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Achieving a US health care system 'second to none'

Washington, January 31, 2008 All candidates running for office in 2008 should commit to an agenda to create a health care system for the United States that is second to none the American College of Physicians (ACP) said today in its annual report on The State of the Nations Health Care. In its report, ACP offers a five-point Candidates Pledge designed to gain candidate commitments to support a series of recommendations.

The recommendations result from a new ACP evidence-based policy paper, Achieving a High-Performance Health Care System with Universal Access: What the United States Can Learn from Other Countries. Published in the Jan. 1 issue of Annals of Internal Medicine, ACPs flagship journal, the paper noted that the U.S. health care system falls well below what residents of other industrialized nations receive from their health care systems.

In 2008, we will spend more on health care than any other industrialized country, David C. Dale, MD, FACP, the president of ACP declared. And we will get much less in return.

Much of the recent public policy discussion about the U.S. health care system has focused on comparative considerations, Dr. Dale noted. By making use of data from a number of respected sources, ACPs paper and report serve to:

  • Illustrate how health care in the United States lags behind other countries.
  • Explain why other countries health care systems out-perform the United States.
  • Propose specific policies for consideration by the presidential candidates to create a health care system that is second to none
  • Provide a general analysis of how the current proposals from the leading presidential candidates compare to ACPs policy benchmarks.
  • Propose immediate action items that President Bush and the 110th Congress can take to help - transition to a high performing health care system.
  • Describe what health care in the United States would be like if ACPs proposals are implemented.

It is not enough to study why the United States has a health care system that is behind other industrialized countries, said Robert Doherty, ACPs senior vice president of Governmental Affairs and Public Policy. Today ACP is asking candidates to commit to the following pledge:

A Candidates Pledge to Make the U.S. Health Care System Second to None

I pledge to work toward enactment of legislation to provide Americans with health care that is second to none. To achieve this, I will advocate policies to:

  1. Guarantee by law that everyone has access to affordable health coverage. Coverage should be without regard to their place of employment, place of residence within the United States, or income.

  2. . Provide every person with access to a primary care physician. Create workforce and payment polices to increase the numbers of primary care physicians, recognize the value of primary care, and support care organized through a patient-centered medical home.

  3. Increase public investment in health information technologies (HIT). Provide positive incentives to physicians to overcome the HIT cost barrier.

  4. Reduce administrative expenses. Create a uniform billing system for all health insurance transactions at the point of care. Reform the medical liability system using proven legal reforms.

  5. Increase funding for research. Fund basic and applied medical research, health services research, and independent research on the effectiveness, costs and benefits of different treatments compared to each other.

ACP will send copies of the pledge to all of the announced Democratic and Republican presidential candidates as well as to all members of Congress who are running for re-election. ACP will ask for their endorsement of the pledge.

Although some Americans have access to excellent health care, the fact that the U.S. lags behind every other industrial country in access and is second to last in qualityeven though we spend the mostshould be a wake-up call to all candidates who are seeking election in 2008.

This report, ACP says, is a call-to-action to its members, the candidates, and U.S. elected leaders to commit to comprehensive health care reforms based on ACPs paper:

  • By providing ACPs members125,000 internists and medical students nationwidewith a Web-based tool to evaluate the candidates positions ( based on ACPs benchmarks for a high performing system, it hopes to challenge the candidates to embrace ACPs proposals and to help our members evaluate the candidates accordingly.

  • ACPs Candidates Pledge provides a specific way for its members to ask candidatesespecially those running for Congressto commit to the specific elements described in the pledge.

  • Finally, ACP urges President Bush and the 110th Congress to take immediate steps in 2008 to help transition to a higher performing health care system for all.

Dr. Dale described what a U.S. health care system that truly was second to none would be like:

  • Everyone would have affordable health coverage.

  • Everyone would have access to a primary care physician to help guide them through the health care system (patient-centered medical home)supported by public policies to assure a sufficient supply of primary care physicians.

  • Physicians compensation would be based not just on how many services are provided, but also for their effectiveness in improving quality, coordinating care, and for preventive services.

  • Primary care physicians would receive higher compensation commensurate with their critical role in helping patients get high quality and efficient care.

  • Patients would be able to receive unbiased information on quality and costs and be rewarded with positive incentives to use health care wisely.

  • Paper claims would disappear and be replaced with a simple electronic billing system that all insurers would honorjust like all banks honor ATM cards.

  • Patients and their physicians would have electronic health records to provide them with evidence-based treatment guidelines, laboratory and diagnostic test results, medication lists, and medical histories at the point of care.

  • Patients and doctors would be able to choose among different treatment options based on independent research on their clinical effectiveness, costs and benefits compared to each other.

  • Patients and physicians would have access to the latest medical advances resulting from scientific research.

Most importantly, patients in the U.S. would have accessible, high quality, equitable, and efficient care that is the envy of the world.

Americans, by our nature, do not like to be second best to anyone, ACPs State of the Nations Health Care briefing concluded. It said that, instead of accepting a health care system that ranks well below other democratic and industrialized nations, voters should insist that our politicians pledge to support policies that will create the best health care system in the world.


Contact: David Kinsman
American College of Physicians

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