Health Care Coverage Task Force Charts Course

Health care coverage for everyone in the United States and wide-scale reform of the health care system are the twin objectives of a new Academy task force.

The AAFP Task Force on Health Care Coverage for All agreed at its Feb. 24-25 meeting to expand its scope beyond its title and address overall health system reform. Task force members also decided all people in the United States should have coverage without regard to their legal status. The AAFP Board of Directors accepted both of these principles at its meeting March 7-12 in Washington, D.C., said Board Chair Mary Frank, M.D., of Mill Valley, Calif., in a recent interview; Frank also is chair of the task force.

A task force meeting summary shared with the Board said, "The conclusion of the group was for the task force to consider system reform as a whole rather than just focus on issues of the uninsured, which are a symptom of a broken system. An American solution to an American problem needs to be developed. This should include workforce issues, where and how care is delivered, the cost, and the legal system, as well as redirection of funds in the health care system."

Frank explained in the interview, "When our task force looked at the issue of the uninsured, it was obvious to us that many components of the problem were actually health system problems." These challenges go beyond insurance and include payment issues, implementation of technology and whether care is based on the best available evidence, said Frank. Ensuring that the care delivered is evidence-based can help caregivers avoid administering unnecessary tests and treatments -- one component driving up the cost of health care, she added. Other questions center on whether there will be an appropriate workforce, based in family medicine, to provide care. "These are actually system issues for all of us," not solely for the uninsured, said Frank.

Commenting on the need for coverage for all people within U.S. borders, Frank said, "This is particularly important in regard to communicable diseases. Everyone is at risk if someone is at risk because of lack of coverage."

The Board accepted the summary from the task force and looks forward to its further work, said Frank. The task force will take a two-step approach, she added. "We'll start by looking at what we would need to do to get the uninsured insured in the current environment. That will be a large portion of the report we'll send this year to the Board of Directors and, depending on the Board's action, to the Congress of Delegates. Then we'll address the follow-up: What do we need to do concerning the system as a whole?"

The Academy convened the task force in response to actions of the 2005 Congress of Delegates, which adopted Frank's recommendation that the Academy be proactive about solving the problem of the uninsured and "address the dysfunction and inequities of the U.S. health care system." In addition, the Congress referred to the Board a resolution that asked the AAFP to develop "a comprehensive health care plan for the administration, financing and organization of a new U.S. health care system that provides coverage for all." The Congress asked for a report on this resolution during the 2006 Congress of Delegates.