Request for Comments on Draft ACP-ASIM Seven Year Plan to Provide Affordable Coverage to All Americans
American College of Physicians American Society of Internal Medicine (ACP-ASIM)
Available at the link below is "a draft seven-year sequential plan for expanding access to health insurance for all Americans. Your review of this document is requested. The Health and Public Policy Committee of the American College of Physicians - American Society of Internal Medicine has developed this draft policy paper with the view that a sequential series of steps within a specific time frame are needed to achieve the goal of access to health insurance coverage for all Americans."
"We would appreciate your comments by January 11, 2002, so that we may incorporate them into a final draft that will be further reviewed by our committee in February 2002 and then brought to our Board of Regents for final approval."
The ACP-ASIM request for comments is available at: <http://www.acponline.org/hpp/seq_plan01.htm?hp>http://www.acponline.org/hpp/seq_plan01.htm?hp
And from the draft of the proposal:
"We recognize that some will argue that the College's proposed reforms don't go far enough... Others will likely argue that they go too far... Some will question the political feasibility... "
"ACP-ASIM welcomes such comments, but requests that those who disagree with some or all of the steps recommended in this paper present an alternative plan of action that would achieve affordable coverage for all Americans within the next seven years. Debate should no longer center on whether all Americans should have access to affordable coverage, but on the means to achieve that end within a reasonable period of time."
"ACP-ASIM also recommends that the ideas in this paper, as well as alternative proposals to achieve the same objective, be discussed in community forums throughout the country. History has shown that health care reform cannot be a top down proposal emanating from Washington, D.C. Rather, the changes that are needed must be understood, guided, and supported by citizens in communities throughout the country."
The full draft of the proposal is available at: <http://www.acponline.org/hpp/seq_plan01.pdf>http://www.acponline.org/hpp/seq_plan01.pdf
Comment: ACP-ASIM proposes a seven year sequential path to reform as follows: (1) A sense of the Congress resolution, (2) Expansion of Medicaid to all below 100% of poverty, and premium subsidies for public or private programs for those up to 200% of poverty, (3) Covering all remaining uninsured through premium subsidies of plans offered and approved by purchasing groups, using FEHBP as the model, and, finally, (4) Enacting legislation "to discourage individuals from voluntarily choosing not to obtain coverage" (individual mandates enforced by financial penalties).
ACP-ASIM is very serious about leading the charge to universal coverage. Although they previously supported a single payer approach, they are now adopting the Clinton approach that we must bring all parties together, including the health plans. This approach can only perpetuate the waste and inequities that are inherent in our fragmented system.
It is easy to respond to the ACP-ASIM proposal with a critique of the flawed health policies perpetuated by their plan. The ACP-ASIM policy committee already fully understands the implications of its proposals, both positive and negative. They need to hear much more from us than a mere critique. They have challenged us to provide "an alternative plan of action that would achieve affordable coverage for all Americans," a plan that "must be understood, guided, and supported by citizens in communities throughout the country."
The challenge is ours. We have the policy. We understand the policy applications that would bring equity to health care, while maintaining affordability. We now need to create a specific action-plan document that we can present to the ACP-ASIM, and, more importantly, to the nation. The alternative is sequential incrementalism that will address only the issue of coverage while perpetuating and solidifying the inequities and flawed policies of our current system. For us to accept sequential incrementalism by default would be a greater moral transgression than that of those that are merely manipulating our system for their own personal gain.