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AMA narrowly defeats single payer amendment

June 12, 2019

Topics: Quote of the Day

By Steven Ross Johnson
Modern Healthcare, June 11, 2019

The American Medical Association will remain opposed to proposals for the U.S. to create a single-payer healthcare system. The group voted narrowly to maintain its stance on Tuesday at its annual House of Delegates meeting.

Delegates of the largest physicians’ organization voted 53% to 47% against adopting an amendment to remove the AMA’s formal opposition to a single-payer healthcare system, ending days of contentious debate that pitted the organization’s leadership against a contingent represented largely by medical students.

“As long as we maintain our blanket opposition our AMA cannot ensure we are a part of every conversation,” said Dan Pfeifle, a fourth-year medical student at the University of South Dakota Sanford School of Medicine and an alternate delegate of the AMA’s Medical Student Section.

Delegates ended up voting overwhelming in favor of adopting a report from the AMA’s Council on Medical Service that reaffirmed efforts to improve upon the Affordable Care Act instead of “nationalized” healthcare coverage.

Some of the report’s recommendations included expanding eligibility for tax credits on insurance premiums beyond 400% of the federal poverty level, as well as to expand eligibility for and increase the size of cost-sharing reductions.

“The AMA proposal for reform, based on AMA policy, is still the right direction … to cover the uninsured, and is cognizant that, in this environment, the ACA is the vehicle through … which the AMA proposal for reform can be realized,” the report stated.

The debate over whether the country should adopt a Medicare for All type of system has gotten increased attention in recent months as it has become a key policy issue among several of the Democratic presidential candidates.

The AMA has long opposed single-payer efforts out of concerns that it would lower provider reimbursement rates and limit patient choice on healthcare coverage and services they can access.

But support for a single-payer system has grown among physicians. At the AMA annual delegates meeting last year, supporters got the body to at least study the impact of changing its policy.

This year, the issue sparked a protest outside of the AMA’s meeting on its first day when medical students joined nurses and advocates to call on the organization to drop its fight against Medicare for All.

More broadly, public opinion for single payer has grown over the years so that a majority of Americans now support such a system. According to a survey conducted by the Kaiser Family Foundation in April, 56% of Americans favor a national health plan in which all individuals got their insurance from a single government plan.



By Don McCanne, M.D.

The Medical Student Section of the AMA and the medical students who helped organize the protest outside of the Chicago meeting of the AMA House of Delegates may be disappointed because the AMA decided to continue its opposition to single payer reform. But actually it was a phenomenal success in that single payer was defeated by the slim margin of 53% to 47% – a remarkable shift from its previous overwhelming opposition to single payer. As the rationale of the single payer model is better understood, and the ice has been broken by almost half of the delegates, just maybe the AMA might be able to shift to a position of support next June, in plenty of time before the November election.

At any rate, we certainly have the medical students to thank, along with the nurses and other health care professionals and activists. One way we can show our appreciation to the students is to donate to the Nicholas Skala Student Activist Scholarship Fund to provide student scholarships for the Annual PNHP Meeting and Leadership Training and for other student outreach programs:


Thankfully, the future of our health care is in their hands.

Stay informed! Visit www.pnhp.org/qotd to sign up for daily email updates.

About the Commentator, Don McCanne

Don McCanne is a retired family practitioner who dedicated the 2nd phase of his career to speaking and writing extensively on single payer and related issues. He served as Physicians for a National Health Program president in 2002 and 2003, then as Senior Health Policy Fellow. For two decades, Don wrote "Quote of the Day", a daily health policy update which inspired HJM.

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