By Joyce Frieden
MedPage Today, August 16, 2019
The American Medical Association has dropped out of the Partnership for America’s Health Care Future, a coalition of healthcare stakeholders dedicated to torpedoing the idea of a single-payer healthcare system such as Medicare for All.
The coalition “has extensively highlighted the many serious problems with Medicare for All and other proposals that would lead to a single payer health care system,” James Madara, the AMA’s executive vice president and CEO, said in a statement about the move, which was first reported by Politico. “Missing in the recent debate is an ongoing discussion of practical solutions that will result in more affordable insurance options.”
“Practical solutions have been identified and continue to be championed by the AMA,” Madara continued. “The AMA decided to leave the Partnership for America’s Health Care Future so that we can devote more time to advocating for these policies that will address current coverage gaps and dysfunction in our health care system.” He emphasized that the association “[remains] opposed to Medicare for All, and policies that reduce patient choice and competition, and are built on flawed financing policies.”
In response, the coalition issued a cordial statement saying it “strongly agrees with the American Medical Association (AMA) that Medicare for all is the wrong approach for America’s healthcare and we have appreciated the opportunity to work with them throughout the past year.” The partnership’s members include America’s Health Insurance Plans, the American Hospital Association, the BlueCross BlueShield Association, the Biotechnology Innovation Organization, and other groups that would be affected by any move to a publicly financed health insurance program.
“Today, too many individuals and families who do not have employer sponsored insurance and are ineligible for government subsidies face costly premiums and high deductibles that restrict their access to care. Action is needed now to assist this population without disrupting coverage that works for most Americans,” he said. “Additional policy improvements will further the goal of expanding coverage and offering more affordable options for the uninsured and those struggling to secure meaningful health insurance coverage.”
Such options could possibly include a “public option” that would allow people to buy into a public program such as Medicare if they would like. At its annual meeting in June, the AMA House of Delegates referred the AMA Board of Trustees to a resolution calling for the organization to “study the impacts of various approaches that offer a public option … including but not limited to a Medicare buy-in; a public option offered on health insurance exchanges; and buying into either the Federal Employees Health Benefits Program or a state employee health plan.” (The Partnership for America’s Health Care Future opposes a public option, which it says could “decimate” rural hospitals’ finances.)
The resolution also reaffirmed AMA policy which states that coverage options offered in a health insurance exchange “be self-supporting; have uniform solvency requirements; not receive special advantages from government subsidies; include payment rates established through meaningful negotiations and contracts; not require provider participation; and not restrict enrollees’ access to out-of-network physicians.” The board will report back to the delegates on the resolution, possibly as early as the association’s interim meeting in November.
Medicare for All was a flashpoint at the June meeting, as several hundred protesters gathered outside the meeting hotel to demand that the AMA support Medicare for All; several dozen protesters came inside the main meeting room and staged a “die-in” on the House of Delegates floor.
At least one group was happy with the AMA’s exit from the partnership. “This is a big victory for single-payer supporters,” Adam Gaffney, MD, president of Physicians for a National Health Program (PNHP), which supports single-payer, said in a statement. “For decades, the AMA has been on the wrong side of history, fighting efforts to establish Medicare and Medicaid in the 1960s, and resisting movements to bring racial equality to the delivery and practice of health care … The AMA’s exit from this explicitly anti-single payer lobbying group shows that change is within reach.” PNHP was one of several groups that organized the protest at the AMA meeting.