{"id":613962,"date":"2018-08-17T09:00:35","date_gmt":"2018-08-17T15:00:35","guid":{"rendered":"http:\/\/nmpolitics.net\/index\/?p=613962"},"modified":"2018-08-16T16:25:53","modified_gmt":"2018-08-16T22:25:53","slug":"once-its-greatest-foes-doctors-are-embracing-single-payer","status":"publish","type":"post","link":"https:\/\/nmpolitics.net\/index\/2018\/08\/once-its-greatest-foes-doctors-are-embracing-single-payer\/","title":{"rendered":"Once its greatest foes, doctors are embracing single-payer"},"content":{"rendered":"<div id=\"attachment_613971\"  class=\"wp-caption module image alignnone\" style=\"max-width: 771px;\"><a href=\"https:\/\/www.flickr.com\/photos\/taedc\/32985974711\/in\/photolist-SfRK4V-6DoDBi-jSRqA6-7S1kNE-7S1dHY-7S1mpG-e7nWHU-7TX9UE-s9iZcn-7RX3L4-e7hhqD-e7hhva-jSRM5T-e7nVNC-6DsR9y-bsGE91-6DsQdE-7KtaAM-e7nZKS-7fCWFr-9z8tCw-9yNAUc-e7hkCn-e7hk8z-6PY6ur-e7hjNP-e7hgZc-7dAkSB-6TZBLc-e7nZW9-7fCU1k-7fCWjt-7Kx6Qb-e7hijn-bsGEZj-7S1ovq-9z5G36-bCyCvE-7fGNnh-e7nWvJ-7fGR8h-7fCUNH-7KxgkA-euLi5x-7Ktaxg-7S1mjU-7KxdqS-e7hkdv-e7hjda-euPukA\" target=\"_blank\" rel=\"noopener\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-613971 size-large\" src=\"http:\/\/nmpolitics.net\/index\/wp-content\/uploads\/2018\/08\/Health-care-for-all-771x489.jpg\" alt=\"ACA rally\" width=\"771\" height=\"489\" srcset=\"https:\/\/nmpolitics.net\/index\/wp-content\/uploads\/2018\/08\/Health-care-for-all-771x489.jpg 771w, https:\/\/nmpolitics.net\/index\/wp-content\/uploads\/2018\/08\/Health-care-for-all-336x213.jpg 336w, https:\/\/nmpolitics.net\/index\/wp-content\/uploads\/2018\/08\/Health-care-for-all-768x487.jpg 768w, https:\/\/nmpolitics.net\/index\/wp-content\/uploads\/2018\/08\/Health-care-for-all-1170x742.jpg 1170w, https:\/\/nmpolitics.net\/index\/wp-content\/uploads\/2018\/08\/Health-care-for-all.jpg 1200w\" sizes=\"auto, (max-width: 771px) 100vw, 771px\" \/><\/a><p class=\"wp-media-credit\">Ted Eytan \/ Flickr.com<\/p><p class=\"wp-caption-text\">A scene from a rally in support of the Affordable Care Act in Washington, D.C. in 2017.<\/p><\/div>\n<p>When the American Medical Association \u2014 one of the nation\u2019s most powerful health care groups \u2014 met in Chicago this June, its medical student caucus seized an opportunity for change.<\/p>\n<p>Though they had tried for years to advance a resolution calling on the organization to drop its decades-long opposition to single-payer health care, this was the first time it got a full hearing. The debate grew heated \u2014 older physicians warned their pay would decrease, calling younger advocates na\u00efve to single-payer\u2019s consequences. But this time, by the meeting\u2019s end, the AMA\u2019s older members had agreed to at least study the possibility of changing its stance.<\/p>\n<p>\u201cWe believe health care is a human right, maybe more so than past generations,\u201d said Dr. Brad Zehr, a 29-year-old pathology resident at Ohio State University, who was part of the debate. \u201cThere\u2019s a generational shift happening, where we see universal health care as a requirement.\u201d<\/p>\n<p>The ins and outs of the AMA\u2019s policymaking may sound like inside baseball. But this year\u2019s youth uprising at the nexus of the medical establishment speaks to a cultural shift in the medical profession, and one with big political implications.<\/p>\n<aside class=\"module align-left half type-aside\">\n<h3>About this article<\/h3>\n<p>This articles comes from\u00a0<a href=\"https:\/\/khn.org\/news\/once-its-greatest-foes-doctors-are-embracing-single-payer\/\" target=\"_blank\" rel=\"noopener\">Kaiser Health News<\/a>,\u00a0is a nonprofit news service covering health issues. It is an editorially independent program of the Kaiser Family Foundation that is not affiliated with Kaiser Permanente.<\/p>\n<\/aside>\n<p>Amid Republican attacks on the Affordable Care Act, an increasing number of Democrats \u2014 ranging from candidates to established Congress members \u2014 are putting forth proposals that would vastly increase the government\u2019s role in running the health system.