Page 10 - Delaware Medical Journal - September 2017
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PRESIDENT’S PAGE
pays all health care expenses except for copays and coinsurance. Providers may be public, private, or a combination of both.
(This year, California introduced the Healthy California Bill [SB 562] which would introduce a single payer system in the state. It failed to advance due to lack of clarity on how the estimated $400 billion the political news website, The Hill, Senator Bernie Sanders (I-Vt.) said that he will “absolutely” introduce legislation on single- payer health care now that the Senate GOP’s bill to repeal Obamacare has failed.)
Two-Tier: The government provides
or mandates catastrophic or minimum insurance coverage for all residents (or citizens) while allowing the purchase of additional voluntary insurance or fee-for service care when desired.
Insurance Mandate: The government mandates that all citizens purchase insurance, whether from private, public, the insurer list is quite restrictive,
while in others a healthy private market for insurance is simply regulated and standardized by the government. In this kind of system, insurers are barred from rejecting sick individuals and individuals are required to purchase insurance in order to prevent typical health care market failures from arising.”
In order to further understand where Delaware physicians stand on the issue of conducted a poll in July which received just over 200 responses.
We asked how physicians think the U.S. can best achieve health care coverage for county, practice type, and specialty, are shown in the chart above.
According to the survey results, it appears that most physicians support a single payer universal health care coverage. Interestingly, more primary care physicians feel a single payer system would best achieve universal health care while specialists feel a two-
tier system would. One must wonder if reimbursement drives this difference. Also interesting is that a majority of the employed (70 percent) and private practice physicians (76 percent) respondents showed a higher propensity in favoring a single payer or two-tier system. Indeed, 90 percent of our respondents feel that simplifying the administrative burden
of reimbursement would encourage more physicians to remain in or enter into independent primary care practice. As two of Delaware’s three counties are designated as Healthcare Provider Shortage Areas (HPSA’s) and physician burnout is on the rise, this is certainly a goal which we must achieve.
At this time, our insurance commissioner is holding public forums on whether
Highmark Blue Cross Blue Shield of Delaware, the only remaining insurer in Delaware’s health insurance exchange, should be allowed to raise premiums by
33 percent. This is not a situation unique to Delaware. Counties and states across our country are contending with the same issue. And while this plays out on the media and in the Capital, the patients are the ones who suffer. We physicians suffer alongside them when we work in a system that usurps our time on a 2:1 basis in administration and meaningless paperwork over actual patient contact. It is high time our legislators come together and lay the plans for universal health care coverage for all Americans while simplifying the system to attract more physicians to primary care. In their discussions, nothing should be off the table!
Prayus Tailor, M.D.
President, Medical Society of Delaware
Single Payer
Two Tier
Insurance Mandate
Other
TOTAL %
COUNTY
New Castle
29.4%
24.4%
9.5%
7.0%
Kent
6.5%
3.0%
1.5%
0.5%
Sussex
3.5%
4.5%
2.0%
2.0%
Other
1.0%
5.0%
0.5%
0.0%
TOTAL
40.3%
36.8%
13.4%
9.5%
100%
PRACTICE TYPE
Employed
47%
29%
14%
9%
100%
Private Practice
39%
37%
13%
11%
100%
Concierge
0%
50%
50%
0%
100%
Direct Care
40%
60%
0%
0%
100%
Other
0%
88%
13%
0%
100%
PCP VS. SPECIALIST
Primary Care
49%
31%
13%
7%
100%
Specialists
34%
41%
14%
11%
100%
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Del Med J | September 2017 | Vol. 89 | No. 9
