American Medical Association
US Healthcare Interest Group
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Plan StatusProposed.Number of People Covered Aims for universal coverage
Estimated CostNot available. But emphasizes the need to build on the strengths of the current system to get all persons access to affordable insurance, so they are getting care early and thus avoiding costly emergency room visits or serious chronic illness.Payment Scheme Keeps private and public systems, but moves away from employer-based insurance, putting control of health insurance decisions into individuals' hands. |
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Plan in Brief
- Nation's largest physician group.
- Expands some public programs (eg SCHIP).
- Reduce reliance on employer-based insurance.
- Provides subsidies and financial incentives to the poor.
- Once insurance is affordable to all, requires everyone to buy it.
- Gives people with pre-existing conditions access to insurance, somehow.
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Impact on Federal Government
- Must give individuals the same kind of tax breaks employers now get for buying their employees health insurance.
- Would need to expand SCHIP and re-examine Medicare, which is headed toward bankruptcy.
Impact on States
- Advocates for more national uniformity of insurance regulation.
Impact on Insurers
- Would need to guarantee renewal of individual policies.
- Would need to find new, innovative ways to help cover more people.
Impact on Providers
- Provide less charity care.
- Provide more preventive care.
- Reduce preventable disease.
- More coordinated healthcare.
- Alternative health care delivery models (eg retail clinics) but must be properly regulated.
Impact on employers
- Employers that drop health benefits would be required to raise their employee’s salaries to cover that, subjecting the employer to higher payroll taxes.
Impact on Individuals
- Would receive tax credits for health care inversely related to income.
- Individuals rather than employers select and own health insurance.
- Rich (making over $250,000/year) will have their health benefits taxed.
- Illegal immigrants get emergency care only.
- Everyone is encouraged to improve their own health, using "carrots and a few sticks."
Proponents/Opponents
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| Supporters agree that making health insurance affordable has to come before requiring everyone to buy health insurance. Making health care better coordinated while expanding coverage are high priorities, and drastic changes are unrealistic. Giving patients choice is preferable to a single-payor system, where rationing is certain to occur. Also, there is no reason to think that employers can make better choices about an individual's health care than that individual themselves. |
Critics charge that subsidies and tax credits will be insufficient to help many afford health care, and that expanding private insurance, without insisting that insurance companies cover every applicant, mainly benefits the insurance industry. There is great debate about how much cost savings will be achieved by increasing the type of preventive care the AMA proposal puts emphasis on. |
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Key Targets for Investment
- Subsidies and/or tax credits to help the poor get health insurance.
- Health information technology
- Cost effectiveness research and quality measures
Notable Feature
- Seeks to phase out employer-based insurance.
- Pro 'market-based' system, but wary of overuse of HSAs and wants tight regulation of alternative delivery systems, such as retail clinics.
- Seeks to ensure that practice guidelines, or pay-for-performance plans, are not overused and based on evidence.
- Emphasizes the need for individuals to also take control of, and responsibility for, their health, through prevention and wellness measure.
- Calls on insurers to help encourage patients to take necessary medicines or treatments, that will reduce costs over the long term, by reducing co-payments for certain conditions
Experts' Comments" Today, we are witnessing a pell-mell rush to pay-for-performance programs based entirely upon grandiose predictions of great improvements in quality and massive savings in cost: Predictions that are completely without any basis in historical fact. There is even a rapidly escalating body of literature that suggests the exact opposite [is true]."
William G. Plested,
President Elect,
American Medical Association, speaking at the 2007 World Health Care Congress.
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For further reading or listening
Expanding Health Insurance: The AMA Proposal for Reform
AMA's Strategies to Address Rising Health Care Costs
AMA White Paper on Individual Responsibility for Health Insurance
AMA's Voice for the Uninsured Site
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Interest Groups 
