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 Inselspital: Fewer CT scans needed after cerebral bleeding
    20.03.2019 | Universitätsspital Bern

    nachricht Building blocks for new medications: the University of Graz is seeking a technology partner
    19.03.2019 | Karl-Franzens-Universität Graz

    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: The taming of the light screw

    DESY and MPSD scientists create high-order harmonics from solids with controlled polarization states, taking advantage of both crystal symmetry and attosecond electronic dynamics. The newly demonstrated technique might find intriguing applications in petahertz electronics and for spectroscopic studies of novel quantum materials.

    The nonlinear process of high-order harmonic generation (HHG) in gases is one of the cornerstones of attosecond science (an attosecond is a billionth of a...

    Im Focus: Magnetic micro-boats

    Nano- and microtechnology are promising candidates not only for medical applications such as drug delivery but also for the creation of little robots or flexible integrated sensors. Scientists from the Max Planck Institute for Polymer Research (MPI-P) have created magnetic microparticles, with a newly developed method, that could pave the way for building micro-motors or guiding drugs in the human body to a target, like a tumor. The preparation of such structures as well as their remote-control can be regulated using magnetic fields and therefore can find application in an array of domains.

    The magnetic properties of a material control how this material responds to the presence of a magnetic field. Iron oxide is the main component of rust but also...

    Im Focus: Self-healing coating made of corn starch makes small scratches disappear through heat

    Due to the special arrangement of its molecules, a new coating made of corn starch is able to repair small scratches by itself through heat: The cross-linking via ring-shaped molecules makes the material mobile, so that it compensates for the scratches and these disappear again.

    Superficial micro-scratches on the car body or on other high-gloss surfaces are harmless, but annoying. Especially in the luxury segment such surfaces are...

    Im Focus: Stellar cartography

    The Potsdam Echelle Polarimetric and Spectroscopic Instrument (PEPSI) at the Large Binocular Telescope (LBT) in Arizona released its first image of the surface magnetic field of another star. In a paper in the European journal Astronomy & Astrophysics, the PEPSI team presents a Zeeman- Doppler-Image of the surface of the magnetically active star II Pegasi.

    A special technique allows astronomers to resolve the surfaces of faraway stars. Those are otherwise only seen as point sources, even in the largest telescopes...

    Im Focus: Heading towards a tsunami of light

    Researchers at Chalmers University of Technology and the University of Gothenburg, Sweden, have proposed a way to create a completely new source of radiation. Ultra-intense light pulses consist of the motion of a single wave and can be described as a tsunami of light. The strong wave can be used to study interactions between matter and light in a unique way. Their research is now published in the scientific journal Physical Review Letters.

    "This source of radiation lets us look at reality through a new angle - it is like twisting a mirror and discovering something completely different," says...

    All Focus news of the innovation-report >>>

    Anzeige

    Anzeige

    VideoLinks
    Industry & Economy
    Event News

    International Modelica Conference with 330 visitors from 21 countries at OTH Regensburg

    11.03.2019 | Event News

    Selection Completed: 580 Young Scientists from 88 Countries at the Lindau Nobel Laureate Meeting

    01.03.2019 | Event News

    LightMAT 2019 – 3rd International Conference on Light Materials – Science and Technology

    28.02.2019 | Event News

     
    Latest News

    Laser processing is a matter for the head – LZH at the Hannover Messe 2019

    25.03.2019 | Trade Fair News

    A Varied Menu

    25.03.2019 | Life Sciences

    ‘Time Machine’ heralds new era

    25.03.2019 | Information Technology

    VideoLinks
    Science & Research
    Overview of more VideoLinks >>>