Open Letter to President Obama on Health Care Reform From Margaret Flowers, MD

Dear President Obama,

I was overjoyed to hear you say in your State of the Union address last night:

“But if anyone from either party has a better approach that will bring down premiums, bring down the deficit, cover the uninsured, strengthen Medicare for seniors, and stop insurance company abuses, let me know.”

My colleagues, fellow health advocates and I have been trying to meet with you for over a year now because we have an approach which will meet all of your goals and more.

I am a pediatrician who, like many of my primary care colleagues, left practice because it is nearly impossible to deliver high quality health care in this environment. I have been volunteering for Physicians for a National Health Program ever since. For over a year now, I have been working with the Leadership Conference for Guaranteed Health Care/ National Single Payer Alliance. This alliance represents over 20 million people nationwide from doctors to nurses to labor, faith and community groups who advocate on behalf of the majority of Americans, including doctors, who favor a national Medicare for All health system.

I felt very optimistic when Congress took up health care reform last January because I remember when you spoke to the Illinois AFL-CIO in June, 2003 and said:

“I happen to be a proponent of a single payer universal health care program.” (applause) “I see no reason why the United States of America, the wealthiest country in the history of the world, spending 14 percent of its Gross National Product on health care cannot provide basic health insurance to everybody. And that’s what Jim is talking about when he says everybody in, nobody out. A single payer health care plan, a universal health care plan. And that’s what I’d like to see.”

But as all of you know, we may not get there immediately. Because first we have to take back the White House, we have to take back the Senate, and we have to take back the House.”

And that is why I was so surprised when the voices of those who support a national single payer plan/Medicare for All were excluded in place of the voices of the very health insurance and pharmaceutical industries which profit off the current health care situation.

There was an opportunity this past year to create universal and financially-sustainable health care reform rather than expensive health insurance reform.

As you well know, the United States spends the most per capita on health care in the world yet leaves millions of people out and receives poor return on those health care dollars in terms of health outcomes and efficiency. This poor value for our health care dollar is due to the waste of having so many insurance companies. At least a third of our health care dollars go towards activities that have nothing to do with health care such as marketing, administration and high executive salaries and bonuses. This represents over $400 billion per year which could be used to pay for health care for all of those Americans who are suffering and dying from preventable causes.

The good news is that it doesn’t have to be this way. You said that you wanted to “keep what works” and that would be Medicare. Medicare is an American legacy of which we can feel proud. It has guaranteed health security to all who have it. Medicare has lifted senior citizens out of poverty. Health disparities, which are rising in this nation, begin to disappear as soon as patients reach 65 years of age. And patients and doctors prefer Medicare to private insurance. Why, our Medicare has even been used as a model by other nations which have developed and implemented universal health systems.

Mr. President, we wanted to meet with you because we have the solution to health care reform. The United States has enough money already and we have the resources, including esteemed experts in public health, health policy and health financing. Our very own Dr. William Hsiao at Harvard has designed health systems in five other countries.

I am asking you to meet with me because the solution is simple. Remove all of the industries who profit off of the American health care catastrophe from the table. Replace them with those who are knowledgeable in designing health systems and who are without ties to the for-profit medical industries. And then allow them to design an improved Medicare for All national health system. We can implement it within a year of designing such a system.

What are the benefits of doing this?

• It will save tens of thousands (perhaps hundreds of thousands) of American lives each year, not to mention the prevention of unnecessary suffering.

• It will relieve families of medical debt, which is the number one cause of bankruptcy and foreclosure despite the fact that most of those who experienced bankruptcy had health insurance.

• It will relieve businesses of the growing burden of skyrocketing health insurance premiums so that they can invest in innovation, hiring, increased wages and other benefits and so they can compete in the global market. For example, it is estimated to provide a major stimulus for the U.S. economy by creating 2.6 million new jobs, and infusing $317 billion in new business and public revenues, with another $100 billion in wages.

• It will control health care costs in a rational way through global budgeting and negotiation for fair prices for pharmaceuticals and services.

• It will allow patients the freedom to choose wherever they want to go for health care and will allow patients and their caregivers to determine which care is best without denials by insurance administrators.

