. by   nursebonkers
    Dear RN MSN FNP_____
    Do you believe that most bedside hospital nurses are overworked. If not tell me why? Can you tell me how long you lasted as a bedside nurse, if at all? Can you tell me why bedside nurses are most affected by Adrenal Fatigue? I am asking this because of the fact that your ID RN MSN FNP leads me to believe that you are a nurse in primary practice. Im sorry your private messages have been blocked
  11. by   kmchugh
    Quote from nursebonkers
    Dear RN MSN FNP_____
    Do you believe that most bedside hospital nurses are overworked. If not tell me why? Can you tell me how long you lasted as a bedside nurse, if at all? Can you tell me why bedside nurses are most affected by Adrenal Fatigue? I am asking this because of the fact that your ID RN MSN FNP leads me to believe that you are a nurse in primary practice. Im sorry your private messages have been blocked
    Since you posted this on another thread, I thought I'd respond here, as well:


    I believe that all the things you say are true. But I can't understand what that has to do with an endorsement of Kerry. I've asked this elsewhere, but I'll ask you: Why do we, as nurses, have to rely on the government to fix the problems in nursing? It seems to me that the greatest problem faced by nursing today is our inability to get our collective act together. Should we we do that, we could dictate to the hospitals, rather than the hospitals dictating to us. But we'd rather have the government do it?

    Given the track record of the federal government when attempting to correct problems in the private sector, I'd far rather see nurses fix the problem.

    (Sorry about the endorsement of Kerry bit, that was from the other thread. My point, however, still stands.)

    Kevin McHugh