Sherif Emil – an American physician in Canada
Commencement Address
The students know. They brought Sherif Emil back from Canada to give them their commencement address. The future of health care in America is in good hands.

WHY IS SINGLE PAYER GOOD FOR MEDICAL PROFESSIONALS

Freedom to make decisions
SB 810 (California single payer bill) and HR 676 (the federal single payer bill) will eliminate the role of insurance companies in making healthcare decisions. No longer will physicians need to ask approval for tests or waste time figuring out what treatment options and pharmaceuticals are covered for each patient. Decision making will be returned to healthcare providers and their patients.

Fewer administrators, more health care providers
Hospitals and medical offices currently employ teams of administrators to bill dozens of insurance companies every month. With one insurer to bill, these groups will refocus their staffing to include more healthcare providers and fewer administrators. This will improve patient care and decrease potential for costly errors.

An end to uncompensated care
SB 810 and HR 676 would end uncompensated medical care by guaranteeing everyone has access to a payer. Hospitals and physicians would no longer need to argue with insurance companies for timely, adequate compensation.

Improved re-imbursement
The bill could also improve physician reimbursement. With so many different coverage plans, doctors are fragmented at the mercy of insurance companies. Under a single-payer system, physicians would pool together and effectively negotiate reimbursement rates and timely compensation. The bill would also end undercompensation for care of patients with Medicare and Medi-Cal.

Expanding practices
By covering every Californian, SB 810 and HR676 would add approximately 7 million new, regular patients to medical practices and hospitals across the state.
 
Continuity of care
Universal coverage would increase continuity of care. Patients will no longer be forced to join another medical group or hospital when they switch jobs or their employers switch providers, which is good for both patient satisfaction and safety.

Lower malpractice costs
They will fall dramatically, for several reasons. First, about half of all malpractice awards go to pay present and future medical costs (e.g. for infants born with serious disabilities). Single payer national health insurance will eliminate the need for these awards. Second, many claims arise from a lack of communication between doctor and patient (e.g. in the Emergency Department). Miscommunication/mistakes are heightened under the present system because physicians don’t have continuity with their patients (to know their prior medical history, establish therapeutic trust, etc) and patients aren’t allowed to choose and keep the doctors and other caregivers they know and trust (due to insurance arrangements). Single payer improves quality in many ways, but in particular by facilitating long-term, continuous relationships with caregivers. For details on how single payer can improve the quality of health care, see “A Better Quality Alternative: Single Payer National Health Insurance.” For these and other reasons, malpractice costs in three nations with single payer are much lower than in the United States, and we would expect them to fall dramatically here. For details, see “Medical Liability in Three Single-Payer Countries” paper by Clara Felice and Litsa Lambkros.

Ensure adequate health care workforce
SB810 and HR676 will help address the nursing crisis. Under the bill, the Commissioner is mandated to establish a budget to support the development and training of a health system workforce that is sufficient to meet the health care needs of the population. This would include assuring that adequate numbers of nurses were trained and available to maintain quality of care standards.

What will happen to physician incomes?

On the basis of the Canadian experience under national health insurance, we expect that average physician incomes should change little. However, the income disparity between specialties is likely to shrink.

The increase in patient visits when financial barriers fall under a single-payer system will be offset by resources freed up by a drastic reduction in administrative overhead and physicians’ paperwork. Billing would involve imprinting the patient’s national health program card on a charge slip, checking a box to indicate the complexity of the procedure or service, and sending the slip (or a computer record) to the physician-payment board.

Why Physicians Are The Key To Health Reform
Doctors as the key to health reform