Healing the nation's health care

Healing the nation's health care

America’s 46 million uninsured patients would fill 587 football stadiums—a crisis by any standards.

So early last year, the nation’s largest physician’s group—the American Medical Association—launched its “Voice for the Uninsured” campaign, with high profile TV, print, and radio ads, Facebook and MySpace profiles of the uninsured, and a “Voices” music tour—a series of concerts across the country to bring awareness to the uninsured crisis.

Impressive, but really, it’s just the latest effort in the group’s long history in health care activism.

In 1847, 250 delegates from 28 states gathered in Philadelphia with an ambitious goal: to promote the art and science of medicine and the betterment of public health. With their vote, they established the American Medical Association. Since then, the AMA has shaped the way medicine is practiced today. The AMA has defined who can call themselves an “M.D.” and has set standards for medical schools, internship programs, and residency training.

Today, the AMA provides professional resources and practice management tools to physicians, sets procedural standards, and accredits medical schools and residency programs. But its national health care agenda brings perhaps the most visibility—and controversy.

AMA president-elect James Rohack, M.D., spoke recently about this agenda: expanding coverage for the uninsured, reforming the medical liability system, and fixing Medicare.

Health care reform, he said, affects everything from the health of the American public to the health of the national economy.

“The uninsured is a crisis that is only going to get worse as the number of unemployed (grows),” Rohack said. “If we don’t have the ability to cover the uninsured, our nation is going to have a much more difficult time getting out of the economic challenges. If you have people that are sick, they’re not going to be able to work. And you need to have people to work to be able to purchase the products that drive the American economy.”

The AMA is lobbying hard in Congress for support of its plan to expand coverage by offering government subsidies to help those in need obtain health insurance, more choice when joining a health plan, and fair rules for the insurance industry that include protections for high-risk patients.

Reducing health care costs is also critical, Rohack said.

“Between 20 to 25 percent of the total health care expenditures in the United States are due to unnecessary tests that physicians order to protect themselves against the fear of lawsuit,” he said. “But the problem won’t go away without medical liability reform.”

He suggested the AMA’s Physician Consortium for Performance Improvement is a step in the right direction. This group is establishing strict evidence-based standards and guidelines for physicians that would, hopefully, offer some protection from lawsuit. But the real solution, he suggested, is capping non-economic damages from medical liability cases, precisely what happened in his home state of Texas in 2003.

That year, Texas voters approved a constitutional amendment that limited non-economic damages to $250,000 for physicians. Since then, medical liability insurance rates in Texas have dropped 25 percent, medical license applications jumped 58 percent, and the number of obstetrician-gynecologists in the state increased by 7.2 percent, according to the Texas Medical Board. While the reform has its critics, the AMA claims it has improved the medical climate in the state.

Medicare is another ongoing crisis the AMA wants to resolve.

In 2008, the AMA successfully lobbied to override a presidential veto of the Medicare legislation, preventing a 10 percent cut in payments to physicians from taking effect. But this was a temporary reprieve; in January 2010, a 20 percent cut is scheduled, and the cuts will continue through 2015—even as Baby Boomers start hitting Medicare in 2012.

Meanwhile, of course, the office overhead of physicians continues to rise, making it difficult for doctors to keep their offices open. If nothing is done, Rohack warned, the crisis will impact access to health care for America’s seniors. The AMA is pushing Congress to rewrite the Medicare formula, but the future of this reform is murky.

Ultimately, Rohack expressed hope that, as the discussion continues, the nation will find a balance to all of the competing pressures, “to make sure that the ultimate goal—making sure that patients have access to high quality, affordable health care—is achieved.”

Beth Carter, Contributing Writer

Posted on Tuesday, January 06, 2009 (Archive on Tuesday, January 13, 2009)
Posted by jstoltz Contributed by jstoltz

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