American College of Physicians
Medical Specialty Society |
Plan StatusProposed.Number of People CoveredAll American citizens.
Estimated CostNot addressed.
Payment Scheme Recommends established universal coverage through either a pluralistic (multipayor) system in which patients can choose from coverage options offered by the government and other parties or a single-payor system in which one government entity is the sole third-party payor of health care costs.
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Plan in Brief
- ACP has 124,000 members—internists, internal medicine subspecialists, and medical students, residents, and fellows.
- Supports universal health care coverage.
- Health insurance coverage and benefits should be continuous and not dependent on place of residence or employment status.
- Emphasizes role of primary care.
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Impact on Federal Government
- Assumes a larger role in administration and coordination of health care insurance programs.
- Funds states initiatives so that states can find innovative ways to offer coverage to all state residents.
- Contributes to inter-operable health information technology infrastructure.
- Establishes federal workforce goals.
Impact on States
- Advocates that states find innovative ways to offer coverage to all state residents, using federally provided funds.
- Supports expansion of SCHIP.
Impact on Insurers
- Creates uniform billing system for all services to reduce health care administration costs.
- Supports portability of health care insurance.
Impact on Providers
- Averts pending collapse of primary care by developing a national workforce policy that ensures an adequate supply of physicians trained to manage care for the whole patient.
- Advocates that primary care physicians manage a patient’s “medical home,” through which overall care is coordinated.
- Supports increased compensation for providers.
Impact on Employers
- Depending on whether a single- or multi-payor system is adopted, employers may or may not continue to offer health insurance.
Impact on Individuals
- Promotes health savings accounts.
- Creates incentives to encourage patients to be prudent purchasers by having access to health information necessary for informed decision-making.
- Warns that initiatives must provide for affordability at all income levels.
Proponents/Opponents
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Proponents say that efforts to resuscitate the role of the primary care physician—one now jeopardized by time demands and inadequate reimbursement—can actually pay off for the system as a whole. Primary care physicians can serve as gatekeepers to control medical costs and ensure quality outcomes. To reach that goal, a national policy is needed to promote primary care and to provide electronic support for administrative, outcomes, and other functions.
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Critics point to the downsides of a single-payor system, which limits choices and often results in treatment delays and poor access to certain treatments and procedures. Others charge one of the greatest causes of rising health care costs is poor quality of care, which is uneven across the United States. More attention to means of standardizing quality are needed.
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Key Targets for InvestmentHealth information technology.
Electronic health records.
Electronic billing.
Clinical effectiveness and cost effectiveness outcomes research.
Notable Feature
- Supports portability of health care.
- Compares U.S. health care data with that of other countries and identifies key differences to account for the better health outcomes achieved in other countries at lower cost.
- Asks candidates for president and other offices to sign a pledge regarding health care reform.
Experts' Comments“Successful national health care systems have taken many routes to paying for health care, but they share one essential characteristic: The government guarantees that every citizen will have health insurance. They have solved a problem that grows worse every day in the United States. Why do Americans tolerate a system that leaves one sixth of its citizens with poor access to basic medical care? When will we elect leaders who will erase this stain on our national character?”
--Harold C. Sox,
Editor,
Annals of Internal Medicine, editorial, January 1, 2008
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For Further Information
American College of Physicians Advocacy: Where We Stand on Election 2008
State of the Nation’s Health Care Briefing 2008
Primary Care: Will It Survive?
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Interest Groups 
