THAT: This proposal would:

1. Guarantee health insurance for all US residents.
2. End the responsibility of US industry to provide health insurance benefits.
3. Create a tax-based (like Medicare) health insurance program funded by the federal government and/or the states.
4. Build on the current strengths of American health care professionals and institutions to deliver quality, scientific based care and prevention.
5. Utilize the strengths of American health insurers to administrate the system.
6. Minimize the economic incentives or disincentives to either over-utilize marginally effective services or underutilize proven beneficial services.
7. Allow flexibility at the state level – except for mandating universal coverage.

THAT: Some of the agreed-upon principles (by the authors of this resolution) of this proposal would include – subject to modification and/or development in more detail by an ACPM committee:

1. Federally funded health insurance coverage for all residents of the USA with a single risk-pool that enrolls every resident automatically (details of enrollment to be worked out) in an Essential Health Insurance (?Care) Package (EHIP) in the state where the individual resides.
2. The proposal could cover all residents initially, or phase in some already covered groups step-wise, such as Medicare, the VA, and military populations.
3. The EHIP would have no premiums; would include primary care, essential specialist care, hospitalizations, and pharmaceuticals; proven preventive care; mental health with parity; basic dental care.
4. There would be no deductibles and minimal co-payments for essential services, with a mechanism to waive co-payments as deemed necessary. [ACPM policy in 1993 stated that basic preventive services should be delivered "free of any co-payment."]
5. Discretionary specialty services would have higher co-payments.
6. Creation of a national board for oversight, regulation, and design of the benefit package.
7. EHIP financed through a progressive payroll tax (or self-employment tax) on all income, collected similar to social security and Medicare taxes.
8. Supplemental insurance, for services or co-payments not covered in the EHIP, would be sold on the private market. Employers could opt to buy supplemental insurance for non-covered services.
9. Current employer contributions for health insurance should be converted to increased wages for employees.
10. Provision for capture of the tax-exemption (currently amounts to about $125 Billion a year) in the financing of this plan.
11. Enrollment process to be developed. Could provide role for current insurers in enrollment as well as administration.
12. Rates and reimbursements negotiated between the EHIP administrators and health care professionals/institutions. Could be fee-for-service or capitation, or other negotiated payment mechanism.
13. Enrollees have full choice of provider participating with chosen insurer.
14. Long term care to be integrated into package when feasible with current Medicare and Medicaid long term care programs retained until altered.
15. States responsible to monitor and regulate insurers in each state and allowed flexibility to add needed benefits, e.g., as with current Medicaid recipients.
16. Assume continued federal/state support for delivery systems for special populations (e.g., Migrant/Community Health Centers, Health Care for the Homeless, Public Health Clinics).
17. Funding for prevention and public health, as well as educational programs, to be included within this financing system – but not excluding other funding as well.
18. Federal government to monitor and regulate state performance in assuring access and quality of care to residents of the states.

THAT: The ACPM work with other professional (?and community) organizations to form a broad base of lobbying support for this Health Insurance for All plan.

THAT: The ACPM form a committee to develop this proposal in detail to present it to our membership for approval.

1. THAT, the ACPM Policy Committee and Board declare that an emergency situation exists in which other business of ACPM must be declared lower in priority to the action needed to immediately strengthen the specialty of preventive medicine.
2. THAT, resources be immediately deployed to rapidly and fully implement the entire workplan of the Job Market Intiative (JMI) – including
1. Web site, job listings,
2. Outreach to actual and potential employers of PM physicians,
3. Outreach and liaison to other national organizations and
4. Development of postgraduate fellowship opportunities.
3. That, in addition to the JMI agenda, action be initiated, renewed or dramatically enhanced on the following fronts:
1. To convince the ACGME RRC (Residency Review Committee) of the importance of formal recognition of the non-clinical portions of PH and PM residency training programs
2. To fully engage ACPM (and possibly other PM national organizations) in
1. The APHA/ASPH project to "certify" public health professionals.
2. The CDC-associated public health workforce enumeration project
3. National deliberations on institutional response to bioterrorism and the provision of the leadership and technical staff needed to assure appropriate response in public health, academic, healthcare delivery and other settings
3. To secure and enhance funding for PM residency training programs, with special emphasis on those oriented toward development of leadership staff for state and local health departments
4. To explore both formal and informal means by which we can redevelop Public Health as a subspecialty of Preventive Medicine – and implement these means in a way that will enable us to assure state and local governments of the qualifications of PH physicians board certified in PM
5. To begin the process of redeveloping all PM training programs to meet the needs of the job marketplace and to identify the ways in which the knowledge and skills needed to fill all potential PH/PM physician job niches can be offered in PH/PM training programs, at MPH, residency and continuing education levels. This will require the following steps
1. Identifying the jobs that should require or prefer PM physicians in the job specifications
2. To identify the knowledge and skills required for such jobs
3. To develop the educational programming to teach such knowledge and hone the skills under skilled mentorship in the context of PM residency training programs
6. To enhance and accelerate development of part-time and off-site PM training opportunities as a path to PM Board certification by currently employed PM physicians and non-PM physicians who might seek such training and certification
7. To take these and other steps necessary to create a situation in which PM training and Board Certification is of substantial value to PM physicians seeking PM related jobs
4. That ACPM play the lead role to enlist the active participation of sister preventive medicine, public health and medical organizations in this effort.
5. That ACPM play the lead role in enlisting the active participation of ACPM members and their respective institutional employers in academic, public health, healthcare delivery, industrial and other settings to further this agenda.