STATEMENT OF THE PRESIDENT
Congress passes health system reform
Legislation is the first step in what will be a long journey to a sustainable health delivery system
After more than a year of contentious debate, President Obama has signed into law a health system reform bill that would extend insurance coverage to 32 million uninsured Americans. On Sunday, March 21, the U.S. House of Representatives voted in favor of the Patient Protection and Affordable Care Act, which the U.S. Senate passed in December 2009. The House also passed a reconciliation bill that contains several changes to the reform bill, which the Senate is likely to pass before Congress adjourns for its spring recess.
Throughout the legislative process, AAFP has been engaged in the debate at the highest levels, working to fend off ideas that would be detrimental to physicians and patients, and making the case that investing in primary care will result in better health outcomes and reduced cost. The health reform package contains many provisions intended to move the country toward a health care system based on primary care, including the creation of pilot projects to evaluate new patient-centered payment models, increasing payment for primary care services for Medicare patients by 10 percent, increasing Medicaid payment for primary care to Medicare levels, promoting preventive and primary care, and protecting Texas’ hard-fought tort reforms.
However, as many TAFP members and leaders point out, the bill is far from perfect, and like any major reform legislation, it will certainly result in numerous unintended consequences. It does not include important provisions AAFP fought diligently for, such as a permanent solution to the Medicare SGR and responsible medical liability reform that would reduce the practice of defensive medicine. Rest assured the Academy will continue to advocate these positions.
The problems plaguing our health care system did not occur overnight, and no single bill is going to solve them all. Nowhere is the evidence of these problems more obvious than in Texas, with the nation’s highest rate of uninsured citizens, high rates of chronic disease, and a dangerous shortage of primary care physicians that threatens access to quality care. Our fragmented, disorganized health care system often fails to provide access to appropriate, high-quality care to those who need it, while allowing insurers to raise premiums and curtail benefits with impunity. Stopping the abusive tactics of insurers and protecting Americans from medical bankruptcy by requiring the private insurance market to offer affordable policies to everyone is essential for our citizens, our small businesses, and our economy. This bill is the first step in a very long journey to reforming our health care system.
The hard part is ahead of us, as the success of this legislation will depend on implementation at the regulatory and state level. There will undoubtedly be changes to the legislation over the coming years, and we’ll learn from trial and error. The reforms will roll out slowly; many won’t take effect for years, and Congress will have every opportunity to shape them as their consequences are revealed.
After the political rhetoric, the misinformation, the wild claims, and frightening predictions have died down, we will still face this fact: our health care system is broken. With the passage of this reform package, we will have many opportunities to improve that system. The road will be hard and the journey difficult, but this is a first step we needed to take.
Kaparaboyna Ashok Kumar, M.D., F.R.C.S.