AMERICAN MEDICAL ASSOCIATION HOUSE OF DELEGATES
Resolution: 422
(A-05)
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Introduced by:
Medical Student Section
Subject:
Development and Support of Prospective Personalized Health Planning
Referred to:
Reference Committee D
(Sally J. Trippel, MD, Chair)
Whereas, A Prospective Health Care (PHC) system represents a paradigm shift in health care
delivery, moving away from the current fragmented methodology in favor of a system that
effectively synthesizes patient education, early intervention and best practices for the prevention
and management of common diseases; and
Whereas, Employing advances in molecular, genetic, and other technologies in a PHC system
may soon allow physicians to establish patient predisposition profiles, and thus begin focusing
treatment earlier in disease processes thereby either slowing or even preventing disease
progression; and
Whereas, Current trends of increased health care costs, decreased services, and an aging
population give physicians pause for concern, and a change-over to PHC may offer a
comprehensive solution for focused lifestyle and disease management programs and play a
large role in addressing patient health while reducing cost; and
Whereas, Replacing the currently reactive health care system with a model grounded in PHC
has the potential to lead to significant declines in many of the most common chronic diseases
that reach epidemic levels in the US today and account for $1 trillion in health care costs
(including heart failure, hypertension, diabetes, cancer, and respiratory diseases); therefore be it
RESOLVED, That our American Medical Association continue to recognize the need for
possible adaptation of the US health care system to prospectively prevent the development of
disease by ethically using genomics, proteomics, metabolomics, imaging and other advanced
diagnostics, along with standardized informatics tools to develop individual risk assessments
and personal health plans (New HOD Policy); and be it further
RESOLVED, That our AMA support studies aimed at determining the viability of prospective
care models and measures that will assist in creating a stronger focus on prospective care in
the US health care system (Directive to Take Action); and be it further
RESOLVED, That our AMA support research and discussion regarding the multidimensional
ethical issues related to prospective care models, such as genetic testing. (Directive to Take
Action)
Fiscal Note: Staff cost estimated at less than $500 to implement.
Received: 5/8/05
Resolution: 422 (A-05)
Page 2
RELEVANT AMA POLICY
H-185.972 Genetic Information and Insurance Coverage
AMA believes: (1) Health insurance providers should be prohibited from using genetic
information, or an individual's request for genetic services, to deny or limit any health benefit
coverage or establish eligibility, continuation, enrollment or contribution requirements. (2) Health
insurance providers should be prohibited from establishing differential rates or premium
payments based on genetic information or an individual's request for genetic services. (3)
Health insurance providers should be prohibited from requesting or requiring collection or
disclosure of genetic information. (4) Health insurance providers and other holders of genetic
information should be prohibited from releasing genetic information without express prior written
authorization of the individual. Written authorization should be required for each disclosure and
include to whom the disclosure would be made. (BOT Rep. 15, I-96)
E-2.135 Insurance Companies and Genetic Information
Physicians should not participate in genetic testing by health insurance companies to predict a
person’s predisposition for disease. As a corollary, it may be necessary for physicians to
maintain separate files for genetic testing results to ensure that the results are not sent to health
insurance companies when requests for copies of patient medical records are fulfilled.
Physicians who withhold testing results should inform insurance companies that, when medical
records are sent, genetic testing results are not included. This disclosure should occur with all
patients, not just those who have undergone genetic testing. (IV) Issued June 1994 based on
the report "Physician Participation in Genetic Testing by Health Insurance Companies," adopted
June 1993; Updated June 1996.