Leaders ponder univeral access to health care
In his address Sept. 15 to the AAFP Congress of Delegates, (then) President-elect Lanny Copeland, M.D., of Albany, Ga., harked back to a long-standing AAFP policy: universal coverage for health care.
Copeland noted changes in the health care system that have intensified the problem of the uninsured and underinsured. "More physicians are now employed, and the profit margin plays a bigger role in physician work. In the past, many physicians donated their time to care for the indigent, but with market-driven changes, less time is available to serve this population." Copeland also charged that competition for the health care dollar by managed care companies will worsen the problem.
One of the Board's 1998-99 objectives is to develop a strategy for universal coverage, in concert with other medical groups. Copeland has already discussed the objective with AMA President Nancy Dickey, M.D., of College Station, Texas, a family physician who has named universal access as one of her presidency's goals as well.
Reflecting on Copeland's remarks, EVP Robert Graham, M.D., told the delegates, "We have disarray in the U.S. health care system. Our future and our path are uncertain. We have fewer people today who have assured financial access to basic health services than we had last year. We are losing ground."
Graham posed two questions: What is the role of the market? What are the obligations of social conscience?
He said America has not made a clear policy decision as to whether health care services are a social good guaranteed to every citizen, or a market commodity available only to those who can afford it.
"Our health system is staggering. It has lost its compass," said Graham. "We will have to fix it."
The Board will most likely develop a plan and report back to the AAFP Congress of Delegates next year about how the United States might guarantee access to health care for all its citizens.