<\/p>\n<p>These include single-payer, Medicare-for-all or an option for anyone to buy in to the Medicare program. At least\u00a0<a href=\"https:\/\/www.thedailybeast.com\/70-democrats-sign-on-to-new-medicare-for-all-house-caucus\" target=\"_blank\" rel=\"noopener\">70 House Democrats<\/a>\u00a0have signed on to the new \u201cMedicare-for-all\u201d caucus.<\/p>\n<p>Organized medicine, and previous generations of doctors, had for the most part staunchly opposed to any such plan. The AMA has thwarted public health insurance proposals since the 1930s and long been considered one of the policy\u2019s most powerful opponents.<\/p>\n<p>But the battle lines are shifting as younger doctors flip their views, a change that will likely assume greater significance as the next generation of physicians takes on leadership roles. The AMA did not make anyone available for comment.<\/p>\n<p>Many younger physicians are \u201caccepting of single-payer,\u201d said Dr. Christian Pean, 30, a third-year orthopedic surgery resident at New York University.<\/p>\n<p>In prior generations, \u201cintelligent, motivated, quantitative\u201d students pursued medicine, both for the income and because of the workplace independence \u2014 running practices with minimal government interference, said Dr. Steven Schroeder, 79, a longtime medical professor at the University of California-San Francisco.<\/p>\n<p>In his 50 years of teaching, students\u2019 attitudes have changed: \u201cThe \u2018Oh, keep government out of my work\u2019 feeling is not as strong as it was with maybe older cohorts,\u201d said Schroeder. \u201cStudents come in saying, \u2018We want to make a difference through social justice. That\u2019s why we\u2019re here.\u2019\u201d<\/p>\n<p>Though \u201csingle-payer\u201d health care was long dismissed as a left-wing pipe dream, polling\u00a0<a href=\"https:\/\/www.washingtonpost.com\/news\/the-fix\/wp\/2018\/04\/12\/about-half-of-americans-support-single-payer-health-care\/\" target=\"_blank\" rel=\"noopener\">suggests<\/a>\u00a0a slim majority of Americans now support the idea \u2014 though it is not clear people know what the term means.<!--more--><\/p>\n<p>A full single-payer system means everyone gets coverage from the same insurance plan, usually sponsored by the government. Medicare-for-all, a phrase that gained currency with the presidential campaign of Sen. Bernie Sanders (I-Vt.), means everyone gets Medicare, but, depending on the proposal, it may or may not allow private insurers to offer Medicare as well. (Sanders\u2019 plan, which eliminates deductibles and expands benefits, would get rid of private insurers.)<\/p>\n<p>Meanwhile, lots of countries achieve universal health care \u2014 everyone is covered somehow \u2014 but the method can vary. For example, France requires that all citizens purchase coverage, which is sold through nonprofits. In Germany, most people get insurance from a government-run \u201cpublic option,\u201d while others purchase private plans. In England, health care is provided through the tax-funded National Health System.<\/p>\n<p>American skeptics often use the phrase \u201csocialized medicine\u201d pejoratively to describe all of these models.<\/p>\n<p>\u201cFew really understand what you mean when you say single-payer,\u201d said Dr. Frank Opelka, the medical director of quality and health policy for the American College of Surgeons, which opposes such a policy. \u201cWhat they mean is, \u2018I don\u2019t think the current system is working.\u2019\u201d<\/p>\n<p>But the willingness to explore previously unthinkable ideas is evident in young doctors\u2019 ranks.<\/p>\n<p>Recent surveys through\u00a0<a href=\"https:\/\/www.linkedin.com\/pulse\/insurance-driving-physicians-mad-nearly-half-now-say-theyd-kutscher\/\" target=\"_blank\" rel=\"noopener\">LinkedIn<\/a>, recruiting firm\u00a0<a href=\"https:\/\/khn.org\/news\/doctors-warm-to-single-payer-health-care\/\" target=\"_blank\" rel=\"noopener\">Merritt Hawkins<\/a>\u00a0and trade publication\u00a0<a href=\"https:\/\/catalyst.nejm.org\/clinicians-support-single-payer-win-lose\/\" target=\"_blank\" rel=\"noopener\">NEJM Catalyst<\/a>\u00a0indicate growing support. In the March NEJM survey, 61 percent of 607 respondents said single-payer would make it easier to deliver cost-effective, quality health care.