February 10, 2020
3 min read

AHA advisory emphasizes reform for health care affordability and access

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John J. Warner

The American Heart Association released its presidential advisory outlining its 2020 goals and principles for adequate, accessible and affordable health care in the U.S.

The organization’s updated goals for 2020 include the following seven principles:

  • All people living in the U.S., regardless of health condition, should have comprehensive, understandable and affordable health coverage.
  • All people living in the U.S. should receive high-quality, affordable, patient-centered health care.
  • All people living in the U.S. should have guaranteed access to evidence-based preventive services with minimal or no cost sharing, regardless of how they gain coverage.
  • Race, sex, gender and geographic disparities in health and health care must be eliminated.
  • Public health infrastructure should be strengthened to effectively engage diverse stakeholders in multiple sectors, to adequately respond to social determinants of health and to support the elimination of systemic inequities in health and health care.
  • The U.S. health care workforce should continue to grow and diversify through a sustained national commitment to culturally competent public health and medical education and clinical training.
  • Support of biomedical and health services research should be a national priority, and inflation-adjusted funding for the NIH, CDC and other agencies must be maintained and expanded.

Healio corresponded with the statement’s lead author, John J. Warner, MD, FAHA, past president of the AHA and executive vice president for Health System Affairs at UT Southwestern Health System, regarding these new goals, issues of affordable access to health care and what clinicians can do to address reform.

Q: What are the main points of this advisory?

A: The AHA has a long history of leading evidence-based efforts to improve access to quality health care for all people. Our work has made a big difference, but major improvements are still needed to improve health care for everyone. Our new principles ensure health care is adequate, accessible and affordable for everyone in America.

Like our previous principles, they highlight the need to improve access to affordable health care and coverage, make evidence-based preventive services better available and accelerate investments in biomedical research. Our updated principles also emphasize the need to ensure everyone in the health care system is treated equitably, promote diversity within the public health and health care workforce and address social determinants of health. There must be a connection between our public health infrastructure and the health care system. The association is also broadening our focus on cost and emphasizing value in health care to ensure health care is affordable, not just for individuals, but for employers, governments and society at large.



Q: What is the take-home message for clinicians?

A: Millions of people are uninsured or have inadequate health coverage, leaving them unable to afford potentially life-extending care. It’s not enough to suggest that everyone should have a health plan or access to a doctor, especially if the plan doesn’t cover their needs or the doctor doesn’t specialize in their condition. Everyone deserves care that is adequate to meet their health needs, accessible where they live and affordable regardless of income. Care should come from a well-trained and culturally competent heath care provider who respects patients’ individual values, beliefs and behaviors, working in a system that gives everyone a chance to live healthier longer.


Q: What is the significance/urgency of reform for affordable health care in the U.S.?

A: Our country has seen significant gains over the past decade in the number of people with quality health care. But 30 million people remain uninsured and 44 million are underinsured, making them unable to afford potentially life-extending care. The fact is that some populations have benefited more than others from the coverage gains of the past 10 years, and health care costs are still a major concern for families, employers and government. One’s chances of surviving CVD vary greatly by sex, gender identity, race and ethnicity — trends that are influenced by where people live, how much they make, their level of education and other social determinants of health. This is unacceptable, and we must do better.


Q: What can clinicians do to help push health care reform?

A: Clinicians have a powerful and respected voice in the national health care discussion. They are on the front lines of our evolving health care system, with the unique perspective of how the system is serving patients and what patients need from it. We invite clinicians and other stakeholders to join us in creating a health care system that equitably meets all patients’ needs while emphasizing value in health care to ensure health care is affordable for individuals, employers, governments and society. – by Scott Buzby


Warner JJ, et al. Circulation. 2020;doi:10.1161/CIR.0000000000000759.

For more information:

John J. Warner, MD, FAHA, can be reached at University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX 75390; email: john.warner@utsouthwestern.edu.

Disclosures: Warner reports no relevant financial disclosures. Please see the statement for the other authors’ relevant financial disclosures.