Physicians for a National Health Program backs a single-payer (government) system –supported by presidential candidate Sen.  Bernie Sanders — as the most effective way to drive true healthcare reform.

A paper  in the American Journal of Public Health and endorsed by 2,000 physicians notes that the Affordable Care Act has left many still uninsured or underinsured while healthcare costs continue to rise faster than  general inflation. The authors also note that private insurers’ overhead is much more than traditional Medicare’s and  that the extremely complex reimbursement system forces providers to waste substantial  time, money and energy on documentation, billing and collections.

“We propose to replace the ACA with a publicly financed National Health Program that would fully cover medical care for all Americans, while lowering costs by eliminating the profit-driven private insurance industry with its massive overhead,” the paper says.

The proposal would ban private insurers and cover every American for all medically necessary services, medications, devices and supplies and finance each hospital with a “global budget” that eliminates per-patient billing.

It would permit  two ways to pay physicians: fee-for-service via a “simple binding fee schedule” and salaries for working in nonprofit hospitals, clinics, capitated group practices, HMOs and integrated systems. The paper’s authors asserted that despite conventional wisdom,  a fee-for-service  system can contain costs if  fees don’t  excessively reward procedure-oriented specialists.