Back to Front PageVOLUME 6, NUMBER 4

Readers Respond

What is the single most important health care issue the presidential candidates should address? The growing numbers of uninsured Americans is the most important health care issue the presidential candidates should address. Despite our spending more than 14 percent of our GDP on health care, approximately 3,000 Americans are added to the uninsured rolls per day. This is socially irresponsible, and results in significant cost-shifting and an overall increase in health care expenses over the long run. Robert Kelch, M.D. Dean, University of Iowa College of Medicine Creating a positive environment for the physician-patient relationship, without intrusion of business and economic concerns. James Linder, M.D. Interim Dean, University of Nebraska College of Medicine The most important health care issue in the upcoming election is the problem of the uninsured. "Letting the marketplace work" to achieve health care reform has been an abysmal failure, with the number of Americans lacking health insurance coverage having climbed to 44 million. It is a moral imperative that our nation develop a comprehensive resolution. Darrell G. Kirch, M.D. Dean, School of Medicine Medical College of Georgia The key question: Insofar as growth in technology is the single greatest driver of health care costs, how do you propose balancing costly new life-saving, or quality-of-life-improving, technologies against the apparently unacceptable rise in health care costs? John W. Frymoyer, M.D. Dean, University of Vermont College of Medicine Give control of the health care system back to the professionals, away from the "insurance" industry, and control escalating costs by putting restrictions on equipment/supply/drug manufacturers, as well as health care providers. Someone must come to the rescue of the health care system and academic health centers before the best system in the world is relegated to second-class status. Wallace Conerly, M.D. Dean, University of Mississippi School of Medicine The greatest need, in order to create a more rational and sustainable U.S. health care system, is coverage for the uninsured and underinsured. Until this is done, a large proportion of our population will not have access to cost-effective care, but only to expensive emergency care-generally from teaching hospitals-which self-fund it although many are already in deficit. This puts the nation's health care infrastructure at great risk. Ralph Snyderman, M.D. Dean, Duke University School of Medicine Inadequate reimbursement to providers (physician groups and teaching hospitals) from Medicare and all managed care organizations, with the effect that academic health centers are being driven into insolvency-a nuclear threat to our societal missions of education, research, and clinical care, not to mention the integrity of health care and medical innovation. Peter Deckers, M.D. Dean, University of Connecticut School of Medicine There are two equally important issues: first, developing a mechanism by which the uninsured and underinsured receive proper health care services, including prevention and pharmaceuticals. Second, creating a health care system to replace managed care, which has produced chaos for patients, physicians, and hospitals, emphasizing cost at the expense of quality. The system must make the extraordinary advances of 21st-century medicine available to everyone. Gerald S. Levey, M.D. Dean, UCLA School of Medicine 1. A federally sponsored health insurance program that provides universal coverage to adults and children. The program should utilize private insurance companies and the program that insures federal employees. 2. An educational program that addresses wellness, prevention, and lifestyle. John G. Clarkson, M.D. Dean, University of Miami School of Medicine Next month's question: Given the many pressures faced by medical students and residents, what can be done to make mental health counseling services more accessible? Please send your responses (75 words or fewer) to "Readers Respond," tbentsen@aamc.org, or fax (202) 828-1123. Responses must be received by Dec. 15 for consideration, and may be edited for length or clarity.

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Revised: 07 December 1999