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following statement was developed in 1999 by the American
Academy of Family Physicians, the American Academy of
Pediatrics, the American College of Emergency Physicians,
the American College of Obstetricians and Gynecologists,
the American College of Physicians-American Society of
Internal Medicine, the American College of Surgeons, and
the American Medical Association. The additional undersigned
physician organizations have indicated their support for
the statement.
The physicians of America believe that adequate health
coverage and access to health care services are vitally
important to their patients and to the nation. Despite
economic prosperity and substantial job creation during
the last decade, there remains a considerable and increasing
portion of the American population that does not have
health insurance coverage. As a result, those individuals
defer obtaining preventive and medical services, jeopardizing
the health and well being of themselves and their families.
Currently, the U.S. relies primarily on a private, employment-based
system to provide health insurance. In the mid-1980s,
the percentage of Americans with employment-based coverage
began to fall and the country began to experience continuing
increases in the number of Americans who are uninsured.
From 1987 to 1997, the number of Americans who were
uninsured rose steadily from 31.8 million to 43.1 million.
During this period, the percentage of people with employer-sponsored
coverage dropped from 69% to 64%. The erosion of employment-based
insurance coverage and the general decline in the number
of people carrying private health insurance has generated
a great deal of concern across the nation, and in particular,
to physicians and other health care clinicians everywhere.
We acknowledge that lack of adequate health insurance
is not the only barrier to accessing health care services
-- there are numerous other barriers. These barriers
include geography, poverty, language, inadequate housing,
environment, cultural considerations, and the organization
of services.
There currently exists an important iwindow of opportunityi
to influence public policy with the upcoming 2000 election.
We challenge the 106th Congress and declared 2000 presidential
candidates to make the critical issues of health insurance
coverage and access a top priority. All of the under-signed
societies believe all Americans should have health coverage
and consider it imperative to push the issue onto the
national agenda, increase public awareness, and set
off a public debate of the issues involved. While each
of our societies may support different approaches, we
all seek to achieve the same objective: providing all
Americans with health care coverage.
Affirmative ideals that will guide any future agenda
include these three important concepts:
-
All Americans must have health care coverage.
-
Health care coverage will contain a benefits package
that provides quality care.
-
Medical necessity determinations made under the benefit
package should reflect generally accepted standards
of medical practice, supported by outcomes-based evidence
evidence-based data regarding clinical appropriateness,
where available. We recognize that these standards
will continue to evolve.
In addition, there are four core values that should
be incorporated into any future policy related to increasing
health care coverage and access. They are:
We
recognize there may be more than one way to finance providing
all Americans with coverage. A variety of financing options,
including employer funding, individual funding, government
funding, or combinations of these options, has been offered
as possible ireforms.i
Expanding the individual's ability to choose among several
health insurance options is crucial. We support pluralism
of health care delivery systems and financing mechanisms
in achieving coverage for and access to health care
services. There is a need to reform the current system
to provide health coverage for all.
We urge all medical societies to join us in advocating
for change and working towards moving the issues of
coverage and access to the forefront. Expanding health
coverage to all Americans must become a high priority
on both the federal and the general public agendas.
In the interest of promoting health coverage for all
Americans, we agree to the following:
- to
commit our organizations to this issue as a high priority;
- to
keep each other informed of our advocacy efforts,
and to coordinate our activities where possible; and
- to
continue this pursuit until our goal of health coverage
for all is achieved.
Signed,
American Academy of Family Physicians
American Academy of Pediatrics
American College of Emergency Physicians
American College of Obstetricians and Gynecologists
American College of Physicians-American Society of Internal
Medicine
American College of Surgeons
American Medical Association
American Academy of Cosmetic Surgery
American Academy of Facial Plastic and Reconstructive
Surgery
American Academy of Neurology
American Academy of Ophthalmology
American Academy of Otolaryngology-Head and Neck Surgery
American Academy of Pain Medicine
American Academy of Physical Medicine and Rehabilitation
American Association for Thoracic Surgery
American Association of Clinical Endocrinologists
American Association of Neurological Surgeons
American Association of Orthopaedic Surgeons
American College of Allergy, Asthma and Immunology
American College of Cardiology
American College of Medical Quality
American College of Nuclear Physicians
American College of Osteopathic Surgeons
American College of Preventive Medicine
American Geriatrics Society
American Osteopathic Association
American Pediatric Surgical Association
American Psychiatric Association
American Society for Reproductive Medicine
American Society for Surgery of the Hand
American Society for Therapeutic Radiology and Oncology
American Society of Abdominal Surgeons
American Society of Addiction Medicine
American Society of Cataract and Refractive Surgery
American Society of Clinical Pathologists
American Society of General Surgeons
American Society of Hematology
American Society of Plastic Surgeons
American Urological Association
Association of American Medical Colleges
Congress of Neurological Surgeons
North American Spine Society
Renal Physicians Association
Society for Critical Care Medicine
Society of General Internal Medicine
Society of Nuclear Medicine
Society of Thoracic Surgeons
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