#AMAGetOutTheWay: Nurses, Doctors, and Students United
On Saturday, June 8th, this precise scenario played out as united healthcare workers protested the American Medical Associations annual meeting. Discover why and what it might mean for health coverage across the country.
On Saturday, June 8th nurses, doctors, and medical students stood side-by-side to protest the American Medical Association's (AMA) annual meeting in Chicago. The AMA, which was founded in 1847, is a large, powerful, and wealthy lobbying group. However, it seems that many young physicians and medical students don't agree with the work done by the group. In fact, in 2016, it was reported that the AMA only represented about 25 percent of practicing physicians. This decrease was a significant change from just a few decades ago when nearly 75 percent of all physicians were members.
#AMAGetOutTheWay
If you perform a quick social media search for #AMAGetOutTheWay, you will find support from many healthcare professionals fighting for Medicare for all. Experts believe that adopting a Medicare for all system in the United States would allow us to join the ranks of the rest of the industrialized world where health coverage is universal. They also feel that this would save money and improve health outcomes.
Protesters feel that the AMA isn't fighting for the right initiatives. Adam Gaffney, President for Physicians for a National Health Program and an instructor at the Harvard Medical School, made his feelings known at the rally. "The AMA is not fighting for their patients, they're not fighting for the uninsured, and they're not fighting for the underinsured. We're here today because the AMA is again on the wrong side of history.”
Other groups well-represented at the rally included Students for a National Health Program (SNaHP), National Nurses United, People's Action, and The Center for Popular Democracy. SNaHP published on their website that showing up at the rally showed support by "taking a stand AGAINST corporate greed, misleading advertising, and the profit motive of health care.” National Nurses United is the largest union and professional association for registered nurses and supports Medicare for All.
What is HR 1384?
Medicare for all isn't just a catchy slogan used by Democrats like Bernie Sanders. It's a legislative proposal, HR 1384, that would create a nationwide health insurance program for all U.S residents. A single-payer system such as this would replace the current mixed healthcare system which includes private and public health programs. It also has a provision to allow people to purchase public coverage during a transitional period to this new system.
Who Would Be Covered?
HR 1384 aims to provide coverage to all U.S. residents, documented immigrants, and even undocumented people. The program would prohibit anyone from being excluded because of citizenship status.
How Would it be Funded?
This single-payer system would not require premiums to be paid. However, it would require new federal taxes for both businesses and individuals.
What Would Be Covered?
All medical care would be covered under this system. Those who support HR 1384 proudly boast that it would also cover reproductive health services. This would include maternity and newborn care.
The Power of Unity
Regardless of your opinions about HR 1384, the rally in Chicago is an example of what could happen when healthcare workers come together. It's estimated that there over one million physicians and nearly three million nurses in the U.S. Imagine how workplace problems and care deficiencies could be approached with this type of unity.
Would we be able to solve some of the top problems that plague healthcare? Just think for a minute how discussions about safe staffing, workplace violence, and long working hours might change if these two "strong-in-number" groups stormed the offices of administration and lawmakers across the nation.
Where Do You Stand?
There are so many different conversations that could come from this one event. Do you support a Medicare for all system? And, what do you think about the unity that was displayed at this protest? Oh, and what other issues do you think a unified front could impact?
it can be argued that three elements (Medicare, Medicaid, and employer sponsored health insurance supported by tax deductible premiums for companies) have combined to fuel the run away cost of our health care system since the early 1970's. We essentially have a "partial single payer system".Very little in the way of "alternatives" have been adequately explored. Health sharing plans are still only used by a minority of people. Insurance still isn't available across state lines. Pharmacy drugs still cannot be imported in most cases. Heath care savings accounts that are fully tax deductible don't exist for most (backed up by low cost catastrophic policies). These are but a few possible innovations. Preventative health measures are widely available, but seldom used. I have no health insurance, but I practice intermittent fasting, exercise, and low carb DASH diet to control my propensity towards obesity and HTN (in addition to not drinking or doing drugs). American health care is actually quite impressive given that we are probably the most obese, drug using, sedentary, smoking, high stress, poor diet eating people on the planet. The fact that we live as long as we do and can still function to a reasonable age is a huge part of why we spend so much on healthcare. Look, you may ultimately win the battle for single payer, but if Trump is reelected or if the Republicans keep the Senate (or take the House) it is game over for single payer. Meanwhile, those of us who oppose single payer as the greatest advancement of socialism in the last 50 years will have been marginalized and opportunities for gains on less contentious issues (such as ratio laws, more unions, and advocating NPO hospital systems over for profit systems will be lost).
