A nexus of politics, healthcare reform and championship football occurred last night at the Oahu Interscholastic Association title game.

About 100 members of the American Medical Association's Medical Student Section were scheduled to fan out to solicit signatures for a petition in support of the AMA's healthcare reform proposal and to keep healthcare in people's minds when they next vote.

The petition drive is one of many efforts under way as the nation moves toward a presidential election next year. The nation's healthcare crisis figures to be among the top issues with voters as people worry about escalating costs, access to insurance and quality care.

The topic will be discussed as the AMA's main policymaking body convenes a four-day meeting today at the Hawai'i Convention Center and was a topic of a talk in Honolulu Thursday by Rich Umbdenstock, president and chief executive officer of the American Hospital Association.

"Healthcare is on just about everyone's minds today," Umbdenstock told a group of top local hospital executives gathered for a Healthcare Association of Hawaii membership meeting. "People are frustrated."

He said polling done by his group shows healthcare problems are a top-of-mind issue in the four Mainland states where presidential primaries will first be held. The issues run a wide gamut, including those immediately before politicians, such as extending health insurance to more uninsured children to long-term issues of making wellness a priority for more people and finding ways to slow climbing medical costs.

"They're not elements you haven't heard before," said Umbdenstock, noting the numerous efforts in the past to improve the U.S. healthcare system. The U.S. life expectancy lags behind 41 other nations, while U.S. Census Bureau data shows in 2005, 44.8 million people, or 15.3 percent of the population, were without health insurance.

The upcoming presidential election is stimulating renewed hopes for healthcare reform, though some pessimists note such efforts seem to pick up steam every 15 years but don't have much success because no one can agree on solutions.

Most people favor government subsidies and tax credits to help pay for public coverage, but are against raising taxes to do so, said Emily Friedman, a health policy and ethics analyst who spoke at the healthcare association meeting.

"That's a little bit of a disconnect," said Friedman. But she said doing nothing has consequences and people should see finding a way to expand healthcare insurance coverage to the uninsured as a moral imperative.

"In the richest nation in the world everybody ought to have coverage."

Several national healthcare associations are pushing for change. The AARP, the Business Roundtable, the Service Employees International Union and the National Federation of Independent Business have come together in an unlikely coalition behind "Divided We Fail," which is pushing for better access for everyone to affordable healthcare and improvements in long-term care.

The AHA's own proposals call for universal coverage, focusing on wellness, revamping the system to focus on the most efficient and affordable care, better quality care and increasing use of information technology.

The AMA's House of Delegates are meeting here through Tuesday with about 3,000 people expected for the event.

Among the topics that will be discussed are ensuring affordable health insurance for patients with expensive medical conditions, trends in employer-sponsored health insurance and guidelines for evaluating state proposals for health insurance.

The AMA, which has 250,000 physician members, has put forward a healthcare reform plan that calls for expanding coverage for the uninsured and increasing access to care. The AMA's effort, run under the Voice for the Uninsured banner, calls for providing everyone with the means to purchase healthcare insurance while giving individuals choices in selecting coverages. It also calls for market reforms.

More on the AMA effort can be found at: www.amaassn.org/ama/pub/category/17712.html, while more on the hospital association's effort can be found at www.aha.org/aha/issues/Health-for-life/index.html.

The American Medical Association said it may modify some of its positions following the policy meeting here. Hawai'i has one of the best insured rates in the nation because of its Prepaid Health Care Act which requires employers to offer insurance coverage to full-time workers.

Among the speakers at the conference will be Dr. Linda J. Rasmussen, a Castle Medical Center orthopedic surgeon, who previously headed the Hawaii Medical Association. She will speak on a panel tomorrow about health system reforms.

Reach Greg Wiles at gwiles@honoluluadvertiser.com.