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OPINION
Insuring more Americans
The AMA has updated its plan for health system reform, which offers more choice for more Americans.
Editorial. Nov. 13, 2000.
The AMA has prepared an updated edition of its plan to make health coverage available to many more Americans. The report is titled "Expanding Health Insurance: The AMA Proposal for Reform."
Its release comes on the eve of an election that will decide the next administration to run the White House. Yet when the subject is health system reform, it is hard not to think of the early, heady days following the change in administration eight years ago.
Candidate Bill Clinton promised a health system reform plan in 100 days. That self-imposed deadline was a bust, foreshadowing the long and painful demise of the complicated (and some would say, clueless) plan itself. No one expects the next administration to champion such a grand plan.
The AMA's proposal is a market-based approach that uses a revision of the tax code to offer health insurance coverage to many more Americans, and with more choice than currently available. At 18 pages long, it is also easier on the eyes than the voluminous Clinton plan.
Put simply, the AMA plan would provide refundable tax credits -- not ineffectual tax deductions -- for money spent on health insurance coverage, including medical savings accounts. Most individuals and families would be eligible, but the amount of the credits would be skewed to those with lower income, the people who are least likely now to be offered insurance or to be able to afford it.
Workers who have employer-based coverage would be able to keep it (the subsidy amount would become taxable under the plan, but would be offset by a credit for all but the highest-paid workers). Or they could join those without employer-based health insurance in a free market offering more options. However, in order to work, the plan will require government support to make large enough tax credits available -- perhaps as much as $65 billion yearly. That figure is in roughly the same league as the transportation funding bill mentioned in this issue's other editorial. Surely a nation's good health is at least as important as its good roads.
The plan is available on the AMA's Health Insurance Reform page (http://www.ama-assn.org/advocacy/healthpolicy/reform/reform.htm).
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