• It will restore the physician-patient relationship and bring satisfaction back to the practice of medicine so that more doctors will stay in or return to practice.

• It will allow our people in our nation to be healthy and productive and able to support themselves and their families.

• It will create a legacy for your administration that may someday elevate you to the same hero status as Tommy Douglas has in Canada.

Mr. President, there are more benefits, but I believe you get the point. I look forward to meeting with you and am so pleased that you are open to our ideas. The Medicare for All campaign is growing rapidly and is ready to support you as we move forward on health care reform that will provide America with one of the best health systems in the world. And that is something of which all Americans can be proud.

With great anticipation and deep respect,

Margaret Flowers, M.D.
Maryland chapter, Physicians for a National Health Program


  1. Wayne Tirone on January 28, 2010 at 3:57 pm

    Single Payer is the solution to our health care problems.
    It’s been over 70 years since this idea was proposed so
    the time is now.

  2. SALVATORE CINA on January 28, 2010 at 3:58 pm


  3. Kent Zavacky on January 28, 2010 at 4:02 pm

    that is exactly what we need, and until the “for Profit” motive is taken away only then can we join the rest of the developed world.
    Though not an ideal solution , having a public option would put us on the way to full coverage for all a very long eventually…) and might stop a little bleeding , but unless costs are under control and managed by an overseer (fed gov’t agency-like in other countries ) then without controls we will continue to have a joke of a health care -dare i say system?

  4. Karen Kowalski on January 28, 2010 at 4:33 pm

    Please don’t give up on this priority. Without our health coverage we will continue to be sick and tired and unable to accomplish all the great things that we as Americans can do both fo ourselves and the world.

  5. libsechumanist on January 28, 2010 at 4:33 pm

    Health Insurance Reform doesn’t deliver Health Care; Medicare For All delivers Health Care to everyone in the nation at the lowest cost. Money paid in by everyone – not premiums – goes to someone’s health care to the tune of 97%. A 3% overhead to pay administrative costs insures that people can receive the CARE they need, not “coverage” that can be canceled at any time after people pay inflated premiums to for-profit companies who primary goal is to make profits for the shareholders and Board of Directors – not pay for health care. These companies do not provide ANY service; they do not produce ANYTHING; they are NOT needed.

  6. Harold (Hal) Iler on January 28, 2010 at 4:37 pm

    I am a retired insurance agent and CFP (Certified Financial Planner).
    I totally believe the time has come for single payer Medicare for all. I am also a strong Obama supporter who donated to his campaign.

    One item that I have never seen or heard mentioned regarding the expansion of Medicare to all is that such an expansion of enrollment to all citizens would bring about a very positive risk factor that would greatly decrease the average claim per enrollee. By enrolling everyone we would have a much healthier risk pool due to the enrollment of many healthy young and middle aged people, and not just the elderly and ill, like my wife and I.

    I think this fact should be pointed out to President Obama and included in all political advertising and correspondence in favor of single payer Medicare for all.

    Good luck on meeting with the President.

  7. Pat Sarotte on January 28, 2010 at 5:00 pm

    Mid-America is hurting today, in spite of the “recovery” that hasn’t happened yet for us. Allowing Health Insurance Companies to hold us hostage is not “Change” but one more nail to tighten the coffin on our futures. Please listen to us. We need Single Payer, now!

  8. Elizabeth Rosenthal on January 28, 2010 at 5:29 pm

    As a physician for 36 years, I have seen what a mess our health care system has become. Medicare for all would solve our problems and bring quality health care to all Americans for no more than we are already spending. It is time to make a committment to taking care of all our citizens instead of taking care of the private health insurance companies!

  9. Margie Rece on January 28, 2010 at 5:51 pm

    I am on medicare only and it has worked well for me. It would work even better if all of us in this country were on it and people would not be losing their health, their homes. their ability to care for their families, their jobs and their retirement funds. They would be focused on recovering their lives, post illness, instead of struggling to pay bills and worrying about what they can do to pay for other necessities. I love my life, working on health care for everyone. As retired RN I enjoy seeing all get the health care they need.
    We can do this, yes we can.

