Dr. Nancy Nielsen, the Buffalo physician and University at Buffalo Medical School senior associate dean who became the president of the American Medical Association in June, told UB medical students and alumni Friday that it was “unconscionable” that 47 million Americans do not have health insurance.

“One in seven [Americans] does not have insurance,” she said. “These are not people who live under a bridge. These are people who are in our families. These are people who are our neighbors.”

Nielsen delivered UB medical school’s inaugural Oliver Perry “O. P.” Jones Lecture, named in honor of the late alumnus turned professor. Later Friday, she received the 2008 Distinguished Medical Alumnus award at the Buffalo Club.

Nielsen, only the second woman to be president of the AMA, took an unusual path into the medical field. She started medical school at UB at age 29, after the birth of her fifth child. As head of the venerable national doctors’ association, she has devoted herself to reforming health care.

She shared some of her concerns and hopes for the future of medicine with students and alumni, focusing mostly on the inequities of the way health insurance is provided in the U. S. Decades ago, health insurance wasn’t necessary. People could pay for their health care out of pocket.

But that all changed after World War II. She said wages were frozen and employers began using health insurance as an incentive to lure and keep workers. She explained that the IRS began exempting health insurance from taxation.

Health care costs “have skyrocketed” in the years since, she said. The two factors created an unequal system that has excluded more and more people from being able to get or afford health insurance.

“It is unconscionable that we, the richest nation in the world, have allowed this to continue,” she said. “It is unconscionable that thousands of patients die every year because they delay treatment until it’s too late.”

Nielsen recounted a recent conversation she had with a woman who runs a business at the Transitown Plaza. As a business owner, she had to get her own insurance policy. It costs her $873 a month. If she wanted to add her husband to her policy, the cost would be about $1,300.

“Go back and look at your next paycheck,” she said as she urged the crowd to compare how much cheaper employer-provided health insurance is. “We are very fortunate — those of us who have employer-based health plans.”

The AMA wants the government to provide a system of tax credits so individuals can buy health insurance.

Nielsen discussed the presidential candidates’ proposals for health care reform. She applauded both of their desires to assure health care is available to every American but she doubted that they would work.

“Nobody has the answer on how to pay for it,” she said.

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© 2008 The Buffalo News.