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All Americans Must Have Health Insurance

A Joint Statement

The physicians of America believe that adequate health coverage and access to health care services are vitally important to their patients and to the nation.  Despite economic prosperity and substantial job creation during the last decade, there remains a considerable and increasing portion of the American population that does not have health insurance coverage.  As a result, those individuals defer obtaining preventive and medical services, jeopardizing the health and well being of themselves and their families.

Currently, the U.S. relies primarily on a private, employment-based system to provide health insurance.  In the mid-1980s, the percentage of Americans with employment-based coverage began to fall and the country began to experience continuing increases in the number of Americans who are uninsured.  From 1987 to 19997, the number of Americans who were uninsured rose steadily from 31.8 million to 43.1 million.  During this period, the percentage of people with employer coverage dropped from 69% to 64%.  The erosion of employment-based insurance coverage and the general decline in the number of people carrying private health insurance has generated a great deal of concern across the nation, and in particular, to physicians and other health care clinicians everywhere.

We acknowledge that lack of adequate health insurance is not the only barrier to accessing health care services – there are numerous other barriers.  These barriers include geography, poverty, language, inadequate housing, environment, cultural considerations, and the organization of services.

There currently exists an important “window of opportunity” to influence public policy with the upcoming 2000 election.  We challenge the 106th Congress and declared 2000 presidential candidates to make the critical issues of health insurance coverage and access a top priority.  All of the under-signed societies believe all Americans should have health coverage and consider it imperative to push the issue onto the national agenda, increase public awareness, and set off a public debate of the issues involved.  While each of our societies may support different approaches, we all seek to achieve the same objective: providing all Americans with health care coverage.

Affirmative ideals that will guide any future agenda include these three important concepts:

1.      All Americans must have health care coverage.

2.      Health care coverage will contain a benefits package that provides quality care.

3.      Medical necessity determinations made under the benefit package should reflect generally accepted standards of medical practice, supported by outcomes-based evidence evidence-based data regarding clinical appropriateness, where available.  We recognize that these standards will continue to evolve.

In addition, there are four core values that should be incorporated into any future policy related to increasing health care coverage and access.  They are:

1.      We place the interest and well being of our patients as paramount.

2.      We support universal coverage that is designed to improve the individual and collective health of society.

3.      We must have an infrastructure that maintains the highest quality of service, education, research and administration of care.

4.      We believe that patients, individually and in partnership with their physicians, also have a responsibility for their own well being and health.

We recognize there may be more than one way to finance providing all Americans with coverage.  A variety of financing options, including employer funding, individual funding, government funding, or combinations of these options, has been offered as possible “reforms.”

Expanding the individual’s ability to choose among several health insurance options is crucial.  We support pluralism of health care delivery systems and financing mechanisms in achieving coverage for and access to health care services.  There is a need to reform the current system to provide health coverage for all.

We urge all medical societies to join us in advocating for change and working towards moving the issues of coverage and access to the forefront.  Expanding health coverage to all Americans must become a high priority on both the federal and general public agendas.

In the interest of promoting health coverage for all Americans, we agree to the following:

1.      To commit our organizations to this issue as a high priority.

2.      To keep each other informed of our advocacy efforts, and to coordinate our activities where possible;

3.      To continue this pursuit until our goal of health coverage for all is achieved.


American Academy of Family Physicians

American Academy of Pediatrics

American College of Emergency Physicians

American College of Obstetricians and Gynecologists

American College of Physicians- American Society of Internal Medicine

American College of Surgeons

American Medical Association


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