Single-Payer Reform
Authors: Steffie Woolhandler, David U. Himmelstein
Journal: Annals of Internal Medicine (2017)

Letters3 October 2017Single-Payer ReformSteffie Woolhandler, MD, MPH and David U. Himmelstein, MDSteffie Woolhandler, MD, MPHFrom The City University of New York at Hunter College, New York, New York.Search for more papers by this author and David U. Himmelstein, MDFrom The City University of New York at Hunter College, New York, New York.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L17-0326 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Dr. Silverman aptly describes the advantages of practice in New Zealand's single-payer system, where patients face few financial barriers and physicians are spared much of the billing and administrative hassle that plagues our profession in the United States. Recent studies (1, 2) document what every physician knows: We waste countless hours on useless bureaucratic tasks, which doubtless contribute to soaring burnout rates.Drs. Lancaster and Drozda view their proposed reform as more realistic than a single-payer one. Although several nations offer examples of highly functional single-payer systems, their proposal rests on several speculative assumptions. Their claims for a ...References1. Sinsky C, Colligan L, Li L, Prgomet M, Reynolds S, Goeders L, et al. Allocation of physician time in ambulatory practice: a time and motion study in 4 specialties. Ann Intern Med. 2016;165:753-60. [PMID: 27595430]. doi:10.7326/M16-0961 LinkGoogle Scholar2. Tai-Seale M, Olson CW, Li J, Chan AS, Morikawa C, Durbin M, et al. Electronic health record logs indicate that physicians split time evenly between seeing patients and desktop medicine. Health Aff (Millwood). 2017;36:655-62. [PMID: 28373331] doi:10.1377/hlthaff.2016.0811 CrossrefMedlineGoogle Scholar3. Himmelstein DU, Woolhandler S. Hope and hype: predicting the impact of electronic medical records. Health Aff (Millwood). 2005;24:1121-3. [PMID: 16162553] CrossrefMedlineGoogle Scholar4. Himmelstein DU, Jun M, Busse R, Chevreul K, Geissler A, Jeurissen P, et al. A comparison of hospital administrative costs in eight nations: US costs exceed all others by far. Health Aff (Millwood). 2014;33:1586-94. [PMID: 25201663] doi:10.1377/hlthaff.2013.1327 CrossrefMedlineGoogle Scholar5. Congressional Budget Office. Congressional Budget Office cost estimate: H.R. 1628 American Health Care Act of 2017: as passed by the House of Representatives on May 4, 2017. 24 May 2017. Accessed at www.cbo.gov/system/files/115th-congress-2017-2018/costestimate/hr1628aspassed.pdf on 27 May 2017. Google Scholar Author, Article, and Disclosure InformationAffiliations: From The City University of New York at Hunter College, New York, New York.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M17-0302. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoSingle-Payer Reform: The Only Way to Fulfill the President's Pledge of More Coverage, Better Benefits, and Lower Costs Steffie Woolhandler and David U. Himmelstein Single-Payer Reform David Silverman Single-Payer Reform Gilead I. Lancaster and Joseph P. Drozda Jr. Metrics Cited byExpand the scorecard for health-care reform to achieve a better result and enhance clinical and translational science 3 October 2017Volume 167, Issue 7Page: 527KeywordsDisclosureDrugsForecastingHealth careHealth information technologyIschemiaLesionsPatientsQuality of lifeType 2 diabetes ePublished: 3 October 2017 Issue Published: 3 October 2017 Copyright & PermissionsCopyright © 2017 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...