AMA's 7 guiding principles for health system reform

Health system reform is moving forward in both the House and the Senate, and we are nearing the home stretch in achieving the improved system that the United States needs.

Now it's up to Congress to work with physicians to find common ground on the proposals that will improve our health care system for both patients and physicians.

We all can agree that the status quo is unacceptable, and we can't afford to squander this opportunity. The AMA is committed to making reform a reality this year and has seven principles guiding our vision and work. They are:

Cover all Americans

Forty-six million people in America don't have health insurance, and physicians work day and night to provide patients with high-quality care within the confines of a broken system. Covering the uninsured is a priority of the AMA -- we are committed to reform this year that provides all Americans with affordable, high-quality health care.

Physicians are on the front lines of the health care system and see the problems uninsured patients encounter firsthand. Nearly one in 10 children and one in five adults younger than 65 are uninsured. Last year, six in 10 families put off medical care due to costs, and this number likely has grown with the troubled economy.

Expand choice, eliminate denials

For those with insurance, a job loss and/or serious illness or injury can suddenly disrupt their security and stability. Our goal is to enact insurance market reforms that expand the choice of affordable coverage and eliminate denials for preexisting conditions or denials due to arbitrary caps. All Americans deserve affordable, portable, high-quality health care, regardless of their health or job status.

Protect the patient-physician relationship

The AMA is committed to protecting this relationship and putting medical decisions in the hands of patients and their physicians, not in the hands of insurance companies or government bureaucrats. Patients also should be able to contract privately with physicians, so their health care choices are respected.

Repeal Medicare SGR

Permanent repeal of the payment formula is an essential element of health reform, to ensure the security and stability of Medicare. Without repeal, the current sustainable growth rate formula projects even more cuts in future years. The gap between payments and costs will make it very difficult for physicians to keep their doors open to all Medicare patients and make quality improvements to their practices that benefit all patients.

Reduce defensive medicine

The AMA continues to believe that medical liability reform is essential to reduce the cost of defensive medicine. A 2003 Health and Human Services report estimated the cost of defensive medicine to be between $70 billion and $126 billion per year. Without reform, this cost driver will not go away. If we want physicians to adhere to the best practices and conserve resources, we need to provide protections for physicians who are conforming with practice guidelines.

The AMA worked closely with Rep. Bart Gordon (D, Tenn.) and the House Energy and Commerce Committee, which adopted an amendment to its bill that authorizes state-based pilot programs for "early offer" and certificate-of-merit initiatives. As a result of AMA advocacy, President Obama authorized $25 million for grants to implement state pilots for alternative medical liability reforms.

Streamline administration

Physicians want to focus on caring for their patients, not fighting with insurers over delayed, denied or shortchanged payments for their services. Now more than ever, reforms are needed to provide savings and allow doctors to crawl out from under an administrative burden that detracts from caring for patients. The AMA has recommended the adoption of standard payment rules and common claims processing requirements that would create a measurable decrease in administrative costs for physicians, as well as insurers.

Promote quality, prevention, wellness

Everyone has a role in making the system better -- we need investments and incentives for initiatives that improve quality and enhance prevention and wellness. Seventy-five percent of total health care spending is linked to chronic illnesses. Physicians can help Americans live healthier through preventive care and wellness programs -- reducing disease and health care spending. Healthier patients spend less money on health care, reducing the cost burden on individuals and the entire health care system. One resource the AMA has that can help patients learn about proper exercise and nutrition is online (link).

The challenges in our health care system are many, and we are working to improve it for the dedicated physicians who work day and night to provide high-quality care. Comprehensive health reform will create the foundation for a stronger, better-performing health care system; improve access to affordable, high-quality care; and reduce unnecessary costs.

The AMA and our individual members are working hard to improve health care delivery and quality through a broad range of initiatives. The AMA has been at the table throughout the legislative process and will remain engaged in the regulatory process to work on behalf of our patients and physicians. We remain committed to building a system that better serves patients and empowers the dedicated physicians who care for them.