Author Affiliations: Department of Health Care Systems, The Wharton School, University of Pennsylvania, Philadelphia.
In this issue of THE JOURNAL, the publication of the most recent version
of the American Medical Association's (AMA's) proposal1 to
reduce the number of Americans without health insurance comes at a good time.
In the early stages of the presidential campaign, health care has been identified
as a priority issue, and the trends in escalating medical premiums and the
increasing proportion of the population that is uninsured are also of concern.
The AMA has tried to develop an approach that would make a major contribution
to enhancing access in private insurance; it does not pursue the idealistic
but probably (given the current political and public finance environment)
infeasible goal of universal coverage right now. Even so, by extrapolating
past trends on increasing private insurance coverage, it is clear that the
proposal will have to address several challenges—some are economic,
some are fiscal, and the most serious ones involve politics and policy in
Pauly MV. Keeping Health Insurance Tax Credits on the Table. JAMA. 2004;291(18):2255–2256. doi:10.1001/jama.291.18.2255