Reuters/Gary Cameron

Medicare for All supporters got a huge endorsement on Monday from the American College of Physicians.

It's the second largest doctor group in the United States.

The ACP in a health journal called for reforms of American healthcare that lead to universal coverage, backing both a single-payer system under Medicare for All and the creation of an optional government health insurance plan.

Though the organization didn't endorse a politician or party, the ACP's new support for deep reforms comes as Democrats brawl over the best approach to remake the US healthcare system.

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Medicare for All supporters locked down a significant endorsement on Monday: the second largest doctor group in the United States.

The American College of Physicians called for the federal government to embark on sweeping reforms of the nation's healthcare system that would lead to universal coverage, making the statements in the Annals of Internal Medicine, a health journal.

The organization endorsed the ideas of both a government-run single-payer system that would cover everyone, popularly known as "Medicare for All," or the creation of a public insurance option that would compete with private plans.

Though the ACP didn't throw its weight behind any politician or party, it did call for an expansion of the government's influence in American healthcare and increased alignment with what other developed countries have done - a position that many Democrats are pushing for.

The group said too many Americans lack health insurance and raised the issue of affordability. It also noted byzantine medical billing practices and high spending that doesn't usually lead to better health outcomes for patients.

"The U.S. health care system is like a chronically ill patient, and ACP is proposing a new prescription," three ACP officials said in the journal. "Simple market solutions have been unsuccessful elsewhere, and we do not believe that health care is a commodity."

The organization's support for a wider role for government in healthcare comes as Democrats in the presidential primary are brawling over the best approach to reforming the US healthcare system, which now makes up nearly 18% of the economy. It's also a top concern among voters, according to the Kaiser Family Foundation.

Sens. Bernie Sanders and Elizabeth Warren have championed enrolling everyone in the US in a government-run healthcare system under Medicare for All. Warren, though, said she would attempt to enact a public option first.

But their moderate rivals - former Vice President Joe Biden, former South Bend Mayor Pete Buttigieg, and Sen. Amy Klobuchar - are fighting against Medicare for All. They argue that it is too ambitious, and prefer the creation of an optional government plan.

Doctors' groups historically resisted attempts to reform US healthcare, fearing payment cuts, but there is growing awareness that the system's skyrocketing costs are hurting their patients. They have backed the Affordable Care Act as Republicans try to toss out the law under President Donald Trump.

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