The United States should abolish private health insurance and instead provide Canadian-style government coverage for everyone, a group representing 1,200 doctors proposed Thursday.
"Our health care system is failing," the group wrote. "It denies access to many in need and is expensive, inefficient and increasingly bureaucratic."They suggested a system modeled on Canada's national health program that they said would cost no more than the United States' current mix of public and private coverage.
"Every year, as the costs of the current system go up and up and the number of uninsured people goes up and up, that will be a push toward this fundamental change in our system," said Dr. David U. Himmelstein.
The proposal was drawn up by the 1,200-member Physicians for a National Health Program and published in the New England Journal of Medicine.
The group's 30-member writing committee was chaired by Dr. Steffie Woolandler and Himmelstein. The two doctors, based at Cambridge Hospital in Cambridge, Mass., recently published "a Marxist view of current U.S. health policy," which also praised the Canadian system.
"There are people of all political stripes involved in writing this, from the right to the left wing," Himmelstein said in an interview. "I am clearly one of the left-wing people."
A second paper in the journal, written by Alain Enthoven and Richard Kronick of Stanford Business School, proposed a less drastic plan for universal health insurance.
Their program would retain private insurance but require employers to provide coverage for their workers. Those not covered at work would contribute through taxes, and poor people's coverage would be totally subsidized by the government.
These authors argued that a complete government takeover of health care financing "would represent far too radical a change to be politically feasible in this country."
Dr. Arnold S. Relman, the journal's editor, wrote in an editorial that the "time has come" for universal health insurance, but he did not endorse either plan.