Medical students bring the AMA into the single payer dialogue

AMA House of Delegates 2018 Annual Meeting, June 9-13, 2018

Resolution 108

Introduced by: Medical Student Section

Subject: Expanding AMA’s Position on Healthcare Reform Options

Referred to: Reference Committee A


Whereas, Current AMA Policy H-165.847 establishes that comprehensive health system reform achieving quality healthcare for all Americans is of the highest priority to our AMA; and

Whereas, Our AMA is limited in its ability to engage in open and honest debate about all health care reform options via its blanket opposition to single payer financing mechanisms (AMA Policy H-165.838); and

Whereas, Evidence suggests that our AMA’s stance on single payer does not currently represent the majority of physicians, with two recent surveys by the Merritt Hawkins and the Chicago Medical Society each reporting a majority of physicians either strongly or somewhat supporting the concept of a broadly labeled single payer health care system; and

Whereas, Several US senators have recently supported legislation to move forward with a national single-payer health care financing reform, and as such our AMA must be equipped to have open, productive discussions on the matter in the coming years; and

Whereas, H.R. 676 - Expanded & Improved Medicare For All Act - has 122 cosponsors, and as such will likely come to the AMA for debate in the near future; therefore be it

RESOLVED, That our AMA rescind HOD Policy H-165.844; and be it further

RESOLVED, That our AMA rescind HOD Policy H-165.985; and be it further

RESOLVED, That our AMA amend HOD Policy H-165.888 by deletion as follows:

Delete: "B. Unfair concentration of market power of payers is detrimental to patients and physicians, if patient freedom of choice or physician ability to select mode of practice is limited or denied. Single-payer systems clearly fall within such a definition and, consequently, should continue to be opposed by the AMA. Reform proposals should balance fairly the market power between payers and physicians or be opposed."

RESOLVED, That our AMA amend HOD policy H-165.838 by deletion as follows:

Delete: "12. AMA policy is that creation of a new single payer, government-run health care system is not in the best interest of the country and must not be part of national health system reform."


Report of Reference Committee A


Your Reference Committee heard mixed testimony on Resolution 108. A member of the Council on Medical Service recommended reaffirmation of existing policy in lieu of Resolution 108, and shared the Council’s belief that the current approach of our AMA’s policy to health reform is the right one – emphasizing pluralism, freedom of choice, freedom of practice and universal access to patients. Another Council member noted that the Council has already studied international approaches to single payer. Testimony on both sides was passionate. Testimony in opposition raised concerns that Resolution 108 would open the door to the AMA supporting single payer, while testimony in support of the resolution noted the changes to policy outlined in the resolution would enable the AMA to participate in legislative discussions addressing single payer. An amendment was also offered to call for a study. Your Reference Committee underscores that this issue is highly complicated, and there is a need to examine AMA policy addressing health reform and single payer, study the pros and cons of single payer and alternative approaches to universal coverage, and study the impacts of single payer systems on physician practices and patients. As such, your Reference Committee recommends that Resolution 108 be referred.


HOD ACTION: Resolution 108 referred.



By Don McCanne, M.D.

The Medical Student Section of the American Medical Association is to be commended for advancing the consideration of single payer health care reform. Until now, the AMA has been consistently opposed to single payer. Resolution 108 calls for the AMA to expand its consideration of health care reform options by including single payer in its deliberations.

Although the resolution striking single payer opposition from AMA policies was not adopted at this time, rather than recommending that it be rejected, the reference committee recommended that it be referred to the AMA Board of Trustees for further consideration. In the words of the reference committee, "there is a need to examine AMA policy addressing health reform and single payer, study the pros and cons of single payer and alternative approaches to universal coverage, and study the impacts of single payer systems on physician practices and patients."

The recommendation to refer was approved by the AMA House of Delegates.

This could be historic, and the thanks go to the medical students.

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