PNHP’s open letter to President Trump

An Open Letter To Trump: The GOP Health Plan Won’t Work, Replace ACA With Single Payer

The Huffington Post, March 9, 2017

Dear Mr. President,

You vowed to replace the Patient Protection and Affordable Care Act (ACA) with something great that would provide Americans with universal coverage and lower deductibles and copayments. As leaders of Physicians for a National Health Program (PNHP), a nonpartisan organization of 20,000 physicians and medical students, and as a business leader who desires fundamental health reform, we request an opportunity to meet with you to explain why single-payer, Medicare for all, is a great solution that will meet your stated goals.

Health care reform is urgently needed. Seven years after the passage of the ACA, 26 million Americans remain uninsured, tens of millions more are underinsured, and health care costs – already twice as high as the average of other wealthy nations – continue to rise. In a recent survey, Americans were more likely to report financial barriers to health care than citizens of any of the 11 other nations surveyed. One-third of Americans, including 43 percent of low-income persons, went without health care due to cost last year.

Unfortunately, “The American Health Care Act” (AHCA) would be a big step in the wrong direction. The bill would shrink Medicaid benefits for millions of poor and low-income families. It would sharply reduce the value of government subsidies, leaving millions of near poor and middle income Americans unable to afford coverage, and shifting millions of others to the kind of bare bones plans that you have decried. Meanwhile, it would give hundreds of billions of dollars of tax breaks to the wealthiest 2 percent of Americans, and reward insurance firms that pay outrageously high executive salaries.

In sum, this legislation will degrade already inadequate coverage, increasing financial barriers to care and endangering tens of thousands of lives, merely to reduce taxes on rich individuals and corporations.

The working people of America are looking to you for something better.

In contrast, a single-payer system, essentially an expanded and upgraded version of traditional Medicare, could meet your stated goals of more coverage, better benefits and lower costs. Such reform would drastically cut insurance overhead and the paperwork insurers inflict on doctors and hospitals, saving more than $500 billion annually. Those savings would cover the cost of universal, first-dollar coverage – including dental services and long-term care – upgrading coverage for the vast majority of Americans.

And a single-payer reform would allow the U.S. to use proven-effective tools to control costs. Instead of disrupting the delivery of care by shoehorning every doctor and hospital into a gigantic corporation, it would support practices and hospitals of all sizes with negotiated fees and global budgets. Negotiating prices with drug firms as other countries do would save another $150 billion annually. Controlling costs is the only way to make our health care system sustainable for future generations.

Single payer would lift the burden of health benefit costs from employers, making U.S. business more competitive. Richard Master, a business owner in Pennsylvania, produced the film “Fix It” to explain the benefits of single payer to business. Adopting a single-payer system would help keep jobs in the U.S.

Legislation for “improved Medicare for all,” H.R. 676, was introduced in the Congress last month by Rep. John Conyers. Polls have shown that 58 percent of Americans favor replacing the ACA with a single-payer system, as do 59 percent of physicians, 81 percent of Democrats, and a rapidly growing share of Republicans.

Single payer has proven effective in countries around the world, as evidenced by experience in Canada and Scotland, which spend far less than we do, cover everyone, and provide care free at the point of delivery. Tommy Douglas, the founder of Canada’s system, is ranked the most popular figure in that nation’s history, and Sen. Bernie Sanders attracted a huge following with his support for single payer, Medicare for all in his run for the Democratic primary.

PNHP has, from the outset, been strongly critical of the ACA’s failure to solve our nation’s health care crisis. The AHCA would divert us even further from the goal of solving that crisis and tarnish your legacy. Single-payer reform is the only solution.


Steffie Woolhandler, M.D., M.P.H., Co-founder PNHP

David Himmelstein, M.D., Co-founder, PNHP

Carol Paris, M.D., President, PNHP

Don McCanne, M.D., Senior Health Policy Fellow, PNHP

Adam Gaffney, M.D., Board member, PNHP

Janine Petito, Medical student board member, PNHP

Richard Master, Chairman & CEO, MCS Industries, Inc.



By Don McCanne, M.D.

President Trump was not well informed on health policy when he took office. He has been too busy with other things. He did know that serious problems persisted in spite of Obamacare - too many uninsured, insurance plans that left people with excess medical debt, too many had impaired access to the health care they needed, and health care costs were too high. So he promised that Obamacare would be repealed and replaced with a really terrific plan - “insurance for everybody… much less expensive and much better.”

He is surrounded by advisors who have given him lessons on health policy, but, unfortunately, all the wrong lessons. He now understands that health reform is very complicated, so he left it to his advisors and Congress to provide the details. They are currently trying to pass a program that insures fewer people and makes access to health care much more expensive because of high out-of-pocket costs - a program that is much worse for the American people - the opposite what he promised us.

The primary goal of his advisors is to reduce the role of government - fewer regulations and less government spending. They thought that they could cover their misdeeds with rhetoric that did not reveal their nefarious intentions - like making sure that everyone had “access” though remaining silent on the fact that for many actual health care would not be affordable even if accessible.

If President Trump is sincere in wanting everyone to have better health care that is affordable, then he needs a crash course in beneficial health policy.

Physicians for a National Health Program has a mission of educating the public and policymakers on the truth behind health care financing - that we are already spending enough to provide high quality health care for absolutely everyone without causing anyone to face financial hardship because of the costs of health care.

We even have a very successful businessman, Richard Master of MCS Industries, who can explain the advantages of single payer in terms that Donald Trump can really understand.

PNHP’s open letter needs to make it to the President’s desk, or better, directly handed to him so that he realizes that he was correct when he mentioned that single payer systems seemed to work well in other nations.

Time to make some noise - social media, community action, or whatever. He needs to see this letter.