The second-largest physician group in the United States on Monday endorsed single-payer healthcare system reform to achieve universal insurance coverage.
The American College of Physicians has expressed openness to a single-payer system before, but this is the first time the group has explicitly recommended a transition to single-payer. ACP also endorsed a universally available public insurance option in April.
ACP's definitive endorsement of a single-payer system is the latest indication of a sea change on the idea in the physician world.
The American Medical Association House of Delegates narrowly voted 53% to 47% in June to maintain the group's opposition to a single-payer system. The AMA dropped out of a national healthcare industry coalition vehemently opposed to any form of single-payer or public insurance reform.
ACP senior vice president Robert Doherty said ACP released its policy framework intentionally for discussion in political debates in the 2020 election cycle. The medical specialty society still envisions a limited potential role for private supplemental insurance in its preferred single-payer model, and supports a public insurance option available to all, including individuals with employer-sponsored insurance.
"We planned to release it now, in early 2020 because we want it to have an influence. We will not endorse a candidates' plan, but any candidate out there would be able to look at recommendations," Doherty said.
ACP also plans to send its paper to the AMA Council of Medical Service to inform the panel's research on a public insurance option. ACP offered a resolution that called for broad approval of a public option program last summer in the House of Delegates, but the issue was referred for further study.
The group argued government involvement is necessary to reduce administrative costs, ensure coverage is available regardless of employment status, guarantee essential benefits and prevent discrimination.
"We found that market-based approaches would not achieve key policy objectives," policy paper authors Ryan Crowley, Hilary Daniel, Thomas Cooney and Lee Engel wrote for ACP.
All-payer rate setting for hospitals and reference pricing for some elective healthcare products and services could still be options to lower healthcare costs even if policymakers eschew more comprehensive reforms.
"We would recommend expanding on those approaches even without expanding coverage. Those policies can be implemented on their own or in conjunction with other," Doherty said.