  10. Diane Richardson on January 28, 2010 at 6:00 pm

    Yes! I have a better idea! If the question is not empty rhetoric.

    I believe that a simple way to pay for Universal Health Care (UHC) is through a national sales tax collected by each state and administered within each state by a private sector company (by open bid – non-profits could be chosen if they were the lowest bidders), without any other government involvement.

    If this suggested tax exempts the retail purchase of food and clothing, and transportation costs, and pays only for preventive care, testing, overnight hospitalization, prescription drugs and other important needs that most people could not like afford, that’s fine with me.

    The many benefits should be obvious:

    We all pay for what get through the sales tax.

    The tax might include a portion to payoff debt in health care.

    No cost to the government, and no year-to-year or future health care debt.

    No added federal controls and bureaucracies – no federal government involvement in health care after creating the proper legislation.

    No profits for companies providing health care insurance – all the money goes directly into actual health care costs. I’m a conservative and support free enterprise but don’t feel health care risk insurance is a place for profit.

    Those that wish to have health care insurance for the services not covered by UHC could still buy it.

    No limits on necessary health care, even when unemployed, although we probably need a mechanism to prevent frivolous demands for service. (To make this work we probably need to ask hospitals to create separate low-cost sliding-scale profit centers for those that go to their their ERs. More immediate care centers would also help here.)

    Each state would control its own health care system.

    To contain spending (and keep the federal government out of the process) I would suggest that the sales tax collected should not cross state borders – the money collected in a state is used only in that state.

    Each state hires a private sector company to administer the payments to its health care providers, with payments drawn from the state UHC sales tax trust account, and the state acts only as an overseer and QA administrator – checks and balances.

    To control fraud the state could ask the private sector company administering the payment system to report potential fraud, and when the state finds fraud it pays the private sector company a reward and prosecutes the criminals. Or health care investigation companies could be hired on a contingency plus reward basis, so the state is not directly involved, for all the reasons we don’t want government doing any more than they need to do – bureaucratic procedures, excessive costs, etc.

    My estimate is that this universal sales tax would be about 8%, or about $800B/year, and eliminate the cost of most other health care programs and insurances. perhaps even Medicare if some tort reform where to be enacted. Most important to me, and most conservatives I presume, is keeping government involvement to a minimum and controlling fraud. So if you truly want bipartisan support for UHC, then you will need to find a way that does that, and this methods solves that problem.

    If desired it should wait until the economy is recovering. And I have a suggestion to fix it too.

    • John Barker on January 30, 2010 at 12:19 am

      It is often said that a national sales tax would not be progressive “like” the income tax and hurt the poor. Alas, its an illusion. The poor and the middle class pay anyway every time they buy goods or services because corporations, retailers, and small business people pass their taxes on to consumers. The rich have options to reduce or even evade taxation so why not eliminate income taxes and impose a value added tax on goods and services that everyone must pay, rich or poor. That way everyone pays taxes on legal or illegal gains and the Republican mantra of no increase in taxation would lose some of its political punch.

  11. Corinne Willinger on January 28, 2010 at 7:19 pm

    The fight for Medicare for All has been going on for too long, but we can’t give up now and accept the weak bills that both the Senate and the House of Representatives are proposing – they have made Healthcare legislation ineffective. Congress must get rid of the Insurance and Pharmaceutical Companies’ influence.

  12. Beverly Riggie on January 28, 2010 at 9:44 pm

    It is time for healthcare reform. The insurance companies place such a burden on individuals and businesses because of cost. I know people who could benifit from national healthcare. It is so disgusting to see the profits being made at the expense of the people of our country. We need healthcare for ALL our people.

  13. Angela Ross on January 29, 2010 at 12:05 am

    Dear Dr. Flowers,
    Thank you so very much for delineating so clearly the rationales for a single payer health care system. And thank you for delivering this important message to President Obama. People like you are authentic American (and humanitarian) heroes. Keep up the great work! We must not give up on this issue. You have my deepest admiration and gratitude.

  14. Susan Tabpr on January 29, 2010 at 1:14 am

    I also was excited by President Obama’s words that he wants to hear from us with better ideas to solve our health care crisis. I sent an email to him (the phone line was continually busy) declaring that it’s time to put HR 676, single payer universal healthcare back on the table! Medicare for All will ensure that everyone has the right to quality health care. Eliminate the for profit insuance & pharmaceutical industries’ hold on our country now before it’s too late!

