Solving the uninsured crisis: Doctors' voices must be heard

President-elect Barack Obama made health system reform a central issue of his campaign.

So, too, did the AMA, with an election effort of its own. Although it is not the AMA's role to endorse any presidential candidate, and the Association's plan differs from what's known about Obama's, there is a common core: expanding health insurance coverage and choice.

This shared goal is the basis for a conversation. It's one that has, in fact, already begun between the AMA and key political leaders in health system change.

Just as presidential campaigns are marathons and not sprints, being heard on major issues requires sustained effort. This election year marked the second of the AMA's three-year Voice for the Uninsured campaign (www.voicefortheuninsured.org). This important initiative uses a combination of inside-the-beltway advocacy and outside-the-beltway awareness, including an election-season multimedia advertising campaign, to alert political leaders and the public to the 46 million people in the U.S. who have no health insurance.

American Medical Association officials have met frequently with various stakeholders representing hospitals, businesses, unions, retirees and health plans. They have conferred with representatives of key congressional leaders, and the AMA participated in a Sept. 18 Capitol Hill event with Sen. Ron Wyden (D, Ore.), and Rep. Michael Burgess, MD (R, Texas), calling for the next Congress and president to get all Americans covered.

Since Obama's election, the AMA has continued its fight to make sure that physicians' voices are being heard in the discussion on how best to address the uninsured problem.

It's becoming clear that for many Americans, as the economy weakens, access to health care weakens with it, adding to the ranks of the uninsured and putting more pressure on already strained public programs.

Even a spot of good news -- a slight dip in the number of uninsured last year -- comes with a caveat. The major factor in that decline was an increased enrollment in Medicare and Medicaid.

The AMA's plan gives people a choice in plans to allow them to pick the coverage they deem best. It provides subsidies for those who need the most financial help to purchase health insurance. And it also creates fair insurance rules, which protect high-risk patients and make insurance more affordable.

The AMA met several times with each presidential candidate's staff during the election, and each side answered questions in writing. As stated in the AMA questionnaire, Obama wants "universal" coverage. His plan has been described in broad brush strokes. Obama's representatives say he is looking at a Massachusetts-style system that would create one national plan with benefits similar to those offered to federal employees, with that plan serving as an affordability benchmark for participating private plans.

And separate from whatever Obama proposes, bills already are being written in the House and Senate to address the problem of the uninsured.

The AMA also is in discussions with key figures involved in that legislation.

The AMA has offered a plan that it believes will solve the uninsured problem, but the Association also has demonstrated its determination and skill in remaining a player in the inevitable political wrangling along the way to a solution.

Back to top