A 39-physician panel Thursday unveiled a proposal for single-payer healthcare reform, endorsed by 2,231 physicians, that promises to remove all financial barriers to medical care with no increase in current spending.
Here are six things to know about the proposal.
1. The physicians maintain their proposal is "strictly nonpartisan." It does, however, coincide with the "Medicare for All" policy promoted by Democratic presidential candidate Sen. Bernie Sanders (I-Vt.) and the topic has benefitted from the attention in the primary campaigns, they wrote.
2. The proposed National Health Program would cover healthcare costs for every citizen and immigrant. It would cover outpatient and inpatient care, rehabilitation, mental healthcare, long-term care, dental care and prescription drugs, effectively eliminating premiums, co-payments, deductibles and co-insurance. Patients would be free to choose their physician and hospital.
3. Hospitals would remain private and physicians would continue to practice fee-for-service medicine. The plan would allow hospitals and clinics to remain privately owned and operated, and their costs would be reimbursed with a global lump sum budget from the federal government. Physicians would be salaried by their hospital, practice or clinic. "The largest hospital [pay for performance] demonstrations found initial gains, but no lasting improvement in outcomes," the proposal says. "Systematic reviews on P4P have concluded that high-quality evidence of benefit is lacking."
4. The NHP would reduce bureaucracy compared to the ACA, the physicians claim. This reduction in administrative overhead costs — potentially saving up to 15 percent of national health expenditures — would free up almost $500 billion annually to offset the costs of the program. It would also require "modest" tax increases, though these would be offset by reductions in premiums and out-of-pocket costs, the physicians wrote.
5. The plan would prohibit private insurance coverage that duplicates federal coverage, putting health insurance workers out of jobs. The proposal plans to generate retraining and placement resources for these displaced workers with increased employment in care delivery and other sectors of the economy, as employers would no longer have to provide health insurance.
6. It has already received similar criticisms as Sen. Sanders' Medicare for All. Sen. Sanders' plan has weathered criticism from heavyweight economic advisers in the Democratic party, who said the math does not work out and that they are concerned his promise undermines the party's reputation of responsible, evidence-based policy. Similarly, criticisms of the NHP have already emerged. Jeffrey Flier, MD, dean of Boston-based Harvard Medical School told The Washington Post he thought the proposal was "backward" and not a meaningful contribution.
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