“Viewpoints” | The Medical Community’s View on Health Reform
Our country recently took an historic and long overdue step toward health system reform. While the new law is not perfect and more still needs to be done, this sweeping reform package will greatly benefit America’s patients and their physicians.
For the last year, our country has been locked in heated debate over health system reform. There has been widespread agreement that the status quo is unacceptable and that we need reform, but there have been varying, and often conflicting, viewpoints on what to do about it. In the halls of Congress, in the public and within the physician community, divisions have been evident. Throughout this whole process and guided by its House of Delegates, the American Medical Association has remained constructively engaged to ensure the physician voice was heard.
We worked closely with lawmakers from both sides of the aisle, key members of the administration, and our physician colleagues from around the nation to secure the best outcomes for patients, physicians, and the medical profession as a whole. Some provisions of the health reform bill signed into law will need to be changed, but on balance it signifies an important step forward on the journey toward an improved American health care system, and it is far better than the status quo.
The health reform package extends health coverage to more than 30 million uninsured, improves competition and choice in the insurance marketplace, promotes prevention and wellness, reduces administrative burdens, and promotes clinical comparative effectiveness research. There are increased payments for primary care physicians caring for Medicare and Medicaid patients and bonus payments for primary care physicians and general surgeons in underserved areas.
The final bill also acknowledges that the current medical liability system is broken and provides funding to test reforms such as health courts and early disclosure laws. This is not the proven medical liability reform physicians and the AMA want, but it is more than we’ve achieved on this critical issue at the federal level in the past, and it is an indication that legislators on both sides of the aisle are beginning to understand the impact that liability exposure has on escalating health care costs.
The AMA’s active involvement in the health system reform debate succeeded in ensuring a number of proposals were not included in the final bill. We are happy to report that the final bill has the following victories for physicians:
- No proposed Medicare and Medicaid enrollment fees for physicians
- No proposed five percent cut to physicians identified as outliers
- No proposed payment cuts for specialty care services to fund primary care increases
- No proposed tax on elective cosmetic surgery and medical procedures
The new health reform law includes significant improvements, but there are still some important measures that need to be addressed. Congress still has not acted to permanently repeal the broken Medicare physician payment formula that threatens steep cuts to physicians for the care of seniors and military families. For years, Congress has been relying on Band-Aid fixes for the payment formula, and now they are dealing with it on a month-by-month basis. These short-term fixes have created instability in Medicare, eroding its physician foundation and increasing the cost of a permanent solution for taxpayers. A permanent solution is necessary so physicians aren’t forced to limit care for seniors, baby boomers, and military families. Make no mistake: The AMA will hold Congress’ feet to the fire to ensure this is achieved.
We are also working for changes to the scope and authority of the planned Independent Payment Advisory Board to prevent misguided payment cuts that undermine access to care and destabilize health care delivery, and we will address the implementation of new value index adjustments to physician payments. Health reform didn’t change the status quo on private contracting, and we need to expand the rights of patients to privately contract with the physician of their choice without penalties.
This bill is not the final step; it’s simply the next step toward real health system reform and for the first time in decades we are making significant progress in addressing long-standing challenges with our health care system. Ultimately, history will judge whether the decisions we made during this historic and turbulent time were the right ones. In the meantime, the AMA will remain fully engaged to secure the best outcomes for physicians and the patients under our care.
“Viewpoints” blog postings are intended to allow non-Altarum Institute authors to pose their own opinions and policy positions in the realm of health care and health policy. As a leading nonprofit health care research and consulting institute dedicated to improving human health, Altarum encourages open discussion and debate about the many challenges in health care today. All postings to the Health Policy Forum (whether from employees or those outside the Institute) represent the views of the individual authors and/or organizations and do not necessarily represent the position, interests, strategy, or opinions of Altarum Institute. Altarum is a nonprofit, nonpartisan organization. No posting should be considered an endorsement by Altarum of individual candidates, political parties, opinions, or policy positions. Read more.
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