Feature

Reforming the Health System

American Medical Association (AMA) President Ronald M. Davis, AM’81, MD’83, was back at his “old stomping grounds” on January 30. But instead of sitting in a lecture hall listening to a professor or playing softball with other medical students, Davis was at the podium in the University of Chicago Medical Center’s lecture auditorium laying out the AMA’s plan to reform the health care system and improve American’s health.

Davis called the fact that 47 million Americans are uninsured “unacceptable for the wealthiest nation on earth.” In Illinois alone, 1.4 million people do not have insurance and, contrary to popular belief, eighty percent of these uninsured citizens have jobs.

Expanding medical coverage for the uninsured is one of five priorities of the AMA’s health care advocacy agenda. “Our simple plan is to give people money to buy health insurance,” explained Davis. The plan includes providing individuals and families with tax credits, which would be available at the start of the year and would be inversely related to income.

Recipients would use the tax credit to purchase coverage from a variety of plans in a reformed insurance market. Davis said, “The benefits of choice are that it would generate more competition among health plans and that it would generate more vibrant health insurance markets.” For example, smaller companies who currently can not afford to insure employees should be allowed to pool their resources to purchase employee health coverage.

The AMA is in the second year of its three-year campaign to make this plan a reality. In 2009, which will see a new president and new Congress, Davis said, “There will be no excuse for not dealing effectively with this problem once and for all.”

But health insurance is only one part of Americans’ well-being and must be coupled with healthy lifestyles. The AMA targets four aspects of unhealthy lifestyles—tobacco use, alcohol abuse, poor diet, and physical inactivity—through both clinical and policy strategies, of which Davis provided a few examples.

To combat poor diet and lack of exercise—two main causes of obesity—Davis outlined the AMA’s recommendations include requiring more physical education and healthy foods in schools, additional bike and walking paths in cities, and grocery stores with fresh fruit and vegetables in inner-city neighborhoods.

Anti-smoking efforts focus on several public policy approaches. The AMA supports a bill introduced in Congress that would allow the FDA to regulate tobacco including strengthening cigarette pack warning labels and reducing nicotine to non-addictive levels, which would make quitting easier. Another policy approach is banning smoking in public places. Davis made the point that several countries have completely banned smoking. “If you can ban smoking from Irish pubs, certainly we ought to be able to ban smoking in the United States.”