DJP 5-11-2004 AMA Update: Liability vote in House and JAMA article on uninsured
ITEM ONE: Medical Liability Vote in House of Representatives
http://www.ama-assn.org/ama/pub/article/9255-8560.html
The U.S. House of Representatives will vote on a comprehensive medical liability reform bill (H.R. 4280) on May 12. H.R. 4280 is essentially identical to H.R. 5 (minor word changes). Goal is to keep the heat up on this critical issue and it is hoped that the Senate will realize that action is needed become more states go in to crisis.
ITEM TWO: AMA proposal to cover the uninsured published in JAMA
http://www.ama-assn.org/ama/pub/article/1615-8565.html
In JAMA: AMA’s proposal to expand health coverage
An article in the May 12 issue of The Journal of the American Medical Association outlines the American Medical Association’s plan to increase health insurance coverage.
“Expanding Insurance Coverage Through Tax Credits, Consumer Choice, and Market Enhancements,” by AMA President Donald J. Palmisano, MD, and two authors from the AMA’s Center for Policy and Research – David W. Emmons, PhD, and Gregory D. Wozniak, PhD – describes a three-pronged approach for covering more of the nation’s 44 million uninsured.
Under America’s current employer-based system, much of the $188 billion federal tax subsidy favors relatively wealthy employed people and their families, but does little for those without employer-based coverage and those in the lowest-income tax brackets.
The centerpiece of the AMA proposal is a federal tax credit system that would replace the current federal tax exclusion of employer-based health insurance. The credits would be inversely related to income, refundable and advanceable – and large enough for most individuals and families to be able to afford insurance. Employers’ spending on employee health benefits would remain fully deductible as a business expense, but employer-based plans would no longer be the only group coverage option. A health insurance market with a variety of choices would increase satisfaction and access to care. The AMA plan would reform the health insurance market with incentives to offer a wider range of new, affordable and permanent insurance options.
Press release follows:
EMBARGOED FOR RELEASE: 3 P.M. (CT) TUESDAY, May 11, 2004
AMA DETAILS PLAN TO COVER THE UNINSURED
BY STRENGTHENING CURRENT SYSTEM
Proposal featured in Special Communication in this week’s JAMA
CHICAGO – The American Medical Association outlines its plan for expanding insurance coverage to approximately 95 percent of Americans in a “Special Communication,” published in this week’s Journal of the American Medical Association.
“There is no question that we must find a solution to the problem of the more than 43.6 million people who are uninsured in this country,” said AMA President Donald J. Palmisano, M.D. “Research shows that the health consequences for Americans without insurance can be devastating. The AMA advocates a solution to the uninsured crisis that builds on the strengths of our current system. We believe that a health care system based on a mix of private and public sector financing will best benefit the uninsured, improve quality, restrain costs, and expand patient choice and individual purchasing power.”
The plan detailed by the nation’s largest physician organization, representing more than 250,000 doctors nationwide, calls for a comprehensive three-pronged program to include:
- Tax credits for the purchase of insurance:
The current federal income tax exclusion system provides the greatest benefits to the wealthiest employed persons and their families. Those that do not have employer-based coverage and those in the lowest tax brackets receive little or no tax benefit. The AMA plan would replace the current tax exclusion of employer-based health insurance with tax credits that are inversely related to income (and large enough to ensure that health insurance is affordable for most people), refundable and advanceable. Advanceable credits would mean that people do not need to wait until their federal income taxes are filed to use the credits to purchase insurance. Employers’ spending on employee health benefits would remain fully deductible as a business expense.
- Individually selected and owned health insurance:
Under the AMA proposal, an employer’s option of health plans would no longer be the only group coverage option for people. Individuals would be able to choose coverage that reflects their personal health care preferences and needs. In the current system, employees often cannot change insurance carriers if they are unhappy with their service or coverage. Providing a choice of plans will allow individuals to be more satisfied and increase access to care.
- Expansion and formation of new insurance markets:
The AMA plan would increase choice in the individual and group health insurance markets by implementing insurance market reforms and incentives to offer a wider range of new, affordable and permanent insurance options. The expansion of managed care has led to the current system, which has limited individual choice and damaged the patient-physician relationship often resulting in patients deferring care.
“The AMA’s proposal would give people the power to choose their health plan and give patients and their physicians what they want and deserve — more control over their health care decisions,” Palmisano said.
The Special Communication, authored by Dr. Palmisano and David Emmons, Ph.D. and Greg Wozniak, Ph.D., AMA’s Center for Health Policy Research, also warns against the dangers of implementing a single-payer, government-run system. The AMA previously has noted that by implementing a single-payer system, the U.S. would be trading the uninsured problem for an entire new set of other problems that may be much worse. Long waits for health care services, a slowness to adopt new technologies and maintain facilities, and development of a large bureaucracy that can cause a decline in the authority of patients and their physicians over clinical decision-making are all hallmarks of the single-payer system.
“The AMA has learned from countries that have a single-payer system, that the solution to the health care problem is a mix of private and public sector financing, with coverage and care remaining in the private sector,” said Palmisano.
In an accompanying editorial, Mark V. Pauly, Ph.D., Department of Health Care Systems, The Wharton School, University of Pennsylvania, writes that “the logic behind the [AMA] proposal is economically attractive.” Pauly further notes that “The AMA proposal is not only to help the uninsured …. In proposing replacement of the current tax exclusion for employment-based coverage with a credit, it takes a major step toward cost containment.”
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NOTE TO REPORTERS: The Journal of the American Medical Association (JAMA) is an editorially independent medical journal, and, as such, may publish views of others that do not always correspond with the American Medical Association’s (AMA) positions and policies.
The AMA health insurance proposal is available at: www.ama-assn.org/go/insurance-reform.
For more information, please contact:
Lori Bolas
Media Manager
(312) 464-4418
Brenda Craine,
Director, Media Relations, Washington Media Relations
(202) 789-7419
LAGNIAPPE:
Now in Divonne, France at World Medical Association meeting, but wired in by international cell phone and e-mail to AMA in Chicago and Washington, DC. A lot is going on. Very pleased that our AMA plan for the uninsured is in the May 12, 2004 issue of JAMA. Also be sure to read editorial about our article by Dr. Mark Pauly of the Wharton School in Pennsylvania.
Finally, I will send another DJP update in a moment that will be a special edition on patient safety.
Donald J. Palmisano, MD, JD
AMA President