The quintessential element in health care—the doctor—may be missing if the Obama administration’s proposed health care reform leads to a government-run insurance program.
President Obama telegraphed just such a possibility in his September 9 address to a joint session of Congress when he expressed his support for the public insurance option. Yet the American Society of Medical Doctors (ASMD), in a nonpartisan nationwide opinion poll of physicians with specialties, found that more than 60 percent of doctors would not accept new patients with government insurance, and 27 percