In his State of the Union address in January, President George W. Bush presented a plan to make health insurance more accessible by providing substantial tax benefits to people with insurance and helping states offer more affordable options.

"We are pleased that healthcare reform is on the national agenda," says Ronald Bangasser, MD, past president of the California Medical Association and a member of the American Medical Association's Council on Medical Service, which recommends health policies to the AMA House of Delegates. "CMA and AMA policies are in favor of providing health insurance to uninsured and underinsured populations. We want to relieve emergency rooms from patients who have no other options for getting care. We are glad that this healthcare discussion has begun, and we are eager to be a part of it."

The president's plan would enable more Americans to afford insurance by reforming the tax code with a standard deduction for health insurance, like the standard deduction for dependants. This levels the playing field for Americans who purchase health insurance on their own rather than receive coverage through their employers. By lowering taxes, uninsured Americans would have a significant incentive to purchase coverage.

Under the proposal, a family of four with health insurance would not pay income or payroll taxes on the first $15,000 in compensation, and singles would not pay income or payroll taxes on the first $7,500. The president's proposal would result in lower taxes for about 80 percent of employer-provided policies.

In addition, the president's plan includes an Affordable Choices Initiative, which would direct federal funding to assist states in helping their poor and hard-to-insure citizens obtain private insurance. By allocating current federal healthcare funding more effectively, the plan accomplishes this goal without new federal spending.

"We applaud the president's funding mechanisms to help states cover their uninsured," Dr. Bangasser says. "They are consistent with what we're doing in California. It gives us some hope that Gov. Schwarzenegger's health expansion plan will obtain some federal backing, which is good news."

However, organized medicine leaders are dismayed by what's missing from President Bush's health proposal. "He did not address the Medicare Sustainable Growth Rate formula, which is the No. 1 issue that physicians battle with Congress about," Dr. Bangasser says. "Plus, I think there needs to be more choices available for individual ownership of health insurance, which wasn't really addressed either. Our hope is that more and more patients will have individual ownership, so if they switch jobs, they are not locked in."

CMA and AMA officials say they are willing to work with President Bush on developing a health plan that will satisfy both physicians and patients. "The AMA stands ready to assist the administration and Congress with efforts to cover the uninsured and encourages bipartisan efforts on an issue that transcends party lines--the health of the American people," says AMA President William Plested III, MD.