AMA: Curbing the rise in health care costs is key to health-system reform

The following is the first in a series of original guest columns by the American Medical Association.

by J. James Rohack, M.D.

In an unprecedented endeavor aimed at achieving health-care reform this year, the American Medical Association (AMA) stood with President Obama and other key health-care stakeholders Monday to announce efforts to “bend the spending curve” on health care. U.S. health-care spending is increasing faster than general inflation, causing strain on individual, business and government budgets, and projected increases in health spending are not sustainable.

Meanwhile, the grim economic climate has forced the unemployment rate to reach nearly nine percent, the highest we’ve seen in nearly three decades, adding many more uninsured patients to the system. Nearly one in 10 children and one in five adults under 65 are uninsured. In the past year, six in 10 families have put off medical care due to costs. Physicians are on the front lines of the health-care system and see the problems uninsured patients encounter firsthand.

It’s clear the time for meaningful reform has come, and physicians must embrace this opportunity to have a seat at the table as reforms are being shaped that will impact the practice of medicine. Traditionally, government and private insurers have relied on across-the-board payment cuts to physicians and other providers in response to rising health care costs. The AMA believes that empowering physicians to implement strategies to improve the quality of care and avoid unnecessary services is a far better approach, reinforcing the profession’s authority in clinical decision making.

The AMA is working to improve access to high-quality, affordable health care for all. We are mobilizing our national grassroots advocacy network and listening to input from our physician members, many of whom came to Washington earlier this year to meet directly with their members of Congress and personally advocate for reform.

In addition to covering all Americans by improving the private health insurance market and strengthening public programs, we need to ensure that we’re getting the best value from our health-care spending. The AMA-convened Physician Consortium for Performance Improvement, with the efforts of more than 100 state and national medical specialty societies, is currently developing measures to improve health-care quality and value and curb unnecessary utilization.

The practice of defensive medicine is also a major factor in rising costs. A 2003 Health and Human Services (HHS) report estimated the cost of defensive medicine to be between $70 and $126 billion per year. Without reform, this cost driver will not go away. If we want physicians to adhere to the best practices and conserve resources, we need to provide protections for physicians who are conforming with practice guidelines. The Obama administration has signaled they are open to medical liability reform, and the AMA will work to keep this issue on the table.

Health Information Technology (HIT) holds promise to reduce unnecessary costs. It can help improve workflow efficiency in the medical practice, reduce test duplication and put clinical information in physicians’ hands at the point of care. It can also help cut down on time spent on paperwork and give physicians more time with their patients. That said, the challenges and concerns of many physicians regarding HIT are valid and must be addressed to achieve greater implementation. Direct financial assistance to physicians in the stimulus bill and standards soon to come from HHS will help patients, physicians and the nation reap the benefits of highly connected and secure HIT.

Medication reconciliation is another area where we can improve patient safety and reduce costs. The AMA is intensifying its efforts in this area, and physicians can get CME credit for reading the medication reconciliation guide and implementing its strategies.

Physicians can’t reduce costs alone; everyone has a role. Seventy-five percent of total health- care spending is linked to chronic illnesses. Physicians can help Americans live healthier through preventive care and wellness programs, reducing disease and health-care spending. Healthier patients spend less money on health care, reducing the cost burden on individuals and the entire health-care system.

We have a chance this year to achieve the health reform our nation needs. I saw firsthand at the White House this week that the physicians’ perspective and commitment is valued as lawmakers work on reform. To the patients and physicians who believe we have a chance to improve the system, please join us in our work.

J. James Rohack is President-elect of the American Medical Association.

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