With 'Medicare for All' up for debate, JAMA publishes first pro-single payer viewpoint in 15 years

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A single-payer health system is up for debate in Washington and among physicians. (Pixabay)

With more and more doctors open to the idea of “Medicare for All,” on Friday, JAMA published the first pro-single payer opinion piece in more than 15 years.

JAMA, the Journal of the American Medical Association, published a Viewpoint piece titled “Single-Payer Reform—Medicare for All” written by the co-founders of the group Physicians for a National Health Program.

While the journal has published many opinion pieces that were critical or skeptical of a single-payer system, this is the first time in more than 15 years that JAMA has published a pro-single payer Viewpoint, according to Clare Fauke, communications specialist at the Physicians for a National Health Program. The group is an advocacy organization of more than 20,000 American physicians, medical students and health professionals that supports a universal, comprehensive single-payer national health insurance program.

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“We believe the rising public attention to Medicare for All—including in Congress—is clearly why they're interested in publishing about the issue,” Fauke said in an email.

Congress is holding hearings on a Medicare for All plan unveiled by progressive Democrats earlier this year. The bill would transition the entire U.S. health system into a single-payer structure over the course of two years.  

RELATED: CBO officials—'Medicare for All' plan would require 'major undertaking'

JAMA wants to include diverse opinions in its pages, said Howard Bauchner, M.D., editor-in-chief of JAMA and the JAMA Network, in an email to FierceHealthcare.

"JAMA has an important responsibility to reflect in its pages the varied opinions about healthcare reform in the U.S. and around the world,” he said when asked about the journal’s decision to publish a pro-single-payer piece.

The opinion piece is authored by Steffie Woolhandler, M.D., and David U. Himmelstein, M.D., both of the School of Urban Public Health at the City University of New York at Hunter College in New York City and the Harvard Medical School in Boston.

In the Viewpoint piece, the doctors warn against the dangers of "halfway" measures such as a public option that they say would forgo nearly all the administrative savings of single-payer and leave millions of patients at risk of medical bankruptcy. 

“The prospect of single-payer 'Medicare-for-all' reform evokes enthusiasm and concern,” the authors write, echoing the divide among doctors.

RELATED: The CBO analyzed what it would take to shift to a single-payer system. Here are 5 takeaways 

In a recent poll of healthcare workers, almost half of physicians said they support Medicare for All. The poll of 1,306 healthcare professionals found physicians are more likely than other healthcare professionals to support the concept of Medicare for All. The poll found that 49% of physicians agree with the concept to replace private health insurance with a new, federally financed healthcare system.

Healthcare professionals said the biggest challenge would be how to pay for the government program. More than half of physicians also said they are worried they would earn less with a Medicare for All system.

But in the JAMA opinion piece, the doctors make their case for a single-payer system. “The $11,559 per capita that the United States spends on healthcare could provide high-quality care for all or it can continue to fund a vast health-managerial apparatus—it cannot do both,” they concluded.

Members of the Physicians for a National Health Program also announced that they and other supporters of a single-payer system plan to protest Saturday at the American Medical Association’s (AMA) annual meeting in Chicago. They are planning a march and rally to demand that the AMA leave the lobbying group Partnership for American’s Health Care Future and drop its long-standing opposition to a single-payer system and support Medicare for All.

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