Personal responsibility: New part of health insurance coverage solution

The AMA adopts policy supporting a requirement that people with the means to buy coverage do so.

Editorial. July 10, 2006.

At nearly 46 million people and counting, the sheer enormity of the nation's uninsured problem makes the status quo unacceptable.

An innovative, comprehensive strategy is necessary. The American Medical Association has long-standing policy promoting individually owned health insurance combined with tax credits inversely related to income to help pay for coverage, and market reforms to make insurance more affordable.

Building on that foundation, the AMA has adopted a complementary measure centered on personal responsibility to obtain insurance.

Under the new policy, approved at its June Annual Meeting, the AMA will support a requirement that people who earn more than 500% of the federal poverty level obtain a minimum of catastrophic and preventive health coverage. That's $49,000 annually for individuals and $100,000 for families of four. The proposal relies on the federal tax structure to achieve compliance.

The rationale is that an income threshold exists beyond which it is no longer a financial hardship to buy health insurance. This is a truly reasonable proposal.

The targeted group represents just 11% of the uninsured population. These people may assume they don't need much care and can pay for whatever they need out of pocket. But individuals can't always control their health, and these people do get sick or injured, sometimes catastrophically. When they can't pay for care, others must pick up their slack. That is not fair.

But most uninsured Americans fail to buy coverage, not because they feel they're invincible, but because they can't afford it. AMA policy also addresses this group. It calls for giving federal money, in the form of tax credits or vouchers, to those who are financially unable to buy insurance. The new portion of the proposal supports individual responsibility for obtaining coverage for people earning less than 500% of the poverty level. However, it is strictly contingent upon adoption of the Association's insurance affordability reforms.