120.001 Health Care Reform


Health Care Reform: The Texas Medical Association weighs heavily in its evaluation of health care reform proposals the following concepts:

Make health insurance benefits part of the gross wage of employees and allow tax credits for premiums on individual tax returns so that employees, rather than employers, bear the cost of waste and reap the benefits of prudence;

Allow individuals who are otherwise uninsured the same tax credit incentive as the above to purchase health insurance;

Make tax credits refundable for low income families;

Allow insurers to sell no-frills, catastrophic group insurance not subject to state-mandated benefits, premium taxes, risk pool assessments, and other costly regulations;

Allow each employee or individual to choose a health insurance policy tailored to individual and family needs;

Limit favorable tax treatment for health insurance to catastrophic policies;

Allow each employee to choose between wages and health insurance coverage so that employees who choose less expensive coverage will have more take home pay;

Establish tax credits for deposits to individual Health Savings Accounts from which individuals would use their own money to pay small medical expenses without penalty;

Allow private insurers to repackage Medicare benefits and establish diverse policies tailored to the different needs of Medicare beneficiaries;

Give the elderly and future elderly and their employers tax incentives to self insure through Health Savings Accounts;

Allow Medicare patients to negotiate outside Medicare for more fair prices to both patient and physician;

Allow Medicaid patients to draw on an account, negotiate prices, and add their own money, if necessary, in order to purchase certain types of medical services--particularly prenatal care;

Encourage hospitals to negotiate a preadmission package price with patients, particularly on elective cases, and to make their bills understandable;

Allow patients to avoid the costly effects of the tort system through voluntary contract;

Establish and support not-for-profit endowed family health clinics in local communities to care for the office visits of the poor, with all physicians volunteering a portion of their time to support these clinics.

Health System Reform Quality Improvement Organization: Under health system reform, the quality improvement organization should be retained as an essential, local base for patient-focused quality assurance activities, and the scope of QIO review should be expanded beyond Medicare to include patients treated under private sector health plans

Health System Reform Establishment of National Health Board: The Texas Medical Association opposes establishment of a national health board under health system reform and supports continued oversight of health services through state and local agencies.

Health System Reform and Fee for Service Options: Under any health system reform plan, managed care organizations should be required to offer an out-of-network benefit. The Texas Medical Association opposes cuts in the Medicare and Medicaid programs to finance any health system reform plans. In addition, TMA voted to take appropriate actions to assure that rural physicians are not excluded from physician networks.

Health System Reform Public Health Funding: The Texas Medical Association endorses inclusion of public health funding and plans to meet public health needs in any health system reform proposals.

Health System Reform: The emphasis of Health Access America should be an incremental approach based on a defined set of AMA priorities. Any proposals for health system reform must address economic, demographic, and regional differences in the health care needs of the states. TMA voted to seek an incremental approach to directed-by-patient care needs and guided by a set of priorities that includes but is not limited to insurance reform, ERISA reform, tort reform, antitrust relief, opposition to Medicare and Medicaid cuts, and support for the Patient Protection Act.

Prompt Access to Benefits: Waiting periods to receive health care coverage in any insurance program in Texas should be eliminated.

Managed Care and Fee for Service: The Texas Medical Association opposes present and proposed managed health care plans that place third party business contracts and other intermediaries between the patient and the physician. TMA believes that medical care for American citizens can best be provided by reinstituting a simple fee for service contract between the patient and the physician with due respect for the patient’s ability to pay, directly or through their individual insurance. In addition, TMA believes that insurance companies should be directed to offer individuals affordable, transportable, community-rated health care plans using appropriate actuarial data to provide coverage for preexisting conditions at equitable rates which ideally should cover high end or catastrophic health care costs (Council on Socioeconomics, p 150, I-92; amended CSE Rep. 3-A-04; amended CSE Rep. 3-A-14).

Last Updated On

October 07, 2016