Health Access America Revisited and Revised Chicago, 111.—After much discussion and debate, the American Medical Association (AMA) has refined and im¬ proved Health Access America, its plan for health care reform in the United States. Health Access America was first presented in March 1990.1 Since then, the AMA has actively discussed health care re¬ form with the government, other health care organizations and interest groups, and representatives of labor, business, and the insurance industry in an effort to refine and improve the plan. Health Access America is based on the principle that reform of the nation's health care system must preserve the system's current strengths. According to the AMA, approx¬ imately 213 million Americans, or 87%, have private or pub¬ lic insurance providing access to high-quality health care. Most Americans receive health coverage through the work¬ place. Employment-related insurance covers 60% of all Americans, with an additional 27% covered by government programs and/or private, individual policies. Health Access America has focused on four major goals to create a comprehensive solution to the problems of access to health care in America. 1. Universal Health Care
Coverage
expand access to health care, employers should be re¬ quired to provide health care coverage to employees and their dependents, just as employers are required to contribute to Social Security and unemployment compensation. Health To
Access America would:
a. Require employers to insure all employees and their families. This mandate would be phased in over several years, based on the size of the employer. Tax modifications and benefits would be offered to employers. b. Expand Medicaid to cover everyone below the poverty level. c. Reform the health insurance market to make private coverage more affordable and predictable. d. Create state risk pools to make private coverage avail¬ able to small businesses and those who remain uninsured. e. Restructure Medicare to a prefunded, actuarially sound program with enhanced catastrophic coverage.
2. Cost Containment of Health Care
Expenses
The AMA believes that all Americans should be assured of high-quality health care delivered at appropriate costs. Health Access America would achieve this goal by promot¬ ing true market forces and by restoring insurance principles to the health care marketplace. To do this, Health Access America would: a. Foster competition in the health care marketplace and empower patients to impact provider payments directly through selection and use of the financing methods of their choice. It would require providers to release price informa¬ tion to patients before treatment and require insurers to re¬ lease, on a prospective basis, information on the amount they Julie Foreman, Section Editor
will pay for medical services included in the minimum bene¬ fits package. It would also encourage tax-deductible contri¬ butions to health individual retirement accounts (IRAs) and would enact legislation to allow medical societies to review patient complaints about physicians' fees and to mediate fee
disputes. b. Repeal or override state-mandated health benefit laws. c. Implement professional liability reform to reduce mal¬ practice insurance premiums and the costs of defensive medicine. d. Curb administrative costs through uniform claim forms, electronic bill processing, and reductions in review
requirements.
Limit the amount of employer-provided health insur¬ that is tax-exempt and provide tax-free rebates to em¬ ployees who select less costly insurance plans. / Develop practice parameters to help ensure that only appropriate health care services are delivered. g. Eliminate "balance billing" for all insured patients below 200% of the poverty level. e.
ance
3.
Quality
of Health Care
The high quality of health care services is one of the great¬ strengths of the American health care system. Health Access America recommends the following to foster this continued level of excellence: a. Develop practice parameters to help ensure that only appropriate medical services are provided, impacting favor¬ ably on the quality and cost of medical care. b. Encourage physicians to practice in accordance with the highest ethical standards and to provide voluntary care. c. Urge expanded federal support for medical education, research, and the National Institutes of Health to help bring about continuing medical breakthroughs, which historically have resulted in many lifesaving discoveries. d. Encourage health promotion and disease prevention. est
4. Freedom of Choice
The individual's freedom of choice to pursue services that or her health care needs, combined with a free and independent medical profession, is a cornerstone of the American health care system. Health Access America seeks to balance private and public responsibilities and preserve the freedom of individuals to select the physician, hospital, and type of health care plan they want. According to Health Access America, the proper role of government should be to: a. Encourage the private sector to deliver the highest quality of care to the most people possible. b. Assist the private sector to deliver the highest quality of care at the most reasonable cost. c. Provide financial assistance for Americans who cannot afford health insurance. Julie Foreman meet his
1. Foreman J. AMA unveils plan to strengthen US health Arch Ophthalmol. 1990;108:649.
system.
Downloaded From: http://archopht.jamanetwork.com/ by a University of Arizona Health Sciences Library User on 05/27/2015
care
Coverage
expand access to health care, employers should be re¬ quired to provide health care coverage to employees and their dependents, just as employers are required to contribute to Social Security and unemployment compensation. Health To
Access America would:
a. Require employers to insure all employees and their families. This mandate would be phased in over several years, based on the size of the employer. Tax modifications and benefits would be offered to employers. b. Expand Medicaid to cover everyone below the poverty level. c. Reform the health insurance market to make private coverage more affordable and predictable. d. Create state risk pools to make private coverage avail¬ able to small businesses and those who remain uninsured. e. Restructure Medicare to a prefunded, actuarially sound program with enhanced catastrophic coverage.
2. Cost Containment of Health Care
Expenses
The AMA believes that all Americans should be assured of high-quality health care delivered at appropriate costs. Health Access America would achieve this goal by promot¬ ing true market forces and by restoring insurance principles to the health care marketplace. To do this, Health Access America would: a. Foster competition in the health care marketplace and empower patients to impact provider payments directly through selection and use of the financing methods of their choice. It would require providers to release price informa¬ tion to patients before treatment and require insurers to re¬ lease, on a prospective basis, information on the amount they Julie Foreman, Section Editor
will pay for medical services included in the minimum bene¬ fits package. It would also encourage tax-deductible contri¬ butions to health individual retirement accounts (IRAs) and would enact legislation to allow medical societies to review patient complaints about physicians' fees and to mediate fee
disputes. b. Repeal or override state-mandated health benefit laws. c. Implement professional liability reform to reduce mal¬ practice insurance premiums and the costs of defensive medicine. d. Curb administrative costs through uniform claim forms, electronic bill processing, and reductions in review
requirements.
Limit the amount of employer-provided health insur¬ that is tax-exempt and provide tax-free rebates to em¬ ployees who select less costly insurance plans. / Develop practice parameters to help ensure that only appropriate health care services are delivered. g. Eliminate "balance billing" for all insured patients below 200% of the poverty level. e.
ance
3.
Quality
of Health Care
The high quality of health care services is one of the great¬ strengths of the American health care system. Health Access America recommends the following to foster this continued level of excellence: a. Develop practice parameters to help ensure that only appropriate medical services are provided, impacting favor¬ ably on the quality and cost of medical care. b. Encourage physicians to practice in accordance with the highest ethical standards and to provide voluntary care. c. Urge expanded federal support for medical education, research, and the National Institutes of Health to help bring about continuing medical breakthroughs, which historically have resulted in many lifesaving discoveries. d. Encourage health promotion and disease prevention. est
4. Freedom of Choice
The individual's freedom of choice to pursue services that or her health care needs, combined with a free and independent medical profession, is a cornerstone of the American health care system. Health Access America seeks to balance private and public responsibilities and preserve the freedom of individuals to select the physician, hospital, and type of health care plan they want. According to Health Access America, the proper role of government should be to: a. Encourage the private sector to deliver the highest quality of care to the most people possible. b. Assist the private sector to deliver the highest quality of care at the most reasonable cost. c. Provide financial assistance for Americans who cannot afford health insurance. Julie Foreman meet his
1. Foreman J. AMA unveils plan to strengthen US health Arch Ophthalmol. 1990;108:649.
system.
Downloaded From: http://archopht.jamanetwork.com/ by a University of Arizona Health Sciences Library User on 05/27/2015
care
