An Analysis of the American Medical Association's Recommendations for Change in the Medical Care Sector of the United States

The medical care sector of the United States is in a profound crisis—a much-used term, but one that I think is appropriate to the sorry state of our medical care nonsystem. Even President Nixon, not allied with the protesting forces in the United States, used the term “crisis” in 1974 to describe our house of medicine. And Fortune magazine, not generally accused of radicalism, described the U.S. medical care system as “chaotic” and “inefficient.” In spite of spending almost 12 percent of our gross national product (GNP) on health care, 17.5 percent of the U.S. population under 65 years of age is still without any form of health benefits, a total of 36.8 million people (1). But the problem is much larger than the uninsured. It includes also the underinsured. Twenty-eight percent of Americans were without coverage for at least one month during a 24-month period (1986-1988) (2). And an astounding 57 percent of Americans have indicated that they have problems in paying for medical care (3). It is not surprising that the majority of Americans are just plain fed up with the funding and organization of U.S. medicine. Though they might like their own doctors, Americans profoundly dislike the medical system. No less than 89 percent of the U.S. population wants to see fundamental changes in the health care sector, with the majority of Americans, Democrats and Republicans, favoring a national health program supported by tax funds (4). Sixty-six percent prefer the Canadian model over the U.S. system. In no other industrialized nation are the people more dissatisfied with the system of funding and organizing health services (5).