AMA: A look at the facts on health reform

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

by J. James Rohack, M.D.

As members of Congress return to their districts this month, it should be a time for thoughtful dialogue on health system reform so that when lawmakers return to Washington they can complete their work. Physicians nationwide are engaged and passionate about the health reform debate. After all, physicians are forced to navigate a dysfunctional system to provide patients with the highest-quality care. As you talk with your patients, colleagues, and lawmakers, here are some questions you may be thinking about.

Why do we need health system reform this year?

Currently 47 million Americans don’t have health insurance . Patients that suffer from disease or disability are subject to coverage denials for pre-existing condition limitations. Physicians and patients have to fight through insurer red tape to get payment for necessary care. We need to remove regulatory barriers and empower physicians with better information at the point of service to improve the quality of care.

What is the AMA working for?

The AMA is committed to keeping medical decisions in the hands of patients and their physicians and preserving that sacred relationship. Insurance needs to be affordable and available to all patients though a choice of plans regardless of job or health status. The flawed Medicare payment formula must be fixed. Medical liability reforms must be adopted. We need a system that promotes quality, incentivizes care coordination and emphasizes prevention and wellness initiatives.

Why has the AMA been engaged in the health system reform debate?

As physicians, we see first hand the devastating effects of our broken health care system. The uninsured live sicker and die younger. Individuals, small business and those suffering a serious disease are disadvantaged in the current health insurance market. Dedicated physicians are driven from the profession by the burdens of bureaucracy and payments in public programs that fail to cover physician practice costs. We take our position at the center of the health reform debate as responsibility and we are committed to achieving affordable, portable coverage for all.

What does the House bill mean to the health reform debate?

The bill expands coverage, offers a choice of plans, eliminates denials based on pre-existing conditions and repeals the broken Medicare physician payment system. It is a starting point for the health reform debate and the AMA is committed to staying engaged to improve the final legislation. Already, the House Energy and Commerce committee passed important AMA-supported revisions to the House bill that will allow physicians to negotiate payment rates in the public plan option and guarantee voluntary physician participation. The committee also voted to add modest medical liability reforms to the bill.

Why is it so important to have Medicare physician payment reform as part of comprehensive health system reform?

Reform of the broken Medicare physician payment formula is necessary to assure access to care for seniors. Without congressional action, Medicare cuts will total about 40 percent over the next five years. The gap between payments and costs will make it very difficult for physicians to keep their doors open to all Medicare patients and make quality improvement to their practices that benefit all patients.

What’s next for the AMA?

America’s patients and physicians deserve better than the status quo. There is significant common ground on a number of important issues. Issues such as financing and whether or not a public plan is offered must be resolved. The AMA will be at the table to improve the final legislation, and we urge all physicians to join us in our quest to pass health reform this year that better serves patients and empowers the dedicated physicians who care for them.

The AMA is reaching out to patients and physicians with information on how all Americans will benefit from improvements to our current health care system. Information is readily available on the AMA Web site, and this month we’ll continue a series of conference calls with physicians across the country and participate in health reform events to build support for the right reforms and to secure enactment of needed health system reform this year.

For more information from the AMA on health reform, please visit www.ama-assn.org/go/hsr.

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

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