Should the U.S. Have Universal Healthcare?

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In a recent presidential debate, the candidates were asked, “Is health care a right or a responsibility?” The National Physicians Alliance believes it is both. Yet in the United States, formidable barriers stand between patients and ideal medical care. Not only is it difficult for many people to acquire health insurance, but even those with coverage are seeing costs rise.

At a time when patients and their families are already overwhelmed by the financial, emotional, and time demands of interacting with today's health care system, a movement is underway to make the situation even worse. Insurers and corporations are sneakily shifting the financial burden onto everyday Americans by driving patients into high deductible, high co-pay plans that offer little protection when a person actually needs medical care.  Half of all bankruptcies are now due to medical problems, and in most of these cases, the person declaring bankruptcy had medical insurance.  This trend of burden-shifting has been promoted under the misleading label of "consumer-directed health care."  Make no mistake: these plans benefit influential insurers and payers, at a high price to actual consumers.  The new Medicare drug plan and "health savings accounts" are two prominent examples of this effort to shift costs to patients—and both are contributing to the dissolution of what it even means to be insured.  The United States may be approaching a time when the word "insured" is nothing but an empty shell, useful for political tabulations but meaningless for patients.  The NPA believes we must have true patient-driven health care by resisting high-deductible health plan proposals and prioritizing accessible, high quality health care for all people.

There are many different options to finance and administer guaranteed, quality, affordable health care and mechanism has its own advantages and disadvantages.  Thus, we endorse the five principles of health care reform identified by the Institute of Medicine as the basis for a just and moral health care system:

1.    Health care coverage should be universal.

1.    No one should be excluded based on poor health status, a pre-existing condition or chronic illness.

2.     There should be few or no administrative barriers to obtaining or renewing insurance.

3.     Coverage should be guaranteed to all persons in the United States.

2.    Health care coverage should be continuous.

1.    Everyone should have access to a primary care provider and medical home throughout their lifespan.

2.    Continuous coverage must be transportable across employment, unemployment or geographic relocation.

3.    Health care coverage should be affordable to individuals and families.

1.    Every American should have access to insurance premium they can afford.  Financial assistance will be necessary for lower-income people.

2.     Co-pays and deductibles present a barrier to care for low-income people. They tend to discourage people from obtaining necessary medical care. We oppose co-payments that impose significant financial barriers to care.

4.    The health insurance strategy should be affordable and sustainable for society.

1.    Physicians and other health care providers must place renewed emphasis on the stewardship of clinical resources.

2.    Costs should be distributed equitably across the entire population.

3.    Any reform should minimize administrative cost, and simplify enrollment, underwriting, and billing procedures.

4.    The government should be able to negotiate prices with pharmaceutical and medical device companies to ensure quality, low-cost medications for all.

5.    Health insurance should enhance health and well-being by promoting access to high-quality care that is effective, efficient, safe, timely, patient-centered, and equitable.

1.    Basic benefit packages must include preventive and screening services, prescription drugs, dental care, and mental health care as well as outpatient and hospital services.

2.    Payment strategies should promote evidence-based medical care.

3.    Reforms such as malpractice reform should promote patient safety and enhance patient care.