Who Will Have Health Insurance in the Future? An Updated Projection

Richard A. Young; Jennifer E. DeVoe

doi:10.1370/afm.1348

Published eLetters

If you would like to comment on this article, click on Submit a Response to This article, below. We welcome your input.

Submit a Response to This Article

Compose eLetter

Title *

Author Information

Contributors
First Name and Middle Initial * First or given name, e.g. 'Peter'. Last Name * Your last, or family, name, e.g. 'MacMoody'. Email Address * Your email address, e.g. higgs-boson@gmail.com Occupation * Your role and/or occupation, e.g. 'Orthopedic Surgeon'. Affiliation * Your organization or institution (if applicable), e.g. 'Royal Free Hospital'.

Statement of Competing Interests

Competing interests? *

Yes

Please describe the competing interests

CAPTCHA

This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.

What code is in the image? *

Enter the characters shown in the image.

Vertical Tabs

Jump to comment:

Author response Re:What would a profession do in response to this report?
Richard A Young

Published on: 22 March 2012
NHS
Hafez A. Nasr

Published on: 16 March 2012
What would a profession do in response to this report?
Larry A Green

Published on: 16 March 2012

Published on: (22 March 2012)
Page navigation anchor for Author response Re:What would a profession do in response to this report?
Author response Re:What would a profession do in response to this report?
Richard A Young, Director of Research
Dr. Green,
I hold out little hope that the house of medicine broadly will rise up to guide the American people to a more sustainable system. SGR politics and the culture of the AMA make this unlikely, and early indications are that ACOs will not solve much either.
I hope that the house of family medicine realizes that it is the most important component to restoring a sense of balance and fairness to the...
Show More

Dr. Green,
I hold out little hope that the house of medicine broadly will rise up to guide the American people to a more sustainable system. SGR politics and the culture of the AMA make this unlikely, and early indications are that ACOs will not solve much either.
I hope that the house of family medicine realizes that it is the most important component to restoring a sense of balance and fairness to the healthcare system. However, we have to rise above our passive philosophical roots and fight for our place as the foundation of a more effective and more efficient system. Decades of research has shown that when we are supported, patients and the broader system benefit: better health and lower costs simultaneously. We have to willing to let the American people know they have difficult choices to make and that just tweaking the current system won't be enough.
But sticking our tails between our legs and skulking back to the RUC does not move us in the right direction. When we lose, the healthcare system, American industry, and our patients lose.
Competing interests: None declared
Show Less

Competing Interests: None declared.
Published on: (16 March 2012)
Page navigation anchor for NHS
NHS
Hafez A. Nasr, Physician
After moving to England in 2010, my son broke his R leg (tib-fib fracture) in the playground. I knew England has a National Health Service (NHS), which is a public, tax funded health care system for anyone in the UK. How would we fare in this system? What transpired was a pleasant surprise. My son was seen and treated within two hours of arrival to the ER and his eventual recovery was uneventful. Most amazingly, when...
Show More

After moving to England in 2010, my son broke his R leg (tib-fib fracture) in the playground. I knew England has a National Health Service (NHS), which is a public, tax funded health care system for anyone in the UK. How would we fare in this system? What transpired was a pleasant surprise. My son was seen and treated within two hours of arrival to the ER and his eventual recovery was uneventful. Most amazingly, when I checked in the ER, the only information needed was my son's name, birth date, address and contact number. There were no forms to fill out or sign. And to top it all, I never saw a single bill! According to the NHS website, since its creation in 1948, it has become the largest publicly funded health service, covering 62 million people. With the exception of charges for some prescriptions and optical/dental services, it is free for anyone who is a UK resident. Primary care is the first contact for most people and everyone must register with a general practitioner. The overall costs in 2008/9 equated to around $3200 for every man/woman/child in UK. Compare this to per capita expenditure of $7200 per person in the US. The Affordable Healthcare Act may be a move in the right direction, but by dropping the government mandate, we have made it much more difficult to provide affordable universal care for our nation.
Competing interests: None declared
Show Less

Competing Interests: None declared.
Published on: (16 March 2012)
Page navigation anchor for What would a profession do in response to this report?
What would a profession do in response to this report?
Larry A Green, Family Physician
This timely update is at risk for being celebrated as confirming progress, defined as "delayed disaster." Instead, it should be seen as further confirmation that the healthcare industrial complex motors on as a stunningly successful business designed to create ever increasing expenditures that create wealth for many households, without sufficient regard for consequences and benefits for all families and communities....
Show More

This timely update is at risk for being celebrated as confirming progress, defined as "delayed disaster." Instead, it should be seen as further confirmation that the healthcare industrial complex motors on as a stunningly successful business designed to create ever increasing expenditures that create wealth for many households, without sufficient regard for consequences and benefits for all families and communities.
Hopefully, like the first presentation of these projections, this report will create a sense of urgency to do something dramatic and bold to alleviate this cancerous growth that crowds out other vital functions. Primary care needs to be kept weak to sustain the trends, or strengthened to abate them. This point about primary care is obvious and not in dispute.
I dispair at the silence of the profession of medicine as this march of unsustainability continues, to the advantage of most physicians, without commensurate return to the people. It seems to violate a fundamental precept of professionalism, to place the well being of the public ahead of the self-interests of the members of the profession. Perhaps we are confirming that medicine is no longer a profession in the US, just a great business to be in. Or, is it possible that the "house of medicine" might awaken and lead, specialists and generalists together? Is it thinkable that physicians might unite in a broadly based, national commitment to be physicians speaking out and stepping up to guide the nation toward a sustainable better performing system? Or, to be only a little harsh, shall physicians continue as mostly silent, compliant line- workers, finding as we can our personal sweet spot in a sick system?
With this update, we won't be able to claim, "we didn't realize what was happening."
Competing interests: None declared
Show Less

Competing Interests: None declared.