AMA Lobbies for Changes to Health Care in New Hampshire

The American Medical Association (AMA) has been promoting a reform plan in the state of New Hampshire that it says would help improve the state's health care system.

Analysts are offering mixed reviews of the plan, with some calling it "a very good step" for the AMA and for New Hampshire, and others criticizing it as simply being an expansion of the "current dysfunctional system."

The AMA proposal, developed in association with 15 other national health care organizations (including AARP and the American Hospital Association), encourages the New Hampshire government to provide tax credits and vouchers, usable only for health insurance, to people who are currently unable to afford health coverage.

The proposal also suggests allowing consumers to choose between competing health insurance plans, including plans from other states, and seeks to create an environment in which individuals would opt for health insurance before they require medical attention, instead of being caught without needed coverage when an emergency arises.

AMA also encourages the New Hampshire legislature to create financial incentives for insurers to encourage them to cover "high-risk" individuals, including those with preexisting conditions.

Emphasizing Individual Choice

John R. Graham, director of health care studies at the Pacific Research Institute in San Francisco, was encouraged by AMA's promotion of such a market-friendly proposal. "[The AMA's plan] encourages people to be self-reliant while supporting low-income people with financial assistance, bypassing government bureaucracy," he said.

"It will be very difficult for politicians to promote single-payer health care or mandatory coverage in the face of this proposal, which emphasizes individual choice," Graham noted.

Charles M. Arlinghaus, president of the Josiah Bartlett Center for Public Policy in Concord, New Hampshire, said, "One good thing about the AMA proposal is that they focus on the 15 percent of the people without insurance, rather than changing the system for the 85 percent who do have insurance."

Subsidies a 'Band-Aid'

"If government is to help people of moderate income," Arlinghaus added, "it makes sense to provide vouchers for real insurance. As far as it goes, that's fine."

The real problem, according to Arlinghaus, is escalating health care costs.

"Subsidizing insurance that is less and less affordable is merely a band-aid rather than a curative," Arlinghaus said. "Greater exposure to the real cost of health care and a reduction in third-party payments that insulate us from the cost of care are a necessary part of any reform."

'Compounds Existing Problems'

Greg Scandlen, president of Consumers for Health Care Choices, criticized the proposal, saying, "The AMA's position assumes that the kind of insurance we have today is the best way to finance health care. It is not.

"In fact," Scandlen continued, "the reliance we currently have on third-party payers has created most of the problems in the health care system--massive waste and bureaucracy, lack of convenience and accountability, questionable quality, and very high costs. It is simply not good for doctors or for patients.

"Expanding the current dysfunctional system to cover more people will only compound the existing problems," Scandlen said. "The AMA should stop trying to be politically cagey and get back to the principles of freedom in health care, including the freedom of doctors to practice medicine and the freedom of patients to choose their own coverage."