  15. Stephen W. Davis on January 29, 2010 at 10:36 am

    I am an analyst for the Social Security Administration. My job is to review Judge’s decisions on claims for disability. One of the costs of our broken heatlh care “system” which few realize is the number of people who file for and may ultimately qualify for disability because they cannot afford treatment for chronic diseases such as diabetes. We have seen in the “Free Clinic” experience the number of people who have zero access to preventive health care and end up in emergency rooms facing medical crisis. Not only is our current system amoral, it is counterproductive for the society as a whole as millions suffer to preserve unholy profit for the few. The monetary costs to the country in terms of disability benefits and emergency room services paid for by all of us by way of higher premiums ought to be sufficient reason for even the most benighted tea bagger to support single payer, and yet, the corporate sponsored propagandists have managed to define and degrade the terms of the debate to the point of stalemate. The people whose cases I review, every day, are in a world of hurt which might be mitigated to some degree by a reformation of our health care philosophy which holds that health is a right, not a commodity.

  16. zahira julie anne allen on January 29, 2010 at 6:41 pm

    Yes yes yes! I am so happy to see this circulating. I voted happily for our president, but this issue is such a disappointment so far. I would love to see a positive outcome, in the direction expressed in this letter. thank you thank you

  17. Russell Novkov on January 29, 2010 at 10:56 pm

    Doctor Margaret Flowers needs to have her voice heard,therefore she shouldn’t be turned away.

  18. Gus Gomez on January 29, 2010 at 11:36 pm

    Single payer health care!

  19. Carol on January 30, 2010 at 1:28 pm

    We can’t afford to go to the doctor at all because we don’t have health insurance nor from what we are looking at we never will be able to afford it and I don’t believe it will ever change.

    As long as you are American/American we considered to be garbage but if you are American/Cuban or any other thing it is given to you as though you are gold and I just don’t get it.

    We had to go to the doctor to get our RX’s renewed but it cost us $82.00 each just for that we paid half because that is what the doctor wanted but just for him to look at us. That makes us really ill just to for him to look at us.

    Maybe we should go out in the ocean and come back on a boat and get whatever we need whenever we need it.

  20. Ann on January 30, 2010 at 1:28 pm

    This all sounds very wonderful. But when you force citizens to buy into these ‘healthcare’ insurances, just make sure you ‘force’ doctors, hospitals/medical facilities and pharmaceuticals to accept ALL healthcare insurances and medicare. More and more doctors and hospitals are refusing any kind of healthcare insurance and Medicare. You must have the money up front, then you have to file with the insurance companies and Medicare. What a nightmare that is. And why is healthcare insurance three times less on the east coast as it is on the west coast?

  21. Gerda Neu-Sokol on January 30, 2010 at 2:19 pm

    Dear Dr. Flowers,
    Thank you for your excellent letter addressing our lamentable current health care situation! And thank you for trying to deliver this message personally to President Obama!! I admire your courage and, your insight and your clearminded, intelligent presentation of our present health care malaise. I am a german-american citizen and have been puzzled, as long as I’ve lived in the US, why a nation would put up with such a poor, wasteful, and so un-democratic a system.

  22. Dr. Jill Harmer on January 31, 2010 at 4:05 pm

    Dr. Margaret Flowers is my hero. Please listen to her, for she represents me and millions of Americans. I have limited my pwsychotherapy services by not using insurance companies who violate confidentiality, even though they say that they are complying with HIPPA. Who in these companies sees the notes needed to ask for more sessions? Why do inexperienced people make important decisions over the treatment such as how many sessions? The answer is easy. Profit matters more than people.

  23. Richard Heckler on January 31, 2010 at 10:45 pm

    24/7 Pro Business Pro Consumer Health Care Coverage! YES!

    Let ME pay for National Health Insurance with MY tax dollars for MY National Health insurance.

    Here’s the deal. National Health Insurance is not a free ride and never will be perhaps with few exceptions.

    You see my tax dollars will pay for my portion therefore no one else would be paying for MY National Health Insurance coverage. A 3.3% payroll tax is doable.

    However if you listen to the republican party NOT and Max Baucus you would be led to believe that my tax dollars are not my tax dollars. How can that be?

    The fact that National Health Insurance would come from the rather substantial tax dollar cookie jars simply means that no monthly or weekly deductions would come out of my pay check per se..

    Since federal, state, and local governments collect trillions in taxes of all kinds—income, sales, property, corporate etc etc this is how medical bills would be paid as it is now.

    You see as we speak the government tax dollars support medical insurance payments to the tune of at least $1.2 trillion which is quite a gravy train I’d say. Next year this will increase by changing nothing and not passing the National Health Insurance Act.

    In essence MY tax dollar amount to pay MY portion of National Health Insurance would be about $2700 annually for the entire family.

    What coverage would this buy the family:

    *long term care such that cancer demands
    *prescription drugs
    * hospital
    * surgical
    * outpatient services
    * primary and preventive care
    * emergency services
    * dental
    * mental health
    * home health
    * physical therapy
    * rehabilitation (including for substance abuse)
    * vision care
    * hearing services including hearing aids
    * chiropractic
    * durable medical equipment
    * palliative care

    A good deal that would free up more expendable cash to be spent elsewhere thus creating new jobs. Things like birthdays,christmas,home improvements,taking better care of my lover and investments would benefit.

    Social Security and Medicare are two very smart insurance plans.

  24. Wayne A. Mayo on February 1, 2010 at 1:41 pm



    We can fight for the goal of mandating private insurance coverage for all, so that … at the very best … tens of millions of Americans can keep scraping together money for premiums with insurance policies featuring high deductibles and coverage loopholes big enough to drive an ambulance through.


    Self-described realists, including many Democrats, are saying that we need to curb our enthusiasm for single-payer health care and cut a deal … once again with the insurance industry powers-that-be and their legions of allies in the nation’s capital. But PDA (Progressive Democrats Of America) isn’t that way.


    The time is now for true health care reform … a new heath care system which has only one priority … the health and well-being of all Americans regardless of their pre-existing conditions, their age, their standard of living, their wealth or lack thereof … ALL AMERICANS!


    Wayne A. Mayo

  25. ozma10 on February 4, 2010 at 6:56 pm

    I think everyone should copy this letter and send it to the White House. Maybe if they get several thousand copies someone will finally ask Obama to read it and maybe even respond.

  26. David Lynaugh on February 5, 2010 at 9:05 pm

    To My Fellow Americans,
    I have a great job, but my health insurance is so hard to work with ( filing claims, not paying what they should) that my care giver of over 20 years dropped me and my family! This is outragious! I firmly believe the attitude in in our nation is wrong. HEALTH CARE SHOULD BE A BASIC HUMAN RIGHT FOR ALL! Now it is viewed as a privilage for the few wealthy and the elite! Health care in the US is a money making business bottom line! It should viewed to help the fellow citizen not as body that is expendable! This attitude of profit and money most important, than the person it should service is the same level as Hitler treaded his poeple, with no feelings or compassion. Please do something to make this system better! Other countries around the world are laughing the great USA that can not fix their own problems! I love the US, but to get better health care for my family and myself, I am willing to leave it for a better life! THANK YOU! GOD BLESS YOU ALL!

  27. Shailja Mukhtyar MD on February 5, 2010 at 11:34 pm

    Dr. Flowers, I fully agree w/ you, as do most friends & family ( most being physicians themselves). National Health Care may give the primary care giver the funds to stay in business, w/o all CYA tactics, and fear of litigation. Paperwork is outlandish, and thus no time for patient care.

    I also support decent hours in residency training… should be at least minimum wage!! The public & unions get minimum wage, physicians should get proper reimbursement for years / a lifetime of dedication, in a society w/ no appreciation.

    Number of seats in Med schools fell 25%, b/c of lack of enrollment, lack of interest, alternative career options w/ a life style. Alas, for every resident position open, nearly 5000 applications from FMGs, will fill the spots in minutes…

    Health care industry must pay respect to the primary care taker, the physicians, not only the nurses & technicians. National Health Care will work towards that goal.

