The AMA has solutions to the health care crisis.
Problems of the U.S. health care system have become all too familiar: relentless growth in the number of the uninsured, skyrocketing costs, dwindling employee health benefits, avoidable illness, premature death, health disparities based on race, ethnicity and income ... Increasingly, many insured, middle-class Americans worry that rising health care costs will jeopardize their ability to access affordable coverage in the future for themselves and their families.
As advocates for patients, physicians have a particular stake in finding viable, effective approaches to ensure that everyone has health insurance coverage. The American Medical Association (AMA) has made covering the uninsured an ongoing, top priority, and its proposal to expand health insurance coverage and choice addresses the needs of all patients, regardless of income or health status. Through the “Voice for the Uninsured” campaign, the AMA is focusing public attention on health system reform as we move through the 2008 election cycle. The campaign encourages everyone to vote with these issues in mind and help drive change in the American health care system.
The AMA proposal to cover the uninsured and expand choice uses an approach advocated by growing numbers of scholars and policymakers from diverse quarters. The strategy is to pinpoint and address fundamental flaws in how people currently obtain and pay for health insurance in the United States, flaws that limit the availability and affordability of coverage, especially for those with low earnings or no employee health benefits.
Dramatic improvement is possible by making better use of existing government resources devoted to health care and health care coverage, including the billions of dollars spent subsidizing employment-based private insurance. These resources should be drawn upon to, in essence, give people money to pay for a health plan of their choosing.
The AMA proposal would expand health insurance coverage and improve fairness by shifting government spending toward those most likely to be uninsured: people with lower incomes. It would also reduce the hidden bias favoring employment-based coverage, which provides special employee tax breaks for insurance obtained through an employer. Those without insurance through a job don’t get this tax break, and would finally get assistance under the AMA proposal. Employees who are dissatisfied with their employers’ health plan offerings could choose to buy insurance elsewhere and still be eligible for assistance. Especially in this context, health insurance market regulations should be reformed to establish fair “rules of the game” that protect vulnerable populations without unduly driving up premiums for the rest of the population. Regulations should also foster market experimentation to find the most attractive combinations of plan benefits, cost-sharing and premiums.
In short, the AMA advocates a clear role for government in financing and regulating health insurance coverage, with health plans and health care services being provided through private markets, as they are currently. The AMA proposal gives patients more control over our nation’s health care dollars, while increasing affordability and choice. It reflects important social values and traditions, such as assistance based on need, freedom of choice, market innovation and fairness.
Pragmatically, the AMA proposal is fiscally sound and permits flexible implementation—for example, any one of these pillars could be implemented independent of other reforms. Three specific actions are needed to achieve this vision of covering the uninsured and strengthening our nation’s health care system.
Next: Three pillars, the foundation of the AMA proposal....
