I was recently asked by my medical school to look up the policy positions of my future medical specialty society and choose a policy about which to contact my state legislators. I was disappointed to find that the Society of General Internal Medicine (SGIM) last published a policy position on American healthcare reform in 2009. The first principle of this position proposes “that all United States residents have access to affordable, comprehensive, equitable health care for medical, dental, mental, and substance use disorders, including prescription drugs and necessary devices, as well as preventive care.”1 Additionally, a 2015 SGIM Forum article identifies healthcare access as a key focus of the Clinical Practice subcommittee and declares that “this subcommittee is committed to universal health care access.”2 Yet, there appears no follow-up SGIM position paper advocating for a specific solution that would help achieve this important objective.
To a growing majority of physicians, this solution is a universal, single-payer health care system.3 I support a single-payer system, also known as Medicare for All, because each of my future patients deserves high-quality care without fear of going bankrupt. As a fourth-year medical student at UNC School of Medicine, I have already cared for many patients whose deaths could have been prevented by simple, cost-effective screening and treatment available with health insurance. While the Affordable Care Act was an important step in the right direction, its limitations have further proven that a universal system that takes the profit out of healthcare is the only path forward to improving and expanding access to care for all Americans. The new reality we face in addressing the COVID-19 pandemic makes the case for Medicare for All even more clear and dire.
McCormick, et al., succinctly argued in their 2018 perspective piece for the moral and practical reasons SGIM should be in favor of a single-payer system.3 Nonetheless, no further policy has been released. While I understand that the primary function of a specialty society such as SGIM is to advocate for policies that protect and support their members, I cannot bring myself to join a physician society that does not actively speak out for the best interests of our patients, a significantly more vulnerable group that we have taken an oath to protect. Other physician organizations have made moves in this direction in response to calls from within and outside of their membership. Since 2018, the American Medical Association backed out of the Partnership for America’s Health Care Future, an alliance centered around opposition to Medicare for All, after its members voted narrowly against endorsing single-payer.4 More recently, the American College of Physicians (ACP) has endorsed single-payer or public option reform as the best ways to achieve universal access.5
SGIM should join the ACP in being a leader on healthcare reform now before policy decisions are made for us and our patients without the expertise and input of America’s general internists.