The coronavirus pandemic and other public health issues make the New Vision policy papers more relevant than ever
Oct. 9, 2020 (ACP) – Since the American College of Physicians released its landmark New Vision for health care in the United States in January, the country has experienced the coronavirus pandemic, the reckoning over systemic racism and the devastation of natural disasters linked to climate change. ACP's detailed roadmap to the future is more important than ever.
“We offered a comprehensive vision for a better health care system for all Americans. Now, after months of tumult and tragedy, we can see even more clearly how important it is to embrace priorities such as implementing universal health coverage, combatting systemic racism, and addressing climate change,” said Bob Doherty, ACP senior vice president for governmental affairs and public policy.
This year, of course, has been unrelentingly grim. More than 200,000 people in the United States have died from COVID-19, and millions more became infected. The death of George Floyd sparked massive protests and a greater understanding of the devastating effects of racism and discrimination. And unprecedented streaks of wildfires in the West and hurricanes in the East put the climate crisis into sharp focus.
In January, ACP addressed health care access, racism in society and environmental protections in its collection of policy papers titled, “Better Is Possible: The American College of Physicians' Vision for the U.S. Health Care System.”
One of the papers, “Envisioning a Better U.S. Health Care System for All: Coverage and Cost of Care,” reflects ACP's 2019 policy that declares “equitable and universal access to appropriate health care is an ethical obligation of society.”
In the paper, ACP notes that the current model of private insurance with out-of-pocket expenses has failed to provide universal coverage. ACP supports a new approach – either a single-payer model or a public option – that provides medical care regardless of a person's place of residence, employment, health status or income.
“Tens of millions of Americans have lost their jobs during the economic havoc spawned by the pandemic, and many now lack health insurance,” Doherty said. “Under ACP's New Vision, this simply wouldn't happen. Everyone would retain coverage and not have to worry about being able to afford potentially life-saving medical care.”
In another New Vision report, titled “Envisioning a Better U.S. Health Care System for All: Reducing Barriers to Care and Addressing Social Determinants of Health,” ACP provides a roadmap to eliminating disparities.
As the report notes, wide health care disparities remain among people of different races and ethnicities. “Policies and interventions must consider these numerous barriers and strive to eliminate disparities,” ACP says. ACP points to numerous strategies that prevent discrimination and support “equitable access to high-quality health care.”
In recent months, ACP has issued statements outlining specific approaches to combatting racism. One ACP statement, issued after the death of George Floyd, said ACP is “gravely concerned whenever any person is subject to discrimination, racism, harassment and violence, whether it's by police and other public authorities, or by private individuals discriminating and committing violence against others because of their race or other characteristics.”
ACP also affirmed that “physical and verbal violence and discrimination, particularly based on race/ethnicity and other perceived characteristics of personal identity, are social determinants of health and, thus, public health issues.”
In a statement, ACP said it “reaffirms and commits to expanding on its previous policies to confront racial and ethnic disparities, discrimination and racism in health.”
The pandemic has revealed the depth of health disparities in the United States. “Black people are at far greater risk of dying from COVID-19,” Doherty said. “One reason is the systemic racism that persists in our health care system to this day. If we had addressed social determinants of health, we would be in a much better place regarding COVID-19 than we are right now.”
The “Reducing Barriers to Care and Addressing Social Determinants of Health” report also notes that climate change is a public health matter because of the role that the environment plays in our well-being. “We can't change the climate change crisis by snapping our fingers,” Doherty said. “But the terrible impact of natural disasters on top of the pandemic this year highlights how we can do much more to mitigate the impact of climate change.”
Looking forward, “it's clear that we are paying a price due to lack of universal health care and lack of progress in areas like the environment and social determinants of health,” Doherty said. “It's important that we diagnose these major shortcomings and propose solutions. We are proud that ACP is a trusted and respected part of the conversation, and we look forward to continuing to speak up on behalf of physicians and patients.”
The ACP call-to-action paper “Envisioning a Better U.S. Health Care System for All: A Call to Action by the American College of Physicians” is available on the Annals of Internal Medicine website.