Letters Section Editor: Robert M. Golub,
MD, Senior Editor.
To the Editor: The American Medical Association's
(AMA's) proposal for reform of the American health care financing system1 fails to account for the fact that, for an essential
product like basic health care services, insurance must be universal and mandatory.
Otherwise, adverse selection occurs, leaving patients at risk of no access
when they need it most. Besides, only 100% enrollment makes coverage affordable
and efficient, as demonstrated by the only US universal health insurance program,
Medicare. The option to choose among various health insurance products is
of little value to consumers. It might be better to offer a uniform basic
health plan package with options for nonessential enhancements that might
be added at individuals' discretion.
Thienhaus OJ. The AMA Health Insurance Proposal. JAMA. 2004;292(10):1173. doi:10.1001/jama.292.10.1173-b