America's doctors can tell you from experience and evidence that those without health insurance tend to live sicker and die younger, a sad fact to consider as our nation continues the highly charged and deeply political debate over health reform.

In recent years, millions of Americans have benefited from the Affordable Care Act, including increased access to coverage and insurance-market reforms such as not penalizing patients with preexisting conditions.

Still, there is much room for improvement in our current health-care system. Among those areas is insufficient competition in the insurance marketplace, which means patients are paying far too much for premiums and sky-high deductibles before their insurance benefits kick in - factors that impede access to care for many Americans.

As health reform advances in our nation's capital, the American Medical Association (AMA) strongly believes that, before Congress takes any action potentially affecting coverage for the 20 million newly insured, policymakers should lay out in advance, and in sufficient detail, a new plan that allows patients, physicians, and other stakeholders to compare any new concept with the current policy. There should be no backslide whatsoever in patient access to quality care.

The AMA is proudly a nonpartisan organization and has sought to guide the national conversation about health-system reform because America's physicians are on the front lines of health-care delivery; we understand well the issues, the challenges, and the greatest potential impact on patients. Responding to patients' concerns, the AMA urges policymakers to be thoughtful in their approach to reform and achieve the following goals:

Ensure that individuals currently covered do not become uninsured, and take steps toward coverage and access for all Americans;

Stabilize and strengthen the individual insurance market;

Maintain key insurance-market reforms like the ability to obtain insurance notwithstanding pre-existing conditions;

Ensure that low- and moderate-income patients are able to secure affordable, adequate coverage;

Ensure that Medicaid, Children's Health Insurance Program (CHIP), and other vital safety-net programs are adequately funded;

Reduce regulatory burdens that detract from patient care and increase costs;

Provide greater cost transparency throughout the health-care system;

Continue the advancement of delivery reforms and new physician-led payment models to achieve better outcomes, high quality, and lower spending trends.

Health care is most effective when it is adaptive, quality-driven, and values not only access to care but affordable coverage for all. It is essential, as Congress and the Trump administration embark on health-system reform, that they preserve what we know works in the current system and builds upon these gains to promote more efficient, effective care and improve the health of our nation.

Andrew W. Gurman, M.D., is president of the American Medical Association.