“Hey Vermont! What do you have to say about this?!” “Doesn’t Vermont get Canadian health care?” “I didn’t know anyone actually lived up there…how do you like the socialism?”
Maybe it was the nametags announcing our origin, or maybe it was the glazed look in our eyes as we wandered into the warm Texas climate, but as Vermonters at the American Medical Association Interim Meeting in Dallas this past November, my colleagues and I got a lot of attention and even more interesting questions from our fellow attendees. As medical student members of the AMA representing our state and region and serving on several committees within the AMA-Medical Student Section, we traveled to Dallas with a few very specific goals in mind. Goal one: Serve our individual roles on our committees, attend programming, and learn as much as possible from the largest physician lobbying group in the country. Two: Attend the meeting of the general assembly, where policy is made, and vote on behalf of Vermont (on one resolution in particular – more on that later). Three: Expand Vermont’s visibility within the AMA, and answer some questions.
One of the most exciting developments at this year’s meeting was the passage of a resolution in support of state-by-state efforts to address healthcare outside of the ACA (Obamacare), including single payer. For context, Vermont’s Green Mountain Care is the first and only state-based attempt at such a system, so this resolution is of particular interest to Vermonters. The University of Vermont AMA is a co-author on this piece of policy along with several other medical schools. Spearheaded by Brad Zehr of Boston University, this resolution is the product of a year of collaboration and a major step forward for the Medical Student Section, and the AMA in general, as it is the first time it specifically highlights single payer as a possible effective strategy for healthcare reform and universal coverage.
Working to write and pass a single resolution across several schools and multiple individuals was a long process that began last winter, before the annual meeting in Chicago. The UVM AMA chapter was contacted by Brad Zehr, then a first year like ourselves, to sign on as co-authors to a strongly-worded resolution that proposed single-payer as the only solution for achieving universal coverage in the United States. Through a number of maneuvers at the Annual Meeting in Chicago last June, this resolution was pushed to the end of the docket, then quickly voted down. It seemed that we had struck out too far too fast to gain the support of the AMA-MSS. However, Brad continued to lead a smaller number of schools through the summer and fall, and we revised the resolution to include other possible options to achieve universal coverage.
Once this new version was drafted and ready for Dallas in November, the next objective was to gain support and hopefully votes. This meant writing clear and well-researched testimony on behalf of the resolution and posting it for potential voters to read, and speaking about the policy with other delegates. When it came time to vote, we worried that other delegates might attempt to delete “single-payer” language, and render the resolution toothless. When our resolution came up for consideration, long lines formed at both the “pro” and “anti” microphones in the general assembly ballroom. Vermont gave testimony about our experience training in a state that is implementing an ACA waiver plan. Many schools spoke vehemently against limiting the AMA’s policy toward one stratagem or another. Ultimately, a vote was called and our resolution was adopted into official AMA-MSS policy. Vermont’s efforts—and other states should they choose that path— will be officially supported by the future physicians in the AMA.
Simply by receiving our education in Vermont, each of us will be called upon to comment on the complex process currently underway in our state. You won’t have to travel to Dallas or Chicago, put on a suit and stand behind a microphone to have it happen. It will happen in coffee shops, in the clinic, when we do our rotations and when we disperse for residency. “Hey Vermont, what do you think about…” will continue to be a question posed to all UVM medical graduates. So educate yourself! Form an opinion! Learn the basic differences between the approaches to the healthcare crisis facing our nation. It matters to us as professionals, to our patients, to our families, and to our communities.