AMA to help states on programs for uninsured

Chicago -- Physicians alarmed by the rising number of uninsured patients called on the American Medical Association to help empower the states to try to figure out how to solve the problem.

Doctors participating in the AMA Annual Meeting in June asked the organization to lobby for changes in federal rules and financing that would make it easier for states to develop and test new programs that could reduce the number of people lacking health insurance.

The Association also will work with state and specialty societies, as well as other organizations, to come up with new ideas and to better develop existing ideas on how to improve health care coverage. The AMA's Council on Medical Service will study alternatives that could expand health insurance coverage and will report its findings in June 2005.

These initiatives build off existing AMA policy stating that "all Americans must have health insurance."

"We need to get support for innovative thinking and let states develop things that work for their local areas," said New Jersey internist Mary T. Herald, MD, a delegate from the American College of Physicians.

AMA President John C. Nelson, MD, MPH, said that physicians are already providing thousands of hours of charity care, and it is time that the nation find additional ways to increase coverage.

"While we seek a national solution to provide affordable health insurance to all Americans, we also should further support current state efforts that are providing excellent care," Dr. Nelson said. "We should support the states and grassroots physicians that are undertaking efforts to care for their neighbors and families."

South Carolina pediatrician O. Marion Burton, MD, a delegate from the American Academy of Pediatrics, agreed.

"States need more support from [the Centers for Medicare & Medicaid Services] to continue projects," he said.

But the AMA doesn't want the states to be the ones footing the bill. The Association will push for the federal government to help pay for new programs to avoid creating an unfunded mandate on the states.

"We want to have pilot projects, and we want the federal government to be involved in the funding," Dr. Herald said.

Reacting to the AMA action, Families USA Executive Director Ron Pollack said that the money needs to come from a new source and not take away from funding for existing public programs.

"If you take away from one group to give the money to another group, it won't help solve the problem," he said.

Not just the poor are uninsured

The AMA called for the new efforts the same week that Families USA, a national health care consumer organization, released a study that found that about 81.8 million people younger than 65 -- one out of three people -- went without health insurance during a portion of 2002 or 2003.

About two-thirds went without insurance for at least six months, and half were uninsured for at least nine months, according to the study.

Last year, the U.S. Census Bureau estimated that 43.6 million people lacked insurance for the previous entire calendar year. It based its figures on its Current Population Survey.

The Families USA study used those data combined with newer data from the Census Bureau's Survey of Income Program Participation to determine how many people were uninsured for at least part of the previous two years.

If a person was uninsured, had insurance and then lost insurance again during that two years, he or she was counted only once.

The study found that the problem isn't just hurting the poorest segment of the population. Four out of the five people without health coverage were in working families.

Pollack said the numbers underscore the need for the issue to rise to the top of the national agenda.

"The number of uninsured is astoundingly high, but what is so significant is how this affects the middle class," he said. "This problem is no longer simply an altruistic issue affecting the poor, but a matter of self-interest for everyone."