Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Internists diagnose health-care system ills, show how to achieve universal coverage

04.12.2007
Second largest physician group in U.S provides evidence-based recommendations after analyzing health care systems in 12 industrialized countries
In a new evidence-based paper, the American College of Physicians (ACP) analyzes health care in the United States and 12 other industrialized countries and identifies lessons that could be applied to the particular political and social culture of the United States to achieve a high performing health care system, including achieving universal health insurance coverage for all Americans.

“As the nation’s largest medical specialty organization, the American College of Physicians is uniquely qualified to inform the public debate and the presidential campaign about reforming the U.S. health care system,” said ACP President David C. Dale, MD, FACP.

“A growing number of studies by health policy experts have exposed the limitations of the U.S. health care system.

“Our recommendations provide evidence-based solutions to our country’s many health care problems – including the appalling lack of access to affordable heath coverage, the impending crisis caused by the insufficient supply of primary care physicians, rising health care costs, and excessive administrative and regulatory costs.”

In the paper, "Achieving a High Performance Health Care System with Universal Access: What the USA Can Learn from Other Countries," published on the Web site of ACP’s flagship journal, Annals of Internal Medicine, ACP notes that spending on health care in the United States is the highest in the world and has been rising at a faster pace than spending in the rest of the economy.

Yet an estimated 47 million Americans – nearly 16 percent of the population – lack health insurance protection. Even among those with health insurance coverage, wide variations exist in terms of cost, utilization, quality, and access to health care services.

Based upon the lessons learned from a review of health care systems in 12 industrialized countries, ACP makes eight recommendations to improve health care in the United States:

1. Proide universal health insurance coverage to ensure that all residents have equitable access to appropriate health care without unreasonable financial barriers. Health insurance coverage and benefits should be continuous and not dependent on place of residence or employment status.

ACP calls on policymakers to consider adopting one of the following two pathways to achieve universal coverage:

  • a pluralistic system in which government entities as well as not-for-profit and private, for-profit organizations ensure universal access while allowing individuals the freedom to purchase private supplemental coverage. An advantage of a pluralistic system is that it builds on the current American approach to provision of health services. The disadvantages of this system are that it is likely to result in inequalities in coverage and higher administrative costs, both of which are features of our current system. To be successful, pluralistic financing models need to provide a legal guarantee that all individuals have access to coverage and sufficient government subsidies to pay for coverage for those who cannot otherwise afford it.

  • a single-payer system in which one government entity is the sole third-party payer of health care costs. The advantages of single-payer systems are that they generally are more equitable, have lower administrative costs, have lower per capita health care expenditures, have higher levels of patient satisfaction, and have higher performance on measures of quality and access than systems using private health insurance. The disadvantages of this system include potential shortages of services subject to price controls and delays in obtaining elective procedures. The financial model for a single-payer system must be flexible and expandable, given the projected growth in the population of the elderly and expected advances in medical science and technology.

    In the new paper, ACP offers a comprehensive analysis of the advantages and disadvantages of pluralistic systems (Australia, Belgium, Denmark, France, Germany, Netherlands, New Zealand, and Switzerland) and single-payer systems (Canada, Japan, Taiwan, and the United Kingdom).

    “The American College of Physicians does not want to replicate what other countries do,” said Joel S. Levine, MD, FACP, chair of ACP’s Board of Regents. “We try to identify approaches that the evidence shows are more likely to be effective and that ultimately will result in a health care system that is fair, cost effective, and efficient.”

    ACP further calls on policymakers to:

    2. create incentives to encourage patients to be prudent purchasers by having access to health information necessary for informed decision-making;

    3. avert a collapse of primary care by developing a national workforce policy that ensures an adequate supply of physicians trained to manage care for the whole patient;

    4. redirect federal health care policy toward supporting the patient-centered medical home, an innovative practice system designed to strengthen the physician-patient relationship by having a primary care physician coordinate a team of health care professionals as they address the full range of a patient’s needs;

    5. provide financial incentives for physicians for care coordination, disease prevention, and achievement of evidence-based performance standards;

    6. reduce the costs of health care administration by creating a uniform billing system for all services;

    7. support with federal funds an inter-operable health information technology infrastructure;

    8. encourage public and private investment in medical research and assessments of the comparative effectiveness of different medical treatments;

    “The American College of Physicians has a long-standing commitment to improving health care in the U.S.,” said J. Fred Ralston, MD, FACP, chair of ACP’s Health and Public Policy Committee, and an author of the paper.

    “A recent survey by the Commonwealth Fund of adults in seven industrialized nations indicates that Americans share ACP’s view that the U.S. health care system is inefficient and could be greatly improved by providing access for all Americans to a primary care physician for continuous, comprehensive, coordinated care.”

