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 Researchers release the brakes on the immune system
    18.10.2017 | Rheinische Friedrich-Wilhelms-Universität Bonn

    nachricht Norovirus evades immune system by hiding out in rare gut cells
    12.10.2017 | University of Pennsylvania School of Medicine

    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: Neutron star merger directly observed for the first time

    University of Maryland researchers contribute to historic detection of gravitational waves and light created by event

    On August 17, 2017, at 12:41:04 UTC, scientists made the first direct observation of a merger between two neutron stars--the dense, collapsed cores that remain...

    Im Focus: Breaking: the first light from two neutron stars merging

    Seven new papers describe the first-ever detection of light from a gravitational wave source. The event, caused by two neutron stars colliding and merging together, was dubbed GW170817 because it sent ripples through space-time that reached Earth on 2017 August 17. Around the world, hundreds of excited astronomers mobilized quickly and were able to observe the event using numerous telescopes, providing a wealth of new data.

    Previous detections of gravitational waves have all involved the merger of two black holes, a feat that won the 2017 Nobel Prize in Physics earlier this month....

    Im Focus: Smart sensors for efficient processes

    Material defects in end products can quickly result in failures in many areas of industry, and have a massive impact on the safe use of their products. This is why, in the field of quality assurance, intelligent, nondestructive sensor systems play a key role. They allow testing components and parts in a rapid and cost-efficient manner without destroying the actual product or changing its surface. Experts from the Fraunhofer IZFP in Saarbrücken will be presenting two exhibits at the Blechexpo in Stuttgart from 7–10 November 2017 that allow fast, reliable, and automated characterization of materials and detection of defects (Hall 5, Booth 5306).

    When quality testing uses time-consuming destructive test methods, it can result in enormous costs due to damaging or destroying the products. And given that...

    Im Focus: Cold molecules on collision course

    Using a new cooling technique MPQ scientists succeed at observing collisions in a dense beam of cold and slow dipolar molecules.

    How do chemical reactions proceed at extremely low temperatures? The answer requires the investigation of molecular samples that are cold, dense, and slow at...

    Im Focus: Shrinking the proton again!

    Scientists from the Max Planck Institute of Quantum Optics, using high precision laser spectroscopy of atomic hydrogen, confirm the surprisingly small value of the proton radius determined from muonic hydrogen.

    It was one of the breakthroughs of the year 2010: Laser spectroscopy of muonic hydrogen resulted in a value for the proton charge radius that was significantly...

    All Focus news of the innovation-report >>>

    Anzeige

    Anzeige

    Event News

    ASEAN Member States discuss the future role of renewable energy

    17.10.2017 | Event News

    World Health Summit 2017: International experts set the course for the future of Global Health

    10.10.2017 | Event News

    Climate Engineering Conference 2017 Opens in Berlin

    10.10.2017 | Event News

     
    Latest News

    NRL clarifies valley polarization for electronic and optoelectronic technologies

    20.10.2017 | Interdisciplinary Research

    Metallic nanoparticles will help to determine the percentage of volatile compounds

    20.10.2017 | Materials Sciences

    Shallow soils promote savannas in South America

    20.10.2017 | Earth Sciences

    VideoLinks
    B2B-VideoLinks
    More VideoLinks >>>