The AMA has in recent years been very supportive of health system reform. This recent letter of support for the President’s 8 principles is but the latest in their active participation.  This site would urge all involved to continue this work but to keep an open  mind about options.  It is true that the employer based system has evolved as somewhat of an anomaly based on social and political realities which followed WWII. In many ways it has worked well.  The worst aspect of it, however, has been to remove from individuals a sense of personal responsibility to make sure that they and their loved ones have medical access (i.e. health insurance or other medical financial coverage).  This, in large part, is the reason why so many Americans who have access and insurance coverage seem distanced from the economics of the system.  In recent years, the rise in levels of deductibles and co-pays has raised awareness among many that they do have to play a role in overseeing their use of medical resources.  In terms of the President’s 8 principles and the AMA’s support of them this site offers the following thoughts:

(1) The surest manner to protect family financial health, in terms of ruinous medical bills, is to make sure that all have access to care via appropriate coverage

(2) The only way to make health coverage affordable is to implement reforms in the manner by which health insurance finances are overseen.

(3) Universality is a goal, not an end point.  Nothing in a free society can truly ever be universal in application, only universal in opportunity or access.  The best we can do is make sure that all citizens have options by which they can access coverage and care.

(4) Portability in coverage is only of concern if the employer based system remains the norm.  In that context, we of course would agree with that.  However, if health insurance were a personal responsibility, portability would be a given and not require legislation.

(5) Choice is the key word.  The concern of a having a general access government program is that it would likely, over time, crowd out market based competitors. The best role for government is oversight of private carriers while continuing to maintain various successful funded programs (Medicare, Medicaid, SCHIP, VA etc.)

(6) Prevention and wellness are laudable goals for the medical system. However, once again, personal responsibility must come into play. We see the extensive evidence regarding the dangers of smoking, alcohol, drug use, obesity, diet, lifestyle choices and leading a sedentary existence.  In almost all of these cases, the system can only advise, encourage and educate.  The health care system cannot mandate or enforce personal choices or behavior.

(7) Improving quality of care and safety are never ending goals of all health care providers and systems.  E-health initiatives can go along way to achieving this goal.  We have commented repeatedly on our enthusiasm for these programs (PHR, EHR, etc.) and have as well raised concerns over various items which will need to be addressed if implementation is to be widespread and rapid.

(8) Fiscal sustainability is perhaps the most difficult item to address.  The system must be fluid enough to absorb changes in demographics as well as medical science.  Thus, the baby boomers will place a strain on the system, just as changing demographics in the inner city, illegal immigration and other social forces have placed strains on the system.  Rapid changes in medical science have occurred and will continue to occur at an ever increasing pace.  The system must be able to integrate those changes while rewarding the investment, creativity and insight that brings about those advances, yet balancing the financial ability of beneficiaries to access those advances.

We would direct you to our post under “the  plan”  – http://realhealthreform.wordpress.com/the-plan/details-on-the-plan

These and many other complex items will need to be addressed to achieve the goal of Real Health Reform . . . jomaxx

AMA Supports Obama’s Principles for Health Care Reform and Outlines Framework for Action
April 15, 2009
This week, the American Medical Association sent a letter (PDF) to President Barack Obama offering physicians’ support for the administration’s eight principles for health care reform and outlining the association’s framework for action.

“The ongoing emphasis on health care from the White House signals that the administration is seizing this historic opportunity to improve the system,” said AMA President Nancy Nielsen, MD. “The American Medical Association is committed to health care reform that improves access to high-quality, affordable health care for all patients. Expanding access to care for all Americans will ensure that people can get the preventive care they need, which will keep them healthy and keep the nation’s long-term health care costs down.”

In the letter, the AMA highlighted the importance of building on the current employer-based system to promote individual choice and ownership of health insurance, the impact that liability pressure has on health care costs, and the need to remove antitrust barriers to quality improvement efforts. The AMA also voiced its support for health information technology, for efforts to improve the value the nation gets from its health care spending, and for greater care coordination.

The administration’s eight principles are: (1) protecting families’ financial health, (2) making health coverage affordable, (3) aiming for universality, (4) providing portable coverage, (5) guaranteeing choice, (6) investing in prevention and wellness, (7) improving patient safety and quality, and (8) maintaining long-term fiscal sustainability.

“We look forward to continuing our work with the administration and Congress to develop health care reform policies within the President’s eight principles,” said Dr. Nielsen.

http://www.ama-assn.org/ama1/pub/upload/mm/399/hsr-principles-letter.pdf

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