Opinion

Voice for the Uninsured campaign growing stronger

A message to all physicians from AMA President Nancy H. Nielsen, MD, PhD.

By Nancy H. Nielsen, MD, PhDis an internist from Buffalo, N.Y. She was AMA president during 2008-09. Posted Sept. 15, 2008.

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When the AMA Voice for the Uninsured campaign began reaching out to voters and candidates during the early presidential primaries in Iowa, New Hampshire and South Carolina, our goal was to raise awareness across the country that there were 47 million uninsured Americans.

At the campaign's launch, I told reporters and others about my own experience as a graduate student whose student health insurance excluded pregnancy benefits or family coverage. I was uninsured for two pregnancies. Those two children were delivered through public health clinics. Without coverage, that was my only option, and I was grateful for it.

When my 14-month-old daughter had a fever of nearly 106 degrees, I brought her to the emergency department. For the rest of the month, I had no money for food for my kids. If this can happen to me, it can happen to anyone.

Lately, the country's economic downturn has captured everyone's attention, so maybe you think our Voice for the Uninsured campaign is mistimed, ignoring big problems like job insecurity, the price of gasoline, and real estate and stock market dives.

But think about it -- we have an employer-based health insurance system, so if one's job status is precarious, so is one's current health insurance. And dwindling cash reserves and investment returns have already worsened a huge problem faced by many Americans -- medical costs. The Commonwealth Fund recently reported that more than two in five adults age 19 to 64 had problems paying medical bills or had accumulated medical debt, a figure that is up from one in three in 2005. And we know that one in seven Americans lack health insurance right now.

So, if a person loses a job and is forced to purchase individual health insurance, we need a strong market to support individual choice. We need to be sure that people are not denied coverage because of a prior health problem. And the AMA also supports direct subsidies that enable even those with high risks to purchase affordable coverage. In short, covering America's uninsured should concern both presidential candidates, all members of Congress and every American.

Since the campaign's launch, we have been in close contact with both parties. We've been unequivocal in stressing the need to find a solution for the uninsured. We are pleased that the parties have adopted many of the features of the AMA plan to cover America's uninsured.

With the election less than less than two months away, the Association's Voice for the Uninsured campaign is making new strides to urge candidates across the country to adopt AMA principles to cover the uninsured.

Under the AMA plan, the vast majority of Americans would have the means to purchase health care coverage. The AMA plan gives individuals choices, so they can select the appropriate coverage for themselves and their families. The AMA plan promotes market reforms in the insurance industry. And most important, the AMA plan is designed by physicians -- so patients know that it can be trusted.

As I write this, part of the effort we're undertaking to increase awareness of the AMA proposal for the uninsured will take place at the Democratic and Republican national conventions. New AMA advertising will be on billboards, on buses and trains, and at the cities' major airports. We'll also be reaching out to physicians through ads in trade magazines and the AMA Web site. We'll continue our massive media outreach as well.

The AMA is making it easy for you -- and your patients -- to reach out to your representatives in Congress.

Specifically, the AMA Voice for the Uninsured Web site has been re-designed with powerful tools that allow you to contact Congress directly; to let them know that you want them to be more aware of the AMA plan (link). We want you and your patients to register and send Congress a letter; to let them know that this is an issue of vital national importance.

At the site, I encourage you to read stories from people who are uninsured. They are our friends, family and neighbors. I realize that the idea of you, your family or someone you know becoming uninsured might be hard to grasp, but when you see and listen to men, women and children tell of having to go without care because they are uninsured, you'll get the point.

Congress is starting to get it. The United States spends nearly $100 billion to provide uninsured patients with health services, often for preventable diseases or diseases more efficiently treated with early diagnoses. This burden is shouldered by everyone, and Congress is starting to hold hearings on different proposals. Be assured that the AMA will be part of those discussions.

The decision the AMA has made is to focus our efforts on a practical, workable solution that will reduce the number of the uninsured. And we're going to get there by building a grassroots network of patients and physicians, so that when 2009 comes, we're moving forward with the force of patients' and physicians' voices from across the nation. We're going to get there because we've laid the groundwork with policymakers throughout the country; with leading health policy experts of both parties; with the key players at the table.

The Voice for the Uninsured campaign already has made tremendous inroads. But we need you to join us as we take advantage of what we've already accomplished. Join us in making sure that we cover America's uninsured.

Nancy H. Nielsen, MD, PhD is an internist from Buffalo, N.Y. She was AMA president during 2008-09.

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