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Physicians advocate for single payer system

James Cowan, J. Mark Ryan argue single payer system would increase access, affordability

By
Senior Staff Writer
Friday, October 18, 2019

The Students for a National Health Program and the Brown Democratic Socialists Organization co-hosted the event explaining Medicare for All.

The United States’ health care system is broken and the only solution is a single payer plan, argued local leaders of Physicians for a National Health Program at an event Tuesday night.

James Cowan, an internal medicine specialist, and J. Mark Ryan MD ’84, clinical assistant professor of medicine at the Warren Alpert Medical School and Rhode Island Chapter president of PNHP, explained the differences between a single payer health care system, a public option and other proposals discussed in the 2020 Democratic primaries.

“What is Medicare for All, and Why Does It Matter” was hosted by Students for a National Health Program and Brown Medical Democratic Socialists Organization, according to Robert Fain MD ’22, a member of SNaHP. After Cowan and Ryan delivered their keynote speech, a question-and-answer session followed.

Under a single payer national health insurance, also known as “Medicare for All,” a single public entity would organize health care financing, while private groups would remain largely responsible for the delivery of care, according to the PNHP website. A single payer program would be funded by the existing government expenses on health care, in addition to modest tax increases based on ability to pay, Cowan and Ryan said.

A single payer system would streamline the current system, which includes multiple insurance payers, Ryan said. Currently, over 100 insurance companies and payors control the flow of money between individuals and providers of care by taking premiums from people who need health care. The single payer plan “gets rid of the middle men, and that’s it.”

By eliminating multiple insurance payors, a single payer system would solve the problems of health care access and affordability, Cowan said.

Around 30 million people remain uninsured under the current U.S. healthcare system because many Americans cannot afford the inflated cost of insurance, he added.

“Medicare for All” would also provide more inclusive coverage than the current system, Ryan said. Under the current system, the United States government provides Medicare for citizens over the age of 65. “Suddenly, you have an insurance plan you can’t lose. Once you have Medicare, you’re insured, and it makes a huge difference in your ability to access health care which in turn results in (an improvement) in health and life expectancy.”

Ryan addressed the common criticism that a single payer system would be too costly to administer. Taxes and public spending currently account for nearly two-thirds of overall health care costs, he said. “The idea that we’re suddenly going to shift how health care is being paid for is not true. It’s already being paid for publicly in the majority of the dollars that go into the system.”

Ryan also clarified the distinction between a single payer plan and socialized medicine. “We are not talking about socialized medicine here,” he said, describing socialized medicine as a system in which the government is “the insurer, owns the hospitals and employs the doctors.”

During the event, Ryan and Cowan expressed support for two single payer plan bills that have been introduced in the United States House of Representative and Senate, sponsored by Rep. Pramila Jayapal (D-Wash.) and Sen. Bernie Sanders (D-Vt.), respectively. Both plans provide comprehensive coverage and eliminate barriers to care, Ryan said.

Some Democratic candidates have advocated for a mixed system of both private and public health insurance, such as Pete Buttigieg’s “Medicare for All Who Want It” plan, which would allow individuals to opt in to public insurance or remain privately insured. But hybrid plans would not improve existing problems, Cowan said. “Any proposal for incremental changes fails to do two things: It fails to capture and reduce the waste in the current system … and fails to address the issue of affordability.”

Katherine Hobbs MD ’23, who attended the event, appreciated how the speakers clearly described the single payer plan. But she wished they had compared the plan against other “proposals by (Democratic) candidates, … just so that we can be armed with more nuanced arguments” going into the election.

One Comment

  1. No physician wants a single payer system. That is socialism. Care would be rationed and mediocre at best. There would be no incentive for innovation. Doctors and hospitals would go bankrupt from low reimbursements, especially in low income areas, and access would go way down.

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