I’m an American Medical Association member. My leadership’s opposition to single-payer healthcare is uninformed and possibly deceptive.
At last week’s meeting, Dr. Daniel Johnson, former AMA president, asked “What is best for patients?” The AMA should not confuse this question with “What is best for physicians?” The questions differ. The answers conflict. The AMA should not pretend otherwise.
Dr. Barbara McAneny, the outgoing AMA president, exacerbates this conflict when she refers to AMA support of “pluralism, freedom of choice, freedom of practice, and universal access for patients.” But physician freedom to reject patients with poor insurance differs from patient freedom to choose physicians. Pluralism of insurance differs from universal access.
Single-payer plans do indeed restrict physician practice by eliminating competition among insurers. Single-payer plans instead create uniform benefits and physician fees. Both compromise physician ability to maximize income.
But single-payer plans do benefit patients. They guarantee access regardless of employment or finances. They reduce patient costs (healthcare taxes, premiums and out-of-pocket payments). They improve outcomes by promoting primary and preventive care. They even provide modest benefits to physicians. Their expenses decrease when every patient becomes a paying patient. Professional costs plummet. But not all physicians consider this benefit worth the compromised income potential.
Every single-payer system provides better care to more people for less money than the dysfunctional, employer-dependent, multirisk-pool American system reinforced by the Affordable Care Act and supported by the AMA.
Even at risk to my income, I want the AMA to acknowledge single-payer. If it won’t, integrity demands that it cite real physician benefits, not specious patient benefits.
Dr. Samuel Metz
Oregon Physicians for a National Health Program
Portland, Ore.