    Public fears are propogated by insurance companies who fear losing business, or need to actually provide services, or inability to drop patients w/ illness…. We need few like you, taking time to be our voice, recognizing we often are too busy to come up for air, trying to keep up w/ the work.

    Shailja Mukhtyar MD

  28. Anand Keathley on February 6, 2010 at 2:05 am

    Since the American people support Medicare, but the idea of dropping the age of eligibility to 55 has been nixed by Joe Leiberman and others, what if we propose that every year we drop the age of entrance to Medicare by one year. So if we started now in 2011 the age to start would be 64. In 2012 the age would start at 63 and so on. Yes, I would prefer to have single payer years ago. But I think this might really get the need 60 votes in the Senate.

  29. James J. Gallagher on February 6, 2010 at 1:20 pm

    Dear Dr. Flowers,
    Thank you so very much for supporting a single payer health care system. And thank you for delivering this important message to President Obama. I think he needs a little help to do the right thing. People like you are heroes. Keep up the great work! We must not give up on this issue. You have my deepest admiration and gratitude.
    If I can do anything to move our counry closer to a single payer system please contact me.
    James J. Gallagher

  30. Margaret Shamonsky M.D. on February 6, 2010 at 9:29 pm

    I agree with Dr. Flowers’ statements and have believed that we should have single payer universal healthcare ever since I went to medical school in the 1970’s. When the first “for profit” hospital appeared I felt things were going in the wrong direction. I believe health care should be a right, not a commodity.

  31. Marie Davis on February 6, 2010 at 11:01 pm

    I voted for the President because of his seeming compassion for American people who are being financially strangled by the inaffordability of quality health care. I recall his impassioned speeches of his mother’s struggle with insurance companies during her final illness. HIS MOTHER’S STRUGGLE WAS WITH INSURANCE COMPANIES.

    The only solution to America’s health care crisis is a single-payer system provided to medical professionals, providers and hospitals. Everyone pays, everyone is covered. Health care money is provided to doctors, medical professionals and hospitals, paid for by all American citizens. Individual health care decisions are made by doctors, patients and their families, NOT INSURANCE COMPANIES.

    We do not need commercials hawking the latest drug for every ailment known to man, and some unknown ones…WE ARE TIRED OF THE GLOSSY COMMERCIALS! WE ARE TIRED OF THE SOFT-SOAP! WE ARE TIRED OF THE SALES PITCH! We need a real, meaningful health care system for ALL AMERICANS!

  32. Lya Sorano on February 8, 2010 at 9:32 am

    I saw you yesterday on Bill Moyers’s PBS program and am delighted to know this movement continues; since last summer, without media coverage, I was afraid you and your colleagues had given up. Universal healthcare is the ONLY solution. Please keep advocating for it.

  33. Rick Novotny on February 8, 2010 at 10:25 am

    Single Payer is he only way to cover everyone but insurance companies want their billions to play with. Which soon will be zillions because after all they should not be out done…….. in the gambling world. grrrrrrrrrrrrrrrrrr

    Thank you for the letter Margaret


  34. sharyl hodges on November 27, 2010 at 1:07 am

    Dr. Flowers: thank you so much for trying to represent the best interests of the public. You and your colleagues public service and hard work has not gone unnoticed or unappreciated. You are a real American Hero. Sadly, President Obama’s lofty rhetoric about change was no more than lofty rhetoric. And the Congress, both Democrats and Republicans are owned by for profit health care providers (actually bought and owned by corporations period.) Our representatives no longer represent us and people no longer go to Washington DC to perform public service.

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  36. unite now on August 6, 2013 at 7:54 pm

    For the life of me I cannot understand how ANY American can want the Private Healthcare system! Health Insurance is a total SCAM! What it DOESNT COVER is bankrupting the American people. How can anyone want
    1.Crazy deductibles
    2.Claim denials
    3. 30-40% that insurance doesn’t cover!
    4. Out of control premiums. wont pay for prescriptions.
    6. out of control rising costs.
    7.rising premiums that are out of control.
    8. American’s still swamped with medical bills
    9. Bankruptcy