For more than a decade the American College of Physicians (ACP; Washington) has staunchly advocated a pluralistic payer health system. That is until now. The group, which is the nation’s largest medical specialty society and second largest medical association, has thrown its support behind single payer health reform perhaps to shine a spotlight on the issue and attract presidential hopefuls in supporting the system.

The 124,000-member group reported the endorsement earlier this week, citing weaknesses within a pluralistic payer system – and saying that a single payer system was the only real choice for universal healthcare at a cost the public could afford.

According to the National Library of Medicine, a “Single-Payer System” is an approach to healthcare financing with only one source of money paying healthcare providers. The single payer method to healthcare is seen in Canada.

“Single-payer systems generally have the advantage of being more equitable, with lower administrative costs than systems using private health insurance, lower per capita healthcare expenditures, high levels of consumer and patient satisfaction, and high performance on measures of quality and access,” according to an ACP position paper published in the December edition of the Annals of Internal Medicine.

“I think this [endorsement] will bring a lot of attention to [the plan] and it will certainly bring a lot of credibility to it,” John Geyman MD, author of “The Corrosion of Medicine: Can the Profession Reclaim its Moral Legacy” and past president of the Physicians for a National Health Program (PNHP; Chicago), told Medical Device Daily yesterday.

He added that the ACP is hoping the endorsement will garner support for the system on the 2008 presidential campaign trail.

“This changes the political landscape for the presidential candidates, who now will need to take a fresh look at single payer,” said Quentin Young, MD, a Master in the ACP and coordinator of the PNHP. “It recognizes the political feasibility of single payer as well as its importance as a leading option for healthcare reform.”

If currying favor from presidential hopefuls for this type of healthcare reform is the goal for this endorsement, then ACP has long road ahead of them. While most candidates have responded to the growing number of uninsured people in this country – now at a staggering 47 million by making healthcare a priority – only one lone candidate Dennis Kucinich, who is hardly a front runner in the race – has come out in full support of the single payer reform.

“I hope this endorsement makes a difference,” Geyman said. “We’re much closer to these patients than these politicians, so we are more attentive to (the patients) needs.”

Here is a list of what some frontrunners are proposing according to articles gathered from and

First off the Democrats.

Hilary Clinton: In her plan, Clinton said families would get tax credits to help pay for coverage. The tax credit would be designed to limit the premiums to a percentage of a family’s income. Federal subsidies would be provided for those who are not able to afford insurance, and large businesses would be expected to provide or help pay for their employees’ insurance. Clinton said her plan would not require small businesses to take part, but will offer tax credits to encourage them to do so.

John Edwards: His plan mandates coverage and requires employers to continue to assume responsibility for employee health benefits. It also calls for the U.S. government to help states and groups of states create regional Health Care Markets, which would act as non-profit purchasing pools offering a choice of competing insurance plans.

Barack Obama: This plan calls for universal coverage and a mandate that all children be covered, but he stops short of extending the mandate to adults. His $65 billion plan also calls for the creation of a National Health Insurance Exchange, which would be a regulated marketplace of competing private health plans that would provide individuals with more affordable options for coverage within the private sector.

And here is what the Republican candidates are proposing.

Rudy Giuliani: His plan is more scaled back – and stresses tax incentives and improving affordability to reduce the number of uninsured.

Mitt Romney: The plan would shift charity care funds to subsidies for private insurance, emphasize high-deductible plans and make Medicaid a block grant allowing states more flexibility in developing healthcare programs.

John McCain: His plan attacks the nation’s healthcare problems from the standpoint of cost control rather than focusing on bringing the uninsured into the fold. The proposal also seeks better management of chronic conditions, such as diabetes or heart disease, which McCain says account for 75% of all healthcare costs. In addition, he calls for hospital and doctor compensation to be linked to performance, starting with the Medicaid and Medicare programs.

But regardless of who is in office the message that the ACP is stressing is one of change to the current healthcare system.

“I think a growing number of people inside of medicine are seeing the current healthcare system as broken and incremental increases aren’t a solution,” Geyman told MDD.

“This new proposal by the ACP brings single payer into the mainstream,” said Anderson Hedberg, MD, President Emeritus of the ACP in a statement. “It’s the logical next step.”

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