WASHINGTON -- In an unprecedented move, leaders of the conservative American Medical Association yesterday urged the federal government to guarantee basic medical insurance to all Americans, saying it is "no longer acceptable morally, ethically or economically" for roughly 33 million citizens to live with inadequate or nonexistent health insurance.
The AMA officials, using uncharacteristically strong language, also blamed "long-standing, systematic, institutionalized" racism, including that of organized medicine, for the fact that most of the uninsured and under-insured are members of minority groups. And they called the status quo "morally unacceptable."
Yesterday's bold challenge to President Bush and Congress to curb runaway health-care costs while providing basic universal coverage coincided with the AMA's publication of more than 70 health-care reform proposals being advocated from a wide range of interest groups, from labor to advocates for the poor.
The proposals cover the entire gamut, ranging from tinkering with the Medicare and Medicaid programs to adopting the Canadian system of universal health care.
Among them were the 1990 Pepper Commission report, which '' would require all employers to provide health insurance to their workers. They also included the AMA's own reform plan, which would call on a combination of government and business to provide every American with "affordable coverage" while preserving all patients' rights to select their own doctors.
AMA officials yesterday did not promote their own proposal; rather, they urged a vigorous national debate on the merits of all the contending ideas -- and challenged Mr. Bush to produce his own proposal.
"I don't know what the solution is. But I believe that somewhere in these pages we have many solutions that would work and be an improvement over what we now have," said Dr. George D. Lundberg, editor-in-chief of the Journal of the American Medical Association and a major force in the growing national debate.
"We as a developed country, along with South Africa, are the only two such countries that have no national health policy and have no plan nationally to take care of all of our people at a basic level," Dr. Lundberg said at a press conference here.
"I would hope that there would be leadership in the executive branch, which will recognize this as a moral imperative as well as a pragmatic necessity to get on and solve the problem."
The AMA's push for health-care reforms contrasts sharply with its role during President Lyndon B. Johnson's administration, when the organization fought vigorously against enactment of the Medicare and Medicaid programs.
The Bush administration is expected to unveil its initial response to the growing health-care crisis tomorrow.
Also yesterday, the Bush administration announced a $171 million program to extend prenatal care to pregnant women in their first trimesters as a way to to reduce the nation's high rate of infant mortality.
Most Americans have basic health insurance. But as the cost of medical care continues to soar -- now accounting for 12 percent of the Gross National Product and still climbing -- more and more people are being squeezed financially or are being abandoned altogether by insurers. At the same time, employers are experiencing alarming increases in their employee health-care costs.
Sen. John D. Rockefeller IV, D-W.Va., who chaired the bipartisan Pepper Commission, said that Congress may enact some reforms during the current session, although many others were far less optimistic.
In leading yesterday's unprecedented call for federal action on the health-care crisis, Dr. Lundberg arranged for the Journal as well as the AMA's nine specialty journals to publish simultaneously single-issue editions devoted entirely to the health-care crisis.