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AMA to Examine Public Option

— Feasibility study stops short of endorsement

MedpageToday

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CHICAGO -- The American Medical Association agrees that it is time to study the feasibility of a public option for the individual insurance market, a new policy that would have been unheard of from the AMA as recently as 10 years ago.

But the delegates who voted to add a public option to the menu of plans being considered to move the U.S. toward universal coverage, also want to make it clear that "a public option is not single-payer."

Michael Miller, MD, a Wisconsin delegate, who favored adoption of an amended resolution, stressed that "public option and single payer are not the same thing ... The word option is not the same as the word mandate."

The public option policy was adopted by the AMA's policy-making House of Delegates on Tuesday.

The author of the initial resolution, titled "Repeal and Replace Our Outdated Refundable Tax Credit Policy," Rodney Trytko, MD, a delegate from Washington State, argued in a reference committee meeting on Sunday that the premium tax credits offered through the exchanges aren't working for everyone. While the reference committee did not include "public option" in its re-worked version of the resolution, it did agree that a study of ways to improve the individual insurance market was needed.

On Tuesday, Trytko pushed the House to reinsert the public option language and after much discussion, was able to reach a compromise with some delegates concerned that any study of such a concept could be misconstrued as an endorsement.

"Perception can become its own reality," said John Armstrong, MD, who chaired the reference committee that studied Trytko's resolution.

On Sunday, one delegate worried aloud that specialties would "cease to function" if a public option were enacted and Medicare payments became the standard benchmark. Others warned that a public option is a "slippery slope" to a single-payer system.

The final language approved by the delegates states that the AMA will explore the feasibility of a public option "as part of a pluralistic health care delivery system."