 February 2003 • Volume 9 • Number 2 |
All people in the United States should have health care coverage. The Academy has championed this goal since 1989. Now -- with leadership from the AAFP -- the AMA has pledged to seek a U.S. Congress resolution endorsing coverage for all.
"Getting the AMA committed to this resolution is important because 'think leaders' and lawmakers see AMA as the 'go-to' organization for the medical profession," says AAFP President James Martin, M.D., of San Antonio. "This resolution tells Congress the American physician is willing to come to the table, try to be part of the solution and forge a way to improve health care for all Americans."
The coalition that introduced the AMA resolution, including the AAFP, focused on bringing a proposal to the U.S. Congress and used the AMA process as a stepping stone. Staff members from the Academy and the American College of Physicians-American Society of Internal Medicine drafted a statement that could be submitted to the U.S. Congress. Then the Academy took the lead in seeking agreement from other specialty groups. That process is continuing.
The resolution originally sent to the AMA read as follows:
"Resolved that our American Medical Association and interested medical specialty societies and state medical societies jointly advocate for enactment of a bipartisan resolution in the U.S. Congress establishing the goal of achieving health care coverage for all persons in the United States by Jan. 1, 2009."
The AMA House of Delegates passed the coverage-for-all resolution during its Dec. 6 11 interim meeting in New Orleans. The AMA reference committee that heard debate on the resolution made changes the house passed, including these: Coverage for all should occur "through a pluralistic system" and in a way "that is consistent with relevant AMA policy." Both revisions reflected some delegates' concerns that the original resolution could have been misconstrued as promoting a single-payer insurance system, totally operated by the government (which currently pays for 45 percent of health care services, according to data for 2001 from the Centers for Medicare & Medicaid Services).
"This resolution and the AAFP are not endorsing in any form or fashion a single-payer system," says Martin. "Our own AAFP proposal clearly calls for a broad-based, public-private system, including payments through private insurance companies."
At the AMA meeting, the AAFP and other medical societies argued against the need to add "consistent with AMA policy" but were outvoted. "We left AMA unhappy with the resolution that was passed -- it does not make sense to ask U.S. lawmakers to pass a resolution 'consistent with AMA policy,'" says Martin, noting that whatever is proposed to the U.S. Congress will be revised and negotiated.
"But, even though we didn't get exactly what we wanted at the AMA, we did get the AMA on record favoring a U.S. Congress resolution on health care coverage for all," says Martin. "This is a major step. When the AMA house began debating the matter, the first vote was too close to call and there had to be a count. Finally getting the resolution passed was great progress."
Besides the AAFP and ACP-ASIM, other groups sponsoring the AMA resolution were the American Academy of Pediatrics, American College of Cardiology, American College of Emergency Physicians, American College of Obstetricians and Gynecologists, and American College of Surgeons. Many other specialty societies, including the American Psychiatric Association, testified in favor of the resolution.
In general, the Academy, with 16 delegates, is viewed as having increasing clout within the AMA. "We're seen more and more as the conscience of the AMA," says Martin. "Medicine must be dedicated to the health of all Americans, and our Academy delegation is viewed as helping lead the AMA in that direction."
To reach writer Jane Stoever, e-mail jstoever@aafp.org.
FP Report is
published by the AAFP News Department.
Copyright © 2003 by American Academy of Family Physicians.