Republican Doctor Advocates Single Payer Health System

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By Dr. David May

I am a Republican. For those who know me that is not a surprise. I live in a red state. I have never voted for a Democratic presidential candidate. I can field strip, clean and reassemble a Remington 12-gauge pump blindfolded. And on top of it, I think we should talk about having a single payer national health care plan. The reason is quite simple. In my view, we already have one; we just don’t take advantage of it.

Firstly, Medicare and the Center for Medicare and Medicaid Services (CMS) are de facto setting all of the rules now. They are a single payer system. When we go to lobby the Hill, we lobby Congress and CMS. Talking to Blue Cross, Aetna, Cigna and United Health care is essentially a waste of time. All the third party payers do is play off the Medicare rules to their advantage and profit. They have higher premiums, pay a somewhat higher benefit and have a significantly higher level of regulation which impedes the care of their customers. This is no longer consumer choice but effectively extortion, a less than hidden shake down in which the “choice” for a family of four is company A at $900 per month or company B at $1100 per month. The payers are simply taking advantage of the system, playing both ends against the middle.

Secondly, in order to move forward with true health care finance we need complete transparency in cost and expense… and we need it now. As was noted in a recent Time magazine piece on the hidden cost of health care, our current system is a vulgar, less than honorable construct more akin to used car sales than medical care, cloaked under the guise of generally accepted accounting principles and hospital cost shifting.

Thirdly, with a single payer system would potentially come real utilization data, real quality metrics and real accountability. The promise of ICD-10 with all of its difficulties is that of a much more granular claims-made data. We could use some granularity in health care data and we will never achieve it in big data quantities without a single payer system.

Lastly, I think that the physicians should be in charge of health care and not the insurance companies and hospital systems. With a single price structure, it becomes all about medical decision making, efficiency, the provision of care to our patients, and shared decision making, all of which we do well.

How, you might say, could a Republican come to such a position? The simple answer is I really think it is quite Republican. Oh, I know there will be many raised eyebrows and many critics. I accept that. I understand the fact that no single payer system is perfect, that it is “socialist,” that it is “un-American.”

I would submit to you, however, that it is un-American to allow many of our citizens to be uninsured, that it is un-American to shunt money away from a strong military in order to support a bloated, inefficient and fraud-laden health care system, that it is un-American not to be open and above board with the cost of what we do, the expense of that service and the profit that we make. Mostly, it is un-American to let this outrageous health care injustice continue.

I would be interested in hearing your thoughts in the comment section below.

This was originally published by the American College of Cardiology.   David May, MD, PhD, FACC, began as the chair of the Board of Governors in March 2013. Dr. May currently works as a managing partner at his private practice, Cardiovascular Specialists, PA (CVS) in Lewisville, Texas.


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  • jean223

    I agree completely with you and I am a Democrat but I don’t think that your party platform is in agreement with you. I hope you can influence your party to go a long with you because I don’t care whether the Democrats or the Republicans institute a single payer system. Just as long we get one. It is the most economical and moral system.

  • Art_As_Social_Inquiry

    I started my art project about accessing healthcare five years ago. I started investigating healthcare because at the time I was a small business owner, and I found myself thinking that I could hire part time workers to replace the one full time employee we had. I couldn’t believe it. I knew if I was doing this so were small business owners across the nation. How were we going to be a great nation when business owners were controlling their healthcare costs by not hiring full time? People need full time jobs with benefits to be productive and feel secure.

    My investigation unearthed unbelievable and often horrific experiences of people trying to access care. About 35 portraits/stories into the project I decided to support the ACA. We just had to start somewhere.

    When I became an advocate, people would think I was being “political.” I would explain that addressing the problem of people accessing care isn’t a political issue but if that is where I have to go to change the system, I will.

    And now five years after starting my project, and three years after the ACA became law, I am in support of a single payer system for the reasons you state.