CHICAGO—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.
"I think we ought to put a stake in the heart of single payer," said Dr. Donald Palmisano, of Metaire, La., who served as AMA president in 2003-04. "We've done it before; we ought to do it again."
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.