PNHP note: The resolution below was submitted to the American Medical Association’s Medical Student Section (AMA-MSS) on April 17 by 61 medical students from 18 schools, primarily from the Northeast and Midwest but with several co-authors in the West. The lead signer was Bradley Zehr of the Boston University School of Medicine. The resolution will be under discussion by AMA-MSS members nationwide in the run-up to the organization’s June 5-7 annual meeting in Chicago, where it is expected to be voted upon. In the interest of conserving space, we have removed the resolution’s 25 footnotes and other back matter.
Resolution on Advocacy for Single-Payer Health Insurance
Whereas, 48 million Americans lacked health insurance in 2012, and an estimated 31 million Americans will remain uninsured in 2024 despite advances made by the Patient Protection and Affordable Care Act; and
Whereas, Underinsurance is expanding as many patients are forced into private health insurance plans with high deductibles (> $1,000) and narrow provider networks; and
Whereas, 28 million low-income Americans will cross between Medicaid and the subsidized private health insurance exchanges annually, an effect called “churning”, which erodes continuity of care; and
Whereas, The United States ranks last out of 19 high-income countries in preventing deaths amenable to medical care before age 75; and
Whereas, The United States ranks last out of 7 wealthy nations in health care access, patient safety, coordination, efficiency, and equity; and
Whereas, The United States spends twice as much per capita on health care compared to the average of wealthy nations that provide universal coverage; and
Whereas, Medicare overhead costs are less than 2%, and private health insurance overhead costs range from 7% to 30%, with an average of 12%;
Whereas, Providers are forced to spend tens of billions more dollars dealing with insurers’ billing and documentation requirements, bringing total administrative costs to 31% of U.S. health spending, compared to 16.7% in Canada; and
Whereas, The United States could save more than $380 billion annually on administrative costs with a single-payer system, enough to cover all of the uninsured and eliminate or dramatically reduce cost-sharing (deductibles, co-payments, co-insurance) for everyone else; and
Whereas, A single-payer Medicare-for-All national health insurance system would fundamentally simplify the financing of health care in the United States; and
Whereas, A single-payer system would cover every American from birth for all necessary medical care and would virtually eliminate health uninsurance and underinsurance in the United States; and
Whereas, A single-payer system would increase patients’ freedom to choose among health care providers and not be constrained by arbitrary private insurance networks; and
Whereas, A single-payer system would protect the physician-patient relationship from interference by for-profit health insurance companies whose purpose is to maximize profit; and
Whereas, A single-payer system would facilitate regional health system planning, directing capital funds to build and expand health facilities based on evidence of need, rather than being driven by the dictates of the market, which increases geographical inequality; and
Whereas, Hospitals and clinics could remain private not-for-profit organizations under a government-financed single-payer system, in contrast to the government-operated hospitals of the Veterans Administration; and
Whereas, A single-payer system would control costs through proven-effective mechanisms such as negotiated global budgets for hospitals and negotiated drug prices, thereby making health care financing sustainable; and
Whereas, Support among physicians for government legislation to establish national health insurance increased from 49% in 2002 to 59% in 2007; and
Whereas, Support among the general United States population for a single-payer health care system climbed from 28% in 1979 to 49% in 2009; and
Whereas, There is single-payer legislation in both houses of Congress, H.R. 676 and S. 1782, that outlines the transition to an expanded and improved Medicare for all, including re-training programs for private health insurance workers whose jobs would be lost; and
Whereas, Vermont passed legislation in 2011 to create a “pathway to single-payer” in that state starting in 2017, the soonest allowed under Section 1332 of the Affordable Care Act, and many other state legislatures are considering similar legislation; therefore be it
RESOLVED, That our American Medical Association shall advocate for legislation to implement a single-payer health insurance system.