Straight TalkA weekly update from management on the issues that matter most. Aug 30, 2018 Amazingly, the American Medical Association, led by its younger members, has embraced a single payer solution. “Doctors Used to Be the Greatest Opponents of Universal Health Care. Now They’re Embracing It,” is the title of an article from Money Magazine earlier this month that included the following: “Meanwhile, lots of countries achieve universal health care—everyone is covered somehow—but the method can vary. For example, France requires all citizens purchase coverage, which is sold through nonprofits. In Germany, most people get insurance from a government-run ‘public option,’ while others purchase private plans. In England, health care is provided through the tax-funded National Health System. American skeptics often use the phrase ‘socialized medicine’ pejoratively to describe all of these models.” Many agree we cannot sustain the current rate of spending and still have a viable economy in a globally competitive world. Recently shared examples include France’s spending 11.6% of GDP on health and 9.7% on education compared to America’s spending 17.9% of GDP on health and 5% on education. Obviously, if the U.S. can shift resources to education, environment, and other worthwhile endeavors, everyone will be better off long-term. The New England Journal of Medicine Catalyst January 2018 article, entitled “Why Clinicians Support Single Payer—Who Will Win and Lose,” shares the following: “Still, support among the public and some parts of the health care community is growing, and medical providers are showing particularly strong enthusiasm.” In a recent NEJM Catalyst Insights Council survey of executives, clinical leaders, and clinicians, nearly half of respondents (49%) identify single payer as the best outcome for future payment reform. Support is greatest among clinicians (55%) whereas only 39% of healthcare executives say they want it. https://catalyst.nejm.org/clinicians-support-single-payer-win-lose/ Variations of “single payer” range from Medicare-for-All to Canada’s model of national health insurance. Guaranteeing all legal residents regardless of age, health status, income, or occupation core medical services as well as reducing administrative expenses and concentrating purchasing power are not only an admirable goals but also noteworthy gains because healthy people are more productive and utilize fewer healthcare resources. An efficient system focused on prevention would quickly add value. Our current system spends overwhelmingly on treating disease. With a long-term view, our nation could move spending forward to prevention rather than treating complications of self-induced disease. Medical costs are reduced by approximately $3.27 for every dollar spent on workplace wellness programs according to the Surgeon General. Avoiding tobacco and obesity is cheaper and better than treating complications. Behavioral economics combined with nudging people to healthier habits in an environment conducive to wellness would create a more productive society. https://www.surgeongeneral.gov/priorities/prevention/strategy/appendix1.pdf Holding us back is a house of cards of five mutually interdependent entities, all of which would be disrupted by a single payer model: (1) physicians/non-physician providers; (2) hospitals/healthcare systems; (3) drug companies; (4) device manufacturers; and (5) health insurance companies. The altruistic, self-motivated, efficient caregivers and entities would flourish whereas selfish, mercenary, and wasteful players and systems would vanish. Our society and the healthcare industry are ripe for change with the common goal of helping everyone live a longer, happier, and healthier life. P.S. DO YOU HAVE A COLLEAGUE OR FRIEND WHO WOULD BE INTERESTED IN UPDATES? Please enter their email address at nchmd.org/straighttalk, and we will add them to our complimentary mailing list.