Our excessive healthcare cost inflation hasn't actually been contributed equally by medicare and private insurance. The rate of cost inflation under private insurance is about twice that of Medicare. This shouldn't be too surprising since under our current model the monetary incentive for private insurers is to do as little as possible to control healthcare cost inflation, and actually the higher the rate of inflation the more they make. Medicare on the other hand has a financial incentive to control both current and future costs. That's the main difference with a universal coverage single payer system, there are still private insurers but their monetary incentive flips to controlling current and future costs, the better they do that the more they make.
Health sharing plans are just another name for health insurance, a group of people coming together to share their healthcare costs is what insurance is. And just like traditional private insurance, health sharing plans rely on shifting these patients to a single payer system when they actually have significant costs.
Insurance actually is available across state lines, these are of limited popularity for good reason. The idea behind multi-state plans is that if people living in high cost areas, such as the bay area, could buy plans provided in lower cost areas, then they could save money. The problem is that in practice this doesn't work. The cost of a plan in the bay area is calculated based on the cost of services for facilities those covered by the plan would most likely utilize. If you try to sell plans that include those higher cost enrollees in a place where costs are less then there's no reason why people in a lower cost area would buy that plan since it would be more expensive than competing plans that didn't include bay area enrollees. This means that even though it's a 'multi-state' plan, the only people enrolled in the plan are in the bay area, which means it wouldn't cost any less than non multi-state plans.
HSA high deductible plans are by far the fastest growing type of insurance plan, they're a good option in a bad system, but it's still just the least bad of a bunch of bad methods.
I applaud your diet and lifestyle choices for modifying your risk, but these actually have relatively little effect on high-cost medical conditions. I get patients all the time who end up on ECMO and VADs who couldn't have better diets or be in better shape, and conversely I get obese, sedentary, fast-food junkies who's arteries and spick-and-span clean.
To have a sensible system for healthcare cost coverage, it has to be driven by how and who we spend money on. Everyone has the right care once a medical condition becomes not only acute, but also very expensive, so it makes no sense to allow people to not adequately ensure their ability to cover these costs (not buy insurance) or to take basic steps to keep these costs from occurring in the first place.
I'm all for reducing the overall costs of our healthcare system by not having to pay for those who are here illegally, but other than improving our rate of deportation I'm not sure what you propose doing about that? We already pay for the costs (although there is good evidence that illegal immigrants pay more into the social safety net than they take out) of the emergent healthcare needs of illegal immigrants. Should they be turned away at the ER door? I'm not sure that's a palatable option to even the most staunch conservatives.
You are 100% incorrect. The heritage foundation estimated a few years back, and given the fact our illegal immigration has soared im sure it’s higher now, illegal immigrants pay into our system around 19 billion a year and cost the country 116 billion. Included in that number is healthcare, education etc. The heritage foundation is a right leaning company but that doesn’t negate the research into this issue.
MunoRN, RN
8,058 Posts
Our excessive healthcare cost inflation hasn't actually been contributed equally by medicare and private insurance. The rate of cost inflation under private insurance is about twice that of Medicare. This shouldn't be too surprising since under our current model the monetary incentive for private insurers is to do as little as possible to control healthcare cost inflation, and actually the higher the rate of inflation the more they make. Medicare on the other hand has a financial incentive to control both current and future costs. That's the main difference with a universal coverage single payer system, there are still private insurers but their monetary incentive flips to controlling current and future costs, the better they do that the more they make.
Health sharing plans are just another name for health insurance, a group of people coming together to share their healthcare costs is what insurance is. And just like traditional private insurance, health sharing plans rely on shifting these patients to a single payer system when they actually have significant costs.
Insurance actually is available across state lines, these are of limited popularity for good reason. The idea behind multi-state plans is that if people living in high cost areas, such as the bay area, could buy plans provided in lower cost areas, then they could save money. The problem is that in practice this doesn't work. The cost of a plan in the bay area is calculated based on the cost of services for facilities those covered by the plan would most likely utilize. If you try to sell plans that include those higher cost enrollees in a place where costs are less then there's no reason why people in a lower cost area would buy that plan since it would be more expensive than competing plans that didn't include bay area enrollees. This means that even though it's a 'multi-state' plan, the only people enrolled in the plan are in the bay area, which means it wouldn't cost any less than non multi-state plans.
HSA high deductible plans are by far the fastest growing type of insurance plan, they're a good option in a bad system, but it's still just the least bad of a bunch of bad methods.
I applaud your diet and lifestyle choices for modifying your risk, but these actually have relatively little effect on high-cost medical conditions. I get patients all the time who end up on ECMO and VADs who couldn't have better diets or be in better shape, and conversely I get obese, sedentary, fast-food junkies who's arteries and spick-and-span clean.
To have a sensible system for healthcare cost coverage, it has to be driven by how and who we spend money on. Everyone has the right care once a medical condition becomes not only acute, but also very expensive, so it makes no sense to allow people to not adequately ensure their ability to cover these costs (not buy insurance) or to take basic steps to keep these costs from occurring in the first place.