Ryan Crowley, BSJ; Hilary Daniel, BS; Thomas G. Cooney, MD; Lee S. Engel, MD; for the Health and Public Policy Committee of the American College of Physicians *
Financial Support: Financial support for the development of this position paper came exclusively from the ACP operating budget.
Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M19-2415.
Editors' Disclosures: Christine Laine, MD, MPH, Editor in Chief, reports that her spouse has stock options/holdings with Targeted Diagnostics and Therapeutics. Darren B. Taichman, MD, PhD, Executive Editor, reports that he has no financial relationships or interests to disclose. Cynthia D. Mulrow, MD, MSc, Senior Deputy Editor, reports that she has no relationships or interests to disclose. Jaya K. Rao, MD, MHS, Deputy Editor, reports that she has stock holdings/options in Eli Lilly and Pfizer. Christina C. Wee, MD, MPH, Deputy Editor, reports employment with Beth Israel Deaconess Medical Center. Sankey V. Williams, MD, Deputy Editor, reports that he has no financial relationships or interests to disclose. Yu-Xiao Yang, MD, MSCE, Deputy Editor, reports that he has no financial relationships or interest to disclose.
Corresponding Author: Ryan Crowley, BSJ, American College of Physicians, 25 Massachusetts Avenue NW, Suite 700, Washington, DC 20001; e-mail, firstname.lastname@example.org.
Current Author Addresses: Mr. Crowley and Ms. Daniel: American College of Physicians, 25 Massachusetts Avenue NW, Suite 700, Washington, DC 20001.
Dr. Cooney: Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239.
Dr. Engel: Louisiana State University Health Sciences Center, 1542 Tulane Avenue, New Orleans, LA 70112.
Author Contributions: Conception and design: R. Crowley, H. Daniel.
Analysis and interpretation of the data: R. Crowley, H. Daniel, T.G. Cooney, L.S. Engel.
Drafting of the article: R. Crowley, H. Daniel, L.S. Engel.
Critical revision of the article for important intellectual content: R. Crowley, H. Daniel, T.G. Cooney, L.S. Engel.
Final approval of the article: R. Crowley, H. Daniel, T.G. Cooney, L.S. Engel.
Administrative, technical, or logistic support: R. Crowley, H. Daniel.
Collection and assembly of data: R. Crowley, H. Daniel.
This paper is part of the American College of Physicians' policy framework to achieve a vision for a better health care system, where everyone has coverage for and access to the care they need, at a cost they and the country can afford. Currently, the United States is the only wealthy industrialized country that has not achieved universal health coverage. The nation's existing health care system is inefficient, unaffordable, unsustainable, and inaccessible to many. Part 1 of this paper discusses why the United States needs to do better in addressing coverage and cost. Part 2 presents 2 potential approaches, a single-payer model and a public choice model, to achieve universal coverage. Part 3 describes how an emphasis on value-based care can reduce costs.
American College of Physicians vision statements related to coverage and cost of care.
Table. Health Insurance System Models
Appendix Table. Prominent “Transformational” Proposals to Achieve Universal Coverage in the United States
January 22, 2020
If anyone thinks a single payor is the fix all for healthcare, they are seriously delusional. Merely pointing out how poorly and expensively Healthcare is run, that more government regulation(or proper lack there of) which is mainly the reason it runs like an over bloated inefficient and disastrously expensive, does not solve any problems. It just guarantees everyone will get thrown into the same line at the DMV. Bragging about saving will be glorified while politicians can feel enthralled claiming "EVERYONE NOW HAS GUARANTEED HEALTHCARE while hiding actually real outcomes in the bureaucracy. Only those who are going to at the top of these institutions and not in the trenches will get a voice and the rest of us in the trenches will suffer trying to make bricks without straw!
Crowley R, Daniel H, Cooney TG, et al, for the Health and Public Policy Committee of the American College of Physicians. Envisioning a Better U.S. Health Care System for All: Coverage and Cost of Care. Ann Intern Med. 2020;172:S7–S32. doi: https://doi.org/10.7326/M19-2415
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Published: Ann Intern Med. 2020;172(2_Supplement):S7-S32.
Healthcare Delivery and Policy, Hospital Medicine.
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