Reduce problem of uninsured Americans through a volunteer medical corps

Change in American health insurance has long been a political football, advanced in downs marked by periodic waves of public outrage or legislative initiative. From a physician's point of view, the answers to public access and cost containment have never been that clear, primarily because so many of the cost issues (e.g., pharmaceuticals, insurance companies, corporate health plans) have been out of reach.

The problem with the politics of modern medicine is no different than that of Congress. We have become handicapped by our reliance on statistics, numbers and plans. American doctors and nurses would be better served to adopt positions of principle and vision, and then go to their constituents to find a way to make their goals a reality. One case in point is that of the uninsured.

In the United States, it is estimated that more than 40 million Americans are without any form of health insurance. Many of these individuals and families constitute the working poor. This is unacceptable, and many of these millions could be aided by a simple gesture of goodwill by the field of health care providers. Here is how I would do it.

I would start with the establishment of the American Medical Corps. Every licensed physician and nurse in the United States would be eligible to sign up to serve. Service would be for two-year terms, and every participant would be eligible for tax-deferred benefits and/or retirement plans in exchange for their work, based on hours contributed.

An average doctor, for example, would donate four hours per week. During this time, patients would be seen and treated who have no insurance. Surgical or facility expenses would be tallied by those affected hospitals, surgery centers and clinics in exchange for tax-related write-offs.

What I'm proposing is a form of community volunteerism. Something that would not be that difficult to organize and institute.

I actually e-mailed this same idea to the White House months ago. I didn't receive a response, and I didn't actually expect one.

But what I would expect from the health care establishment in this country is a positive response to an idea that translates a broad-based, hand-to-hand effort to deliver needed health care services to more citizens of this great land.

Adam Frederic Dorin, MD, San Diego

Note: This item originally appeared at http://www.ama-assn.org/amednews/2004/02/09/edlt0209.htm.