Policy-makers for the American Medical Assn. on Wednesday proposed replacing the Medicare system, and resolved to seek legislation against smoking on airliners.
In the fourth day of their annual, five-day meeting, the 386 AMA delegates also endorsed a minimum age of 21 for purchasing tobacco, and considered measures to stop hospitals from "patient dumping."
The Medicare substitute proposed by the 271,000-member AMA calls for initially higher taxes to meet obligations to current beneficiaries and to build up a trust fund that would replace the pay-as-you-go system, which doctors say will be bankrupt by the mid-1990s.
The AMA plan would cover the costs of catastrophic illness, which Medicare does not.
It also would give the option of opening individual retirement accounts to cover medical costs, similar to the IRAs now available but requiring deposits of much less than the current $2,000 a year. These accounts would help cover deductible expenses and partial payments, for which many now purchase "Medi-gap" insurance.
Nursing Homes Separate
Dr. Jerald R. Schenken, an AMA trustee and co-author of the plan, said that it would not cover nursing home fees--also true of the current Medicare system. He said that the AMA is exploring ways of paying for long stays in nursing homes for the elderly and will formulate a separate proposal on that issue.
The delegates Wednesday also considered the AMA's Council on Medical Service's recommendation that a strong effort be made to end economically motivated hospital transfers of patients, a practice known as "patient dumping."
Patient dumping occurs when a facility that is able to provide required medical care moves a patient to another facility simply because the patient can't pay. These people usually lack adequate insurance or rely on Medicaid, which often underpays hospitals, the council said. It said the AMA should urge county medical societies and local hospitals to establish protocols and agreements among themselves to end patient dumping.
The delegates also approved recommendations from its public-health panel, that the AMA:
--Support a ban on smoking on airliners and a minimum legal age of 21 for sales of tobacco.
--Reaffirm its commitment to the humane treatment of animals used in research, pursue alternate methods of research when possible, and educate the public about the need to use animals.
--Encourage fast-food restaurants to make available on request nutritional information about menu items.
The delegates also chose Dr. William S. Hotchkiss, a thoracic surgeon from Chesapeake, Va., as president-elect. Hotchkiss will take office at the 1987 annual meeting, succeeding Dr. John J. Coury Jr. of Port Huron, Mich.