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Physicians, Med Students Discuss Single Payer in Minnesota

[MMA News Now, Aug. 21, 2014] More than 60 physicians and medical students gathered on the University of Minnesota St. Paul campus on Aug. 19 for an MMA policy forum on single payer and whether it’s right for Minnesota.

Following the presentation, the MMA polled the group to gauge its view of single payer. The group overwhelmingly voted (75 percent) that the single greatest potential of a single payer system is to provide guaranteed/universal coverage. The single biggest limitation, the group said, was obtaining sustainable financing (31 percent).

Lynn Blewett, Ph.D., professor of health policy at the U, kicked off the evening by presenting an overview of single payer and describing the experiences of four countries--the United Kingdom, Canada, Norway and Germany—that have such system. She also described Vermont’s plan to build such a system by 2017.

“As family physicians, knowing that our patients have coverage and can afford care is important,” said Chris Reif, M.D., a family physician with Community University Health Care Center and member of a Minnesota Academy of Family Physicians (MAFP) task force that studied the single payer concept last year. “We see this as a dialogue that will go on for years and wanted to be part of the conversation and to do that, we felt we needed to be educated more.”

Dave Dvorak, M.D., M.P.H., an emergency physician at Fairview Southdale Hospital and a member of the Minnesota chapter of Physicians for a National Health Program (PNHP), presented the case for single payer. “We have a complicated system of insurance coverage,” he said. “It’s disorganized and highly inefficient, and the ACA doesn’t change this mish-mash. It just adds layers.” He noted that when he went on to MNSure, the state’s health insurance exchange, he was presented with 66 different potential health plans.

Some of the benefits he noted include the fact that single payer:

•    Offers potential for cost control (currently 31 percent of health care dollars go toward administration, he noted)
•    Would reduce administrative burden (In the U.S. physicians spend 21 hours a week on paperwork and prior authorization; in Canada they spend 2.5 hours a week, he said)
•    Offers an opportunity to negotiate prices for drugs and services
•    Would ensure a larger percentage of the population is insured (Dvorak said that even with implementation of the ACA 30 million Americans are still uninsured and many more are underinsured).

 

Downsides discussed included the political feasibility of such a system, the perception that single payer would raise taxes, its vulnerability during times of recession, and the fact that thousands of insurance and administrative jobs would be lost as a result.

“We’re not here to debate the issue or to change the MMA’s position, which supports a pluralistic system,” said MMA President Cindy Firkins Smith, M.D., who moderated the event that was live-streamed to locations around the state. Rather, the purpose was to inform the audience and learn their thoughts about such a system.

Sen. John Marty (DFL-Roseville), one of several lawmakers in the audience, indicated that he plans to introduce legislation to create a single payer system in Minnesota during the next legislative session. 

The event was co-sponsored by the MMA, MAFP and Minnesota Chapter of PHNP.

 

Number of views (910)/Comments (6)

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6 comments on article "Physicians, Med Students Discuss Single Payer in Minnesota"

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Robb Campbell MD MPH

8/21/2014 5:11 PM

I have ethical concerns about single payer. What would docs do if the government payor decided, for instance, that all pregnant women would be tested for Down's syndrome and all children with Down's syndrome would be aborted in utero and if not, no funds would be given for post natal care of Down's children? What if the government (payor) decided that there would be no funds alloted for care of disabled premature children? With multiple payors, if the payor decided on unethical actions, the docs could take their business elsewhere but under single payor, the docs are at the mercy of the goverment.


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Josh Faucher

8/23/2014 11:27 PM

On the contrary, such a scenario is highly unlikely under a publicly financed and administered payer because of the outrage it would raise among the public. That kind of policy would be near universally viewed as unethical and immoral, and the democratic process would insure the preservation of the goals of the payment system. Doctors would be strong advocates in terms of holding the payer accountable and making sure public policy matched medical and ethical standards.


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Terry Hood

8/21/2014 6:26 PM

This conference reaffirms why practicing in Minnesota was probably the greatest mistake of my career. So many physicians willing to sell their souls for a government takeover of healthcare. Thank God, I live in a part of the country where the populace as well as the physician community are more mainstream.


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Jeff Baumann

8/21/2014 8:54 PM

I believe in single payer if that payer is the patient. Otherwise, it's the death of medicine as a patient focused profession.


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Lee Kurisko

8/22/2014 4:19 PM

I attended the forum and was sorely disappointed. The word "forum" implies that various views would be presented. The three speakers were either explicitly or implicitly in favor of single payer. There was no speaker against it. Having practiced in a single payer system for 13 years, I can assure you, it is no Utopia. I uprooted my family solely to escape that system. To the uninitiated, the data at the forum would seem convincing but there is another side to the story that was not told that night. This was an egregious oversight of the MMA. Or was it intentional? Does the MMA represent all Minnesota physicians or do they have their own agenda?


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Gabriel Komjathy

9/6/2014 9:58 AM

True, the advantages of SP were emphasized by the 3 speakers.As the MMA states, the forum was to inform the audience on details of what SP actually is.As another MD who has practiced under a SP system, that objective was met.In order to change our present system that is very unpopular with most physicians, we need to be informed on what is occurring elsewhere.The basic question remains:is health care a privilege or a right?

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