Physicians for a National Health Program
Per capita U.S. spending on health care is nearly twice that of any other country. Yet our health statistics are comparatively poor-life expectancy in the U.S. is 27th in the world and 45 million of our citizens go without health insurance (see US Health Care Spending In An International Context). The discrepancy between what we spend and what our health care system provides is clearly related to the fact that, alone among the advanced countries, we lack a national health care program. Our dependence on private, employer-based insurance is unique, and our system is failing-its costs rising by 10% or more each year, and its coverage declining, with less than 45% of private sector workers covered.
Physicians for a National Health Program, an organization of physicians, health care professionals, and concerned individuals, was founded in 1987 to work for a universal comprehensive national health insurance program. Current membership is over 10,000, with chapters throughout the country. The group has worked with Congressman John Conyers to develop H.R. 676, The United States National Health Insurance Act.
PNHP’s proposal for a national health care program was first outlined in a 1989 article in the New England Journal of Medicine. PNHP proposes what is called a “single payer” plan, a system of healthcare that is publicly funded but delivered largely by private entities. The latest version of their plan is the Proposal of the Physicians Working Group for Single Payer National Health Insurance, published in JAMA and endorsed by more than 12,000 physicians. PNHP argues that savings in administrative costs through adopting this efficient financing mechanism-very similar to what the U.S. has today in the Medicare program-would allow everyone to be covered, at no additional cost (see, for instance, “Paying for a Single Payer National Health Insurance Program: Where Will the Money Come From?”, a Forum Report from the NY Metro Chapter.
By international standards, single payer is not a very radical plan; many countries have similar plans, and poll after poll show that two-thirds of the American people would support it. But the continual refrain from the media that it isn’t “politically feasible” keeps it from gaining wider attention. For a lively description of single payer, see this animated presentation.
PNHP has been critical of the idea that marketplace solutions are the answer to the current healthcare problems in the U.S. In part, this criticism has been based on the failures of “actually existing” profit-driven medicine. “Mayhem in the Medical Marketplace” an article in Monthly Review by PNHP’s David U. Himmelstein and Steffie Woolhandler, gives a succinct overview of the current problems with market medicine in the U.S. We know that for-profit medicine is associated with poor quality care, vast amounts of fraud, radically higher administrative costs for paperwork, marketing, profits, and obscenely high CEO compensation, as well as a variety of practices meant to increase profits at the expense of clinical care. (Many of these issues have been discussed in a multiple articles by Drs. Himmelstein and Woolhander in the New England Journal of Medicine).
Other organizations are working for universal health care in the U.S. A principal one is UHCAN, the Universal Health Care Action Network, which brings together state and local health care activists around a range of health care reform issues.
PNHP members are active in writing, speaking and advocacy. Their national website (www.pnhp.org) offers a wealth of information and opportunities for taking action in support of a single-payer plan. In addition you can join their “quote of the day” listserv which provides critical analysis of health-related issues.
The New York Metro Chapter of PNHP is runs lively monthly forums, publishes Forum Reports and Issue Papers, and provides speaker training, grand rounds speakers, and other activities. Medical students and residents are active in the Chapter, with Chapter sub-groups on each of the medical school campuses in the New York area. See the Chapter’s web site, for ongoing programs, publications, and contact information.
- Leonard Rodberg and Matthew Anderson
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