Editor’s Note: This is the second post in a two-part series. Read the first part here.
In January 2020, the American College of Physicians (ACP) published “Envisioning a Better US Health Care System for All: A Call to Action by the American College of Physicians” in the Annals of Internal Medicine outlining the ACP vision for a more inclusive healthcare system.
Specifically, the statement provides for a health system
- where everyone has coverage and access to the care they need, at a price they and the country can afford;
- that improves social factors that contribute to poor and unequal health; overcomes barriers to care for vulnerable and disadvantaged populations; and ensure that no one is discriminated against on the basis of characteristics of personal identity, including but not limited to race, ethnicity, religion, sex or gender identity, sex or sexual orientation, or national origin;
- where payment and delivery systems put patients’ interests first, supporting physicians and their healthcare teams to deliver high-quality, patient-centered care.
- where primary care is supported with a greater investment of resources.
The American health care system is extremely expensive and remains unaffordable for many. As a result, many Americans do not have coverage for the care they need. Based on the CDC National Health Statistics Report 2020, 31.6 million (9.7%) people of all ages were uninsured. The vast majority, 31.2 million (11.5%), were people under the age of 65. Of the children, 3.7 million (5.0%) were uninsured and of the adults of working age 27.5 million (13.9%) were uninsured.
The United States is the only high-income industrialized country without universal health coverage. Despite spending much more on health care per capita than other affluent countries, the United States, by comparison, consistently ranks last or near last in access, administrative efficiency, equity, and health outcomes.
The American College of Physicians has proposed ways to achieve universal coverage with improved access to care and recommended ways to achieve this in a series of policy documents. The three papers provide a comprehensive set of policies to point the way to a better health care system for all.
- In “A Better Healthcare System for All: Coverage and Healthcare Costs,” ACP recommends moving to a universal coverage system through a single-payer or public choice system offered in conjunction with regulated private insurance.
- In “A Better Healthcare System for All: Healthcare and Payment Systems,” ACP calls for higher payments for primary and cognitive care services.
- In “A Better Healthcare System for All: Reducing Barriers to Care and Addressing Social Determinants of Health,” ACP calls for an end to discrimination and inequalities in access and care based on personal characteristics; correcting staff shortages, including the undersupply of general practitioners; and understanding and improving social determinants of health. This position paper calls for increased efforts to address pressing public health threats, including injuries and deaths from firearms; environmental hazards; climate change; maternal mortality; substance use disorders; and tobacco use.
The ACS believes that its recommendations, if adopted, will remedy many of the shortcomings of the US health care system.
As a fellow of the American College of Physicians and co-chair of the TX-ACP Health and Public Policy Committee, I urge all readers to learn more about the ACP, promote the organization’s health promotion strategies and participate (if you are into internal medicine).
by dr. Fabrizia Faustinella, Professor of Family and Community Medicine, Baylor College of Medicine