Should doctors support Congress’ health reform efforts?

The American Medical Association recently gave unqualified support to the House health reform bill, H.R. 3200, and that is drawing the ire of some of their supporters.

To be sure, H.R. 3200 is the most left-leaning of the proposals, and there is clear ideological opposition to the so-called “public plan,” which expands the government’s role in our health care system. It’s a tremendously sensitive topic, with some expressing their outrage (to put it gently) in private e-mails to me.

The AMA has joined other professional societies, including, the American College of Physicians, the American Academy of Family Physicians, American Academy of Pediatrics and the American Osteopathic Association, in support of the bill.

The Wall Street Journal, however, wrote a scathing view of the AMA’s support. In today’s lead editorial, they write that the AMA, along with other lobbying groups, are “putting their short-term self-interest — usually ensuring that government programs remain generous (enough) — ahead of the long-run threats.”

I’ve previously written that it’s tremendously important for doctors to present a unified front, since it’s easier to ignore fragmented voices. But, should doctors support the current, albeit seriously flawed, reform efforts?

I believe the answer is yes, and I understand that there is significant opposition to that stance. Despite reservations about the current approach, including, the threat of a “strong” public plan that uses Medicare (under)payment rates, it does remove the unacceptable sustainable growth rate formula that determines Medicare physician reimbursement, which is a much-needed step forward. Furthermore, it makes an attempt, admittedly paltry, at increasing the pay of beleaguered primary care doctors, who will form the backbone of any reform effort.  Is that far too little to settle for?  Perhaps.

But a more important question is, what if reform doesn’t pass? It’s quite possible that preserving the status quo will be far worse for doctors going foward than the current proposals. I also believe that it’s important for doctors to “get a seat” at the table, lest they be marginalized further if they don’t.

I cited a quote from Paul Krugman a few months ago, where he wrote something along the lines of, “the perfect is the enemy of the good.” He was referring to the single-payer supporters and grassroot reformers who felt that Congress’ proposals didn’t tilt enough to the left, and as such, oppose the current efforts.

I think that sentiment goes both ways. Some reform is better than none, and doctors advocating for a free market-based system shouldn’t hold out, hoping for the perfect package.

It’s not coming anytime soon.

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