Doctors still wield tremendous influence in the health care debate, since they still have the confidence of most patients.
If Congress and the Obama administration can convince doctors to support health care reform, it can be, as the ACP’s Bob Doherty notes, “decisive in determining if the public will be behind the effort, because voters are much less likely to support health care reform if told that it will result in the ‘government’ taking decisions away from their own doctors.”
In his recent blog entry, he notes two points that can sway physician support either way. The first is being paid fairly for their services, and not having Medicare payments tied to the flawed SGR formula. Furthermore, there has to be more than a “token increase in payments” for primary care to make it a viable option for medical students. Indeed, the entire payment system needs to be shifted away from a fee-for-service system, and more towards rewarding time spent with patients and preventive care.
Secondly, paperwork has to be streamlined. As mentioned last week, every doctor generates upwards of 10 hours of bureaucratic work daily. If a public option resembles the paperwork morass that is now Medicare, that will further sway physicians away from government-backed reform.
The best way to convince the public is with the support of the medical profession, and needless to say, we’re following what’s happening in Washington very closely.
Related posts:
- Should a public plan option be part of any health reform initiative?
- Convincing doctors to accept a public health care plan option
- 10 health reform posts you may have missed
- Health reform ignores primary care doctors at its own peril
- How to convince doctors to accept health reform
- Can the American Medical Association still be an influential voice in health reform?
- Should doctors support Congress’ health reform efforts?
{ 8 comments }
I think physicians are slow to support reform for two reasons: 1) limited time–if you are struggling to make your practice viable, you probably don’t have a lot of time to go out and lobby, and 2) the belief that nothing will change, and that efforts will bear no fruit. Our time is so precious, it is hard to spend it on something we view as futile. (?Futile reform?)
Reform is coming either way. If physicians don’t get behind it and grab a seat at the table, these decisions will be made for us by wonks, economists, and politicians. And they certainly don’t have doctor’s best interests at heart.
They can’t streamline the paperwork, that’s one of the few things keeping docs and patients from spending even more tax dollars.
They can get rid of a lot of the hassles if they would admit that we need to ration use of public money, but the political cost is so high that I don’t think we’ll see that until things are much worse.
Of course they can streamline the paperwork. It’s called single payer provider. It will happen eventually. Docs will scream because they did not go into medicine to help sick people and to keep healthy people well, they went into medicine to make money. But, it will happen.
Meaningful health reform cannot happen without the input of physicians – who do their utmost best to care for patients within the confines of our broken system. President Obama and members of Congress value physicians’ experience, and the AMA has had many opportunities to share our viewpoint. In addition to coverage for all, fundamental reform of the broken Medicare physician payment system (the SGR) must be done as part of health reform. Physicians will be hard pressed to implement quality improvements with the threat of 21 percent Medicare payment cuts looming over their head next year and progressing into the future.
The Senate Finance committee has shared three position papers that outline delivery, coverage and payment reform. The AMA has responded to all three papers, and our comments can be read on the AMA Web site at http://www.ama-assn.org/ama/pub/legislation-advocacy/current-topics-advocacy/health-system-reform/health-system-reform-testimony.shtml
Nancy H. Nielsen, M.D.
President, AMA
IANAD, but I read Mr Doherty’s post the other day. I agree reform is sorely needed – whether it’s revising the flawed CMS payment model that rewards piecework and pt volume or reforming EMTALA.
Administrative cost (aka paperwork) has got to be reduced drastically. I used to go to a practice which accepted no insurance, didn’t see drug reps, etc. The quality and delivery of medical care in that practice was superb, and in most cases it cost me less to pay up front and submit the superbill to the insurance company for out-of-network reimbursement.
However, what I read seemed to advocate the use of physician extenders to replace primary care/internal medicine MDs.That post read to me like the ACP was giving the kiss of death to current and future PC/IM physicians.
I don’t have anything against the judicious use of MLPs, but they just don’t have the skills, training, and experience that MDs have. I see my PCP once or twice a year and a couple of specialists a couple times a year for maintenance – most of my reasons for going to the doctor are well out of scope for an NP/PA.
Docs don’t need to sell theirs and their patient’s freedom down the river to reduce paperwork or get paid fairly. Any with the courage can do so now: Cash payment just like in the old days. Little paperwork and the ultimate fairness in fees for both parties–transparent and mutual acceptable free exchange.
Courage is unfortunately rare in American these days and security obsessed cowards will not long be free.
all of you people who want this reform so badly – i hope you are not crying later on when you or a loved one needs a major surgery – but all of those top surgeons aren’t operating anymore because taking into about the liability risk and malpractice premiums, they just aren’t able to! no one is even mentioning tort refort. is that because the democrats are all lawyers who make their livings off of suing doctors? let’s get real and stop playing politics here!
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