He makes a good living as chief of the pediatrics department at Mercy Children's Hospital in Toledo, but he knows that if he ever loses his job - “I'm toast.”
That's because Dr. Schaeufele has cystic fibrosis, a degenerative lung disease. His expensive health care is now paid by the hospital, but he could never afford to pay for his own insurance.
He said 41 million Americans already face that dilemma - they don't have health insurance.
Angered by those statistics and convinced they've got a solution, nearly 8,000 U.S. physicians signed on in support of the article in the journal.
Signers of the article were led by Marcia Angell, former editor of the New England Journal of Medicine, and former Surgeons General Julius Richmond and David Satcher.
Under their proposal, health coverage would be provided for all Americans by eliminating all private insurance and making the government pay health costs, similar to what exists in the world's other industrialized nations. The supporters argue cost savings from eliminating existing administrative costs would pay program costs.
It's not a new concept. Dr. Jonathon Ross, a Toledo physician and supporter of nationalized health coverage, said proposals like this have circulated since the 1930s. Dr. Ross, immediate past president of the Physicians for a National Health Program, the group that wrote today's article, argues that “doctors are beginning to say, `wait a minute, we're worse off and our patients are worse off.'”
Dr. Joseph Shapiro, chairman of the department of medicine at the Medical College of Ohio, also signed on to the article.
He just volunteered in a free medical clinic in Toledo last week and was stunned by what he saw - patient after patient who had jobs but lacked health insurance.
“These weren't people living under a bridge - they had jobs,” he said. “It's an insane system. And the number of patients who are uninsured or underinsured seems to be growing on a daily basis.”
“The system cannot continue much longer the way it is,” Dr. Angell, a Harvard Medical School lecturer, said in an interview. “It is clearly imploding. It isn't that single-payer is the best choice. It's the only choice.”
The American Medical Association remains opposed to a single-payer health care system, Dr. John Palmisano, AMA's president, said in a statement.
“By implementing a single-payer system, the U.S. would be trading one problem for a whole set of others,” Dr. Palmisano said. “Long waits for health care services, a slowness to adopt new technologies and maintain facilities, and development of a large bureaucracy that can cause a decline in the authority of patients and their physicians over clinical decision-making are all hallmarks of the single-payer system.”
The physicians signing on to the article account for less than 1 percent of the 813,770 U.S. physicians as of 2000, according to the AMA.
Karen Davis, president of the New York-based Commonwealth Fund, praised the article's authors for calling attention to the problem, although she doubted their solution was practical.
The nonprofit Commonwealth Fund finances research on health and social issues, including the uninsured.
Her group has proposed a plan that would continue to rely on private insurance and government programs like Medicaid or Medicare.
Those who don't have private insurance or don't qualify for Medicaid or Medicare would qualify for a new government-run program paid for by a payroll tax.
All employers would have to either provide health insurance for their employees or pay into a national fund that would cover uninsured Americans.
The Associated Press contributed to this report.
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