Future Physicians' Demands For National Health Insurance

Future Physicians' Demands For National Health Insurance
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Medical students are becoming strong advocates all over the country for expanded and improved Medicare for All. Spurred on by their increasing awareness of the restricted access, unaffordability, and inequities keeping many Americans from necessary health care, they are organizing and making their voices heard about the urgency of real health care reform.

With the co-sponsorship of the American Medical Student Association (AMSA), the Latino Medical Student Association (LMSA), White Coats for Black Lives, and many regional and local groups, a good example of their activism was the Halloween Day event in Boston a few days ago, which they dubbed #TreatNotTrick. Donning their white coats, often with Halloween costumes, they staged a public demonstration and call-in asking Rep.Mike Capuano to co-sponsor the single-payer bill in the House, H. R. 676. Their message is that private health insurance is a trick, and that they just want to treat patients in a fair system of universal coverage of health care for all Americans. (Kirchner, E. Let's treat our patients, not trick them with private insurance. Common Dreams, October 27, 2016)

The Boston event was part of the Second Annual Medicare-for-All National Day of Action put on by Students for a National Health Program (SNaHP), the student arm of Physicians for a National Health Program (PNHP). Similar events were held from California to Minnesota to Tennessee on no fewer than 33 medical campuses. In Ohio, medical students visited Sen. Sherrod Brown's office urging him to sponsor a single-payer bill in the Senate. In Philadelphia, they rallied to memorialize the lives lost because of being uninsured or underinsured. Their message is clear--private health insurance is a trick that erects barriers to care. (Ibid)

Today's medical students, altruistic as so many are, see a medical profession caught up in a medical-industrial complex controlled by large corporations ranging from the insurance industry to the pharmaceutical and medical device industries. The business model prevails--profits and revenue for corporate CEOs and their shareholders call the tune. Medical students are seeing that almost two-thirds of physicians are now employed by big organizations, mostly expanding hospital systems. They see the decline of small group practice and the professional autonomy of earlier years diminished. They see an increasingly fragmented system with erosion of continuity of care amidst frequent changes of insurance coverage, narrowed and changing networks, and patients losing choice of physicians and hospitals. And they hear about earlier retirements and increasing burnout of physicians trying to keep up with the paperwork and bureaucracy of today's multi-payer, largely for-profit system.

Medical students and their colleagues in other health professions are looking for a simplified system with universal access for all Americans to necessary care based on the principle that health care is a human right. That approach has been adopted for many years, in one way or another, by almost all advanced countries, while the U. S. remains by far the most expensive system with worse access and quality of care than most of these countries.

A sizable majority of Americans have favored national health insurance for many years, usually including about three of five respondents to national surveys. A 2008 survey of more than 2,200 U. S. physicians in 13 specialties also favored NHI. (Carroll, AE, Ackermann, RT. Support for national health insurance among U. S. physicians: five years later. Ann Intern Med 1481: 566-6-567, 2008). Activist positions for single-payer NHI have been taken in recent years by a growing number of leaders of professional organizations, including prominent members of the American College of Physicians, the American Society of Clinical Oncology, the American Psychiatric Association, the American Women's Medical Association, the American Public Health Association, the American Nurses Association, and National Nurses United. Jean Ross, co-president of National Nurses United, recently had this to say about the rapidly increasing insurance premiums in 2017 under the Affordable Care Act:

The [just announced] premium increases are outrageous and just the
most recent sign of a broken, dysfunctional healthcare system. (2)

Medical students and other young health professionals are right in calling single-payer national health insurance (NHI), or Medicare for All, an urgent need. They are the future of health care in this country. Those of us in older generations welcome their empathy and caring in leading toward health care reform. NHI, as soon as it is enacted, will deliver a better system for both patients and health professionals--one based on a service ethic that will transition over 15 years to a not-for-profit system. It would have simplified administration allowing physicians and other health professionals more time for direct patient care, the essential purpose of the medical profession.

1. Carroll, AE, Ackermann, RT. Support for national health insurance among U. S. physicians: five years later. Ann Intern Med 1481: 566-6-567, 2008

2. Queally, J. 'Get the insurance companies the hell out' of our health care system. Common Dreams, October 25, 2016

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