December 2000 • Volume 6 Number 12
Your input wanted
Proposal aims at health care coverage for all AmericansBY JANE STOEVER
Comment on AAFP's proposal by Feb. 28.
The Academy is igniting a nationwide dialogue on a proposal for all Americans to have access to care and coverage for it.
"We want input on our proposal from every AAFP member," says President Richard Roberts, M.D., J.D., of Madison, Wis. "Family doctors think about this stuff all the time. I'd like to tell each member, 'Read the proposal, digest it, be creative with your response.' Assuring coverage for everyone is crucial -- America needs the collective wisdom of each family doctor on this issue."
An AAFP task force analyzed the U.S. health care system for two years and gave a report to the Congress of Delegates this fall. Delegates decided, as the task force suggested, to ask members' views before adopting a plan.
The AAFP Board added financial charts to the task force report and put the resultant proposal online in late November. The proposed program would be funded by a payroll tax split between employers and employees and by revenues from the part of Medicaid covering basic services.
To spark response, the Board peppered the proposal with questions. For example:
Proposal: All people within U.S. borders, whether or not they are legal residents, would have coverage for basic health services without copayments or deductibles.
Questions: Should the plan cover everyone in the country? Would copayments discourage appropriate use of basic health services or simply discourage inappropriate use?
Proposal: Out-of-pocket costs for catastrophic illnesses should be capped. Services between basic and catastrophic levels could be bought directly by individuals, covered by employer-based insurance or individually purchased insurance, or paid for by medical savings accounts.
Questions: If you now offer your employees health insurance, how likely would you be to offer coverage for services outside the AAFP proposal? Should it be left to individuals to decide to seek coverage for this middle tier of benefits?
Reflecting on the state of the health care system, Roberts says, "Our country is already committed to universality. But when it kicks in, it's either late in the disease, when the person shows up in the ER, or early in the disease, when the person comes to the ER after hours with an upper respiratory infection that could have been handled more easily, less expensively and, frankly, more efficiently by the person's family doctor."
He adds, "Our country's been making all the wrong decisions consistently in terms of how to fund, structure and organize the health care system. The AAFP proposal is an attempt to begin to remedy that."
You can access the proposal at http://www.aafp.org/unicov/ or request it (item #R016) by calling (800) 944-0000. The Board will consider all responses, make revisions and submit a plan to the Congress of Delegates next October.
By Feb. 28, 2001, please e-mail your comments to unicov@aafp.org or write to AAFP -- Health Care Coverage, 11400 Tomahawk Creek Parkway, Leawood, KS 66211-2672.
FP Report is published by the AAFP News Department.
Copyright © 2000 by American Academy of Family Physicians.
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