AMA Supports Insurance Mandates
The American Medical Association's House of Delegates on Tuesday voted to support a proposal to require U.S. residents with annual incomes greater than five times the federal poverty level to have health insurance, the Chicago Tribune reports (Japsen, Chicago Tribune, 6/14). The AMA proposal would require qualifying U.S. residents to purchase a health plan that, at a minimum, covers catastrophic medical expenses (Schuler, CQ Today, 6/13).
The measure also recommends that Americans be required to purchase preventive health coverage (Bloomberg/Boston Globe, 6/14). Among the estimated five million uninsured U.S. residents who would be affected by this policy -- out of a total uninsured population of 46 million -- those who purchase health insurance could receive tax credits, and those who remain uninsured would be subject to higher taxes (Ritter, Chicago Sun-Times, 6/14).
The plan does not specify the amount of health insurance coverage or the specific type of plan that must be purchased, and it does not offer specific details on tax penalties (Japsen, Chicago Tribune, 6/14). According to CQ Today, "[d]espite the high-profile efforts" to enact a similar health insurance mandate in Massachusetts, "the idea has not caught fire in Congress.
Many Republican lawmakers say it smacks of government mandates; Democratic opponents complain that it places too much of a financial burden on individuals" (CQ Today, 6/13).
AMA on Tuesday said the vote in favor of coverage mandates was a "significant shift" for the group, which previously has "shied away from government mandates," according to the Tribune (Japsen, Chicago Tribune, 6/14). AMA until 2000 backed a mandate on employers to provide health insurance (Bloomberg/Boston Globe, 6/14).
However, AMA in a report said, "Society should not be penalized by the potentially costly medical treatments of those uninsured who can afford to purchase health insurance coverage" (Chicago Sun-Times, 6/14).
AMA board member Ardis Hoven said AMA will lobby Congress to pass legislation on coverage mandates (CQ Today, 6/13).
Jack Lewin, executive vice president of the California Medical Association, said, "The AMA just took a huge step toward supporting universal health care for all Americans. Historically, the AMA has supported voluntary approaches but never a mandate."
Paul Ginsburg, president of the Center for Studying Health System Change, said, "It's really amazing how quickly the mandate went from an occasional discussion among policy wonks to something advocated by major players, such as the AMA. Broader acceptance of this idea may be the key to government's moving more aggressively to expand health insurance coverage" (Bloomberg/Boston Globe, 6/14).
Michael Cannon, director of health policy studies for the Cato Institute, disagreed with AMA's vote, saying that the group "has a long history of sacrificing consumer freedom when physician incomes are threatened, and they are doing that with this tax increase" (Japsen, Chicago Tribune, 6/14).
- Salt consumption: The delegates voted in favor of a 50% reduction in the amount of salt in processed and restaurant foods over the next 10 years, the Wall Street Journal reports. The AMA resolution said that 95% of men and 75% of women ages 31 to 50 regularly consume more salt than the maximum recommendation and that there is "overwhelming evidence" that excessive salt contributes to cardiovascular disease and hypertension (Gibson, Wall Street Journal, 6/14). Dietary guidelines recommend a maximum daily consumption of 2,300 milligrams of salt and a 1,500 milligram maximum for people with hypertension, blacks and middle-aged and older adults. AMA officials said high salt consumption costs the health care system "tens of billions of dollars" in treatments for hypertension and cardiovascular disease (Schmeltzer/Japsen, Chicago Tribune, 6/14). AMA also recommended labels on food products warning consumers about high salt content and said FDA should revoke salt's classification as a food that is "generally recognized as safe" (Tanner, AP/Long Island Newsday, 6/14). Salt Institute President Richard Hanneman said AMA's report was "unfounded in science and potentially not only a waste of resources but perhaps even dangerous" (Wall Street Journal, 6/14). He called instead for a clinical trial examining the "health outcomes of salt reduction" (Schmeltzer/Japsen, Chicago Tribune, 6/14).
- Binge drinking: The delegates voted to urge health officials on college campuses to "improve their skills" in identifying students with alcohol problems and providing them with assistance. A Harvard University study has found that 2% of college students with alcohol problems seek treatment (Chicago Sun-Times, 6/14).
- Tanning salons: The delegates voted to lobby the federal government to ban the use of tanning salons for individuals younger than age 18 to reduce the risk of developing skin cancer.
- Sugared drinks: The delegates voted against a proposal that would have supported a tax on sugar-sweetened sodas (AP/Long Island Newsday, 6/14).
- Drug price controls: The delegates voted against a resolution that would have called for price controls on prescription drugs. Supporters of the proposal said drug companies earn "excessive profits," but opponents said price controls would go against AMA's traditional support of free-market competition (Chicago Sun-Times, 6/14).
NPR's "All Things Considered" on Tuesday reported on AMA's recommendations on salt consumption. The segment includes comments from Stephanie Childs, a spokesperson for the Grocery Manufacturers Association; Michael Jacobson, executive director of the Center for Science and the Public Interest; John Schneider, chair of AMA's Council on Science and Public Health (Aubrey, "All Things Considered," NPR, 6/13).
The complete segment is available online in RealPlayer.