    The Commonwealth Fund survey found that that U.S. patients are more likely to report experiencing medical errors, go without care because of costs, and say that the health care system needs to be rebuilt completely. As medical care becomes more specialized and complex, adults in all seven countries said they place high value on having a relationship with a primary care or personal physician who is accessible and coordinates their care.

    Patients with this model of care – a patient-centered medical home, which ACP proposes – reported significantly more positive experiences, including having more time with their doctors, more involvement in care decisions, and better coordination with specialists and hospitals. They were also much less likely to report medical errors, receiving conflicting information from different doctors or to encounter coordination problems, such as diagnostic tests or medical records not being available at the time of care and duplicate tests.

    In an accompanying editorial, Harold C. Sox, MD, MACP, editor of Annals of Internal Medicine, notes that the paper “recommends that the country seriously consider a single payer system as one way to provider universal access to health care. Countries have achieved universal access with pluralistic systems, not unlike our own. Both can achieve the greater end that should be our highest priority: equal access to basic health care for every citizen.”

    Stephen Majewski | EurekAlert!
    Further information:
    http://www.acponline.org
    http://www.annals.org

  • More articles from Health and Medicine:

    nachricht Team discovers how bacteria exploit a chink in the body's armor
    20.01.2017 | University of Illinois at Urbana-Champaign

    nachricht Rabies viruses reveal wiring in transparent brains
    19.01.2017 | Rheinische Friedrich-Wilhelms-Universität Bonn

    All articles from Health and Medicine >>>

    The most recent press releases about innovation >>>

    Die letzten 5 Focus-News des innovations-reports im Überblick:

    Im Focus: Traffic jam in empty space

    New success for Konstanz physicists in studying the quantum vacuum

    An important step towards a completely new experimental access to quantum physics has been made at University of Konstanz. The team of scientists headed by...

    Im Focus: How gut bacteria can make us ill

    HZI researchers decipher infection mechanisms of Yersinia and immune responses of the host

    Yersiniae cause severe intestinal infections. Studies using Yersinia pseudotuberculosis as a model organism aim to elucidate the infection mechanisms of these...

    Im Focus: Interfacial Superconductivity: Magnetic and superconducting order revealed simultaneously

    Researchers from the University of Hamburg in Germany, in collaboration with colleagues from the University of Aarhus in Denmark, have synthesized a new superconducting material by growing a few layers of an antiferromagnetic transition-metal chalcogenide on a bismuth-based topological insulator, both being non-superconducting materials.

    While superconductivity and magnetism are generally believed to be mutually exclusive, surprisingly, in this new material, superconducting correlations...

    Im Focus: Studying fundamental particles in materials

    Laser-driving of semimetals allows creating novel quasiparticle states within condensed matter systems and switching between different states on ultrafast time scales

    Studying properties of fundamental particles in condensed matter systems is a promising approach to quantum field theory. Quasiparticles offer the opportunity...

    Im Focus: Designing Architecture with Solar Building Envelopes

    Among the general public, solar thermal energy is currently associated with dark blue, rectangular collectors on building roofs. Technologies are needed for aesthetically high quality architecture which offer the architect more room for manoeuvre when it comes to low- and plus-energy buildings. With the “ArKol” project, researchers at Fraunhofer ISE together with partners are currently developing two façade collectors for solar thermal energy generation, which permit a high degree of design flexibility: a strip collector for opaque façade sections and a solar thermal blind for transparent sections. The current state of the two developments will be presented at the BAU 2017 trade fair.

    As part of the “ArKol – development of architecturally highly integrated façade collectors with heat pipes” project, Fraunhofer ISE together with its partners...

    All Focus news of the innovation-report >>>

    Anzeige

    Anzeige

    Event News

    Sustainable Water use in Agriculture in Eastern Europe and Central Asia

    19.01.2017 | Event News

    12V, 48V, high-voltage – trends in E/E automotive architecture

    10.01.2017 | Event News

    2nd Conference on Non-Textual Information on 10 and 11 May 2017 in Hannover

    09.01.2017 | Event News

     
    Latest News

    Helmholtz International Fellow Award for Sarah Amalia Teichmann

    20.01.2017 | Awards Funding

    An innovative high-performance material: biofibers made from green lacewing silk

    20.01.2017 | Materials Sciences

    Ion treatments for cardiac arrhythmia — Non-invasive alternative to catheter-based surgery

    20.01.2017 | Life Sciences

    VideoLinks
    B2B-VideoLinks
    More VideoLinks >>>