Submitted by: Mark Brakke, MD

Desired actions:

• Advocate legislatively
• Advance the resolution nationally (to the AAFP Congress of Delegates)
• Bring awareness to members, the public, media and/or specific groups/stakeholders
• Provide education to members, the public, media and/or specific groups/stakeholders
• Support/collaborate with other groups/organizations on work that’s already being done

WHEREAS excellent health care cannot be achieved if people avoid seeking care because of cost;

WHEREAS many in the US are underinsured or uninsured causing them to avoid health care;

WHEREAS the US is lacking a planned health care system—what we have is a dysfunctional situation which is driven by profit seeking rather than seeking cost effective, universally available health care;

BE IT RESOLVED that the MAFP should work energetically for a single payer health care system at both the state and national levels.

Comments in support (5):

Elizabeth Ingersent – I agree that our current system hurts patients by making it unaffordable for them to receive care. Moving toward a single payer system will help provide consistent care for patients and have consistent benefits for society as well.

Tim Ramer – Our healthcare system is the best in the world by some measures -if you have good insurance. for those who don’t it is inequitable inefficient and wasteful. We can do better.

Chris Reif – I support single payer as the financial foundation for a universal health care system with the goal of the highest quality health care for everyone.

Robert Koshnick – This is an important resolution. What really needs to happen is to have the corporate practice of law doctrine applied to all corporations, for profit and nonprofit. Return physicians to a practice environment where physicians have the autonomy to practice medicine according to our Hippocratic and more recent oaths.

Kim Krohn – I am a convert on this issue—single payer could save health care.

Comments against (6):

Andrew Slattengren – I support the spirit of this resolution, yet do not support adopting this specific resolution as it does not substantially add to previous adopted measures on this topic. See previous resolutions including, 2021-10 Taking Action on Universal Single-Payer Health Care; 2020-04 Support for Universal Healthcare; 2019-06 Support for Universal Healthcare

Eric Poulin – Single-payer means “Medicare-for-all” government-run health care. Over time, this will result in poorer care for patients (rationing), reduced income for physicians (Canada/Europe), and increased government rules/bureaucracy/complexity. This will immediately require a large tax increase with significant negative economic effects. As a result, this will only practically “work” in the USA if all states make this change together. A national consensus is therefore required, and we are not even close, for the reasons listed above (and many others).

Roli Dwivedi – I want to support this resolution but I want to say similar types of resolution have been adopted previously. I am not entirely sure repeating the resolution which might have already been adopted will add any benefit. Maybe author would like to know MAFP efforts on promoting single payer?

Emily Onello – Agree with Dr. Slattengren’s comments.

Robert Koshnick – I have been able to see health care as it is delivered in Russia and China, among many other nations. State run health care has open ended demand and limited resources. Facilities quickly lack the $ to be updated. Physician payment declines over time. People overuse limited resources. I prefer empowering people to be in control of their own health care dollars. We are working on a proposal that would be a combination of an IRA and a health savings account that does not have restrictions on the dollar contributions, the penalties on withdrawals, nor the regulatory demands. Empowering patients to be in control of their own health care spending with the only requirement that they buy catastrophic coverage of their choice is a far better approach than turning over health care to the government with no ability to control demand.

Sally Jeon – While I am in support of this resolution as a stance that MAFP should continue to take, I’m seconding the comment about redundancy. The MAFP has a long history of supporting universal or single payer healthcare education and advocacy, most recently which has solid overlap: 2021-10 Taking Action on Universal Single-Payer Health Care.