<\/p>\n<p>Delving further, that survey data shows support is stronger among younger physicians, said Dr. Namita Mohta, a hospitalist at Brigham and Women\u2019s Hospital and clinical editor at NEJM Catalyst.<\/p>\n<p>But it\u2019s unclear whether these findings reflect young doctors\u2019 feelings about the policy or whether they are tapping in to broader frustrations with the American health system.<\/p>\n<p>Much like the general public, doctors often use terms like single-payer, Medicare-for-all and universal health care interchangeably.<\/p>\n<p>\u201cOur younger generation is less afraid to come out and say we want universal health care,\u201d said Dr. Anna Yap, 26, an emergency medicine resident at UCLA, who served as a medical student delegate to the AMA until this past June. \u201cBut how? It\u2019s different in what forms we see.\u201d<\/p>\n<p>Younger doctors also pointed to growing concern about how best to keep patients healthy. They cited research that broadly suggests having health insurance tracks with better health outcomes.<\/p>\n<p>\u201cMedical students, I would say, are very interested in public health and improving social determinants of health \u2014 one of them being access to health insurance,\u201d said Dr. Jerome Jeevarajan, 26, a neurology resident at the University of Texas-Houston, referring to non-medical factors that improve health, such as food or housing.<\/p>\n<p>Some of the shift in opinion has to do with the changing realities of medical practice. Doctors now are more likely to end up working for large health systems or hospitals, rather than starting individual practices. Combined with the increasing complexity of billing private insurance, many said, that means contracting with the government may feel like less of an intrusion.<\/p>\n<p>The debate is, at this point, still theoretical. Republicans \u2014 who control all branches of the federal government \u2014 sharply oppose single-payer. Meanwhile, single-state efforts in California, Colorado and New York have fallen flat.<\/p>\n<p>Also, doctors represent only one part of the sprawling health care industrial complex. Other health care interests \u2014 including private insurance, the drug industry and hospital trade groups \u2014 have been slower to warm to catchphrases like single-payer or universal health care, all of which would likely mean a drop in income.<\/p>\n<p>But increasingly physicians seem to be switching sides in the debate, and young physicians want to be part of the discussion.<\/p>\n<p>\u201cThere\u2019s tremendous potential \u2026 to be at the table if single-payer becomes a significant part of the political discourse, and create a system that is more equitable,\u201d Pean said.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Younger doctors are flipping long-held views in their profession.<\/p>\n","protected":false},"author":1,"featured_media":613971,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[11],"tags":[117],"class_list":["post-613962","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-news-and-analysis","tag-health-care"],"_links":{"self":[{"href":"https:\/\/nmpolitics.net\/index\/wp-json\/wp\/v2\/posts\/613962","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/nmpolitics.net\/index\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/nmpolitics.net\/index\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/nmpolitics.net\/index\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/nmpolitics.net\/index\/wp-json\/wp\/v2\/comments?post=613962"}],"version-history":[{"count":0,"href":"https:\/\/nmpolitics.net\/index\/wp-json\/wp\/v2\/posts\/613962\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/nmpolitics.net\/index\/wp-json\/wp\/v2\/media\/613971"}],"wp:attachment":[{"href":"https:\/\/nmpolitics.net\/index\/wp-json\/wp\/v2\/media?parent=613962"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/nmpolitics.net\/index\/wp-json\/wp\/v2\/categories?post=613962"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/nmpolitics.net\/index\/wp-json\/wp\/v2\/tags?post=613962"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}