Health insurance is an essential element of their well-being for many Americans; however, some research findings and myths muddle public understanding about its value here in America.

Americans invest heavily in their health via direct spending, forgone wages and tax policy decisions; yet our system lags far behind other nations in important ways.


Health care costs have become a top concern of voters and are one of the main contributors to our national debt. Americans pay significantly more for health care than people in other countries while receiving inferior quality service – it is time for an approach that offers better value.

The ACP believes that single-payer or public choice models offer the greatest chance for universal coverage at a price both patients and taxpayers can afford. Whatever its specific structure may be, we must also ensure it provides essential healthcare services without exclusion or denial of treatment.

Affordable coverage requires reform of payment and delivery systems. At present, costs are driven by high prices as well as insurer administrative costs and profits; patients face burdensome cost sharing from deductibles to copayments or provider restrictions that increase cost sharing burdens; as a result of these barriers to care increasing dramatically leading to uninsured/underinsured individuals and more people unknowingly falling through coverage gaps.

ACP advocates for policies of zero cost sharing for essential services and reduced out-of-pocket costs for low-income enrollees, which have been proven successful elsewhere. Such policies would promote patient-centric and cost-cutting health care practices while decreasing out-of-pocket spending; such measures could be implemented through changing rules on cost sharing, requiring providers to negotiate discounts directly, or eliminating distinctions between employer sponsored insurance (ESI) plans and Medicare Advantage plans.

As part of its effort to bring down overall healthcare costs, the ACP recommends expanding value-based purchasing and accountable care organization models that foster quality improvement through performance reporting enhancement, shared savings programs and incentives for meeting desired outcomes.

A strong community health system must include efforts to address the social determinants of health. Hospitals and other healthcare systems have considerable wealth and clout, enabling them to use their resources and networks aggressively in tackling poverty, inequality, racism, loneliness and other drivers as effectively as cancer-fighting drugs or surgeries.


Although America boasts world-class healthcare specialists, the country ranks last among developed nations in health outcomes. Furthermore, America is known to have one of the highest rates of health disparities among high-income nations and stands alone as an industrialized country that does not offer universal coverage.

This article from lists Hawaii as the healthiest state, but that hasn’t stopped COVID-19 pandemic from making a devastating impact on the island.  This has made clear the need to alter our healthcare system in order to make it more affordable, accessible and focused on prevention and wellness. We must do a better job addressing social determinants of health such as housing, transportation and food security while simultaneously making sure all members of society have access to quality medical services.

Though the Affordable Care Act (ACA) has succeeded in decreasing the number of uninsured Americans, millions remain without coverage due to lack of funds and eligibility criteria for healthcare coverage. Furthermore, physicians face restrictions in treating people without coverage thus creating another barrier to healthcare services that are essential.

An alternative approach is required, and the American College of Physicians supports a single-payer or public choice model funded through government spending, employer contributions, progressive income taxes, tobacco and alcohol excise taxes, value-based cost sharing arrangements and reallocation of savings from reduced administrative spending. Furthermore, such an approach should maintain current health care programs serving specific populations, such as Veterans Health Administration services for veterans and Medicaid long-term services and supports for Medicaid recipients and Indian Health Service services.

The American College of Physicians promotes efforts to alleviate administrative burdens on physicians, such as billing and regulation which are inefficient and expensive. Research indicates that current practice necessitating physicians to submit duplicate medical records, report identical metrics on every patient, and devote over 50% of their time to administrative duties can contribute to burnout; such demands could even cause errors that endanger patient safety.

State-level experimentation with alternative models for the health system should be allowed within agreed national boundaries, within agreed national guidelines. Our aim should be to design a model which provides better health care while still maintaining popular features of the current system; while this won’t be easy, bipartisan support in Congress may help guide this journey.


Access and affordability of health care are top political concerns and key contributors to our national debt. Recently released OECD data provides insight into America’s health system compared to others across the world; while our current approach may have some flaws, steps can be taken to remedy its deficiencies.

An effective multipronged strategy to increase access is necessary for improving it. First, community health clinics and other local points of access must be expanded for effective grassroots population health services to be created; next should come an equitable subsidy system moving away from employer-sponsored insurance towards “Medicare Advantage for All,” while still permitting for some state variations; lastly quality improvement at point of delivery by targeting social determinants of health should also be prioritized.

People without health insurance tend to postpone visits to doctors or hospitals for routine check-ups, leading to missed health milestones that could have long-term ramifications for their wellbeing – from delaying preventive screenings and appointments, missing important diagnoses or treatments, or incurring prohibitively expensive out-of-pocket costs resulting from high out-of-pocket costs that often outweigh coverage options. This issue can only become compounded without sufficient health coverage in place.

Health system leaders face many financial, geographic and cultural barriers when working to increase access. Though these obstacles may seem formidable at first, successful leaders know there are ways to overcome them.

Poverty stands as one of the biggest hurdles to health care access for many, making it harder for individuals to seek treatment and make wise lifestyle choices that support good health. Poverty stems from many complex factors – low wages and lack of opportunities in the job market come to mind as examples – but ultimately poverty reduction must become our top goal for creating access to health care for all Americans – this long-term objective should be supported by everyone.


Equity is essential to an efficient health system, both horizontally and financially. Horizontal equity refers to providing similar insurance coverage regardless of work status and geography; recent efforts such as exchange plan subsidies, expanded Medicaid eligibility and the Cadillac Tax on generous employer-sponsored insurance (ESI) plans have advanced this goal; but for true reduction of inequality more is required than just expanding exchange plan subsidies or expanding Medicaid eligibility – such as transitioning towards Medicare Advantage for All plans while using program flexibility to encourage state variation in design of coverages.

Hospitals and health care systems possess immense wealth and influence in their communities. Hospitals and other health care systems often rank among the largest employers and contributors to political campaigns; therefore, they must harness these resources and leverage their considerable clout to address social determinants of health with equal vigor as they do diseases with medication or surgery – this task requires bold leadership and structural reform.