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ACP-ASIM Releases Core Principles to Guide Search for Health Care Access

Thursday, Dec. 21, 2000

Principles Address Lack of Health Insurance, Other Barriers to Care

(Washington, DC): The American College of Physicians — American Society of Internal Medicine (ACP-ASIM) has released a set of 14 core policy principles to guide the nation’s quest to provide all Americans with access to affordable health care.

The document, "Providing Access to Care for All Americans: A Statement of Core Policy Principles," maintains that any proposed health policy must include a comprehensive method to provide health insurance coverage to all Americans with a fixed timetable for implementation.

The College asserts that any health reform proposal should establish a uniform minimum package of benefits for healthcare coverage with benefits continuous and independent of place or residence or employment status. The principles note, however, that lack of health insurance coverage is not the only barrier to care that should be addressed by policymakers. The principles advocate that policymakers also address: under-funding of health care facilities that provide care to indigent patients, low levels of reimbursement for covered services, excessive administrative costs, and disparities in the care available to patients based on gender, ethnic nationality, and race.

"The advent of a new administration and Congress creates a wonderful opportunity for our society to do something about the more than 42 million Americans who lack health insurance," said ACP-ASIM President Sandra Fryhofer. "The College’s 14 core principles for providing health care access are intended as a road map to help guide the nation as it searches for ways to expand coverage and overcome other barriers to high quality, affordable health care."

The principles acknowledge the need for mechanisms to encourage individuals to participate in the insurance pool, who otherwise might voluntarily choose not to obtain coverage.

Financing for public programs that provide health insurance coverage should be progressive: individuals with higher incomes should contribute more than those with lower incomes. Explicit means testing of programs, however, should be discouraged.

The financing section of the principles maintain that a substantial portion of federal budget surpluses should provide funds to expand health insurance coverage to the uninsured. Priority should also be given to assuring adequate and predictable financing for "critical access" institutions and providers with a higher burden of uncompensated care. Critical access providers include rural and inner city hospitals, outpatient care, physicians practicing in underserved areas, community health centers, home care, rehabilitation and skilled nursing facilities, and academic medical centers.

The principles also suggest that health reform proposals should address sources of patient and physician dissatisfaction with the current system. Some of these dissatisfactions include:

  • micro-management of clinical decision making
  • diversion of health care dollars away from patient care to administrative inefficiencies
  • excessive pressure on physicians to reduce time spent with patients

A complete copy of "Providing Access to Care for All Americans: A Statement of Core Policy Principles" is available online at http://acpsun01/hpp/pospaper/access_principles.htm.

ACP-ASIM is the nation's largest medical specialty organization and the second largest physician group. Membership comprises more than 115,000 internal medicine physicians and medical students.



David Edelson, ACP-ASIM Washington Office, 202-261-4575

Jack Pope, ACP-ASIM Washington Office, 202-261-4556

Page updated: 11-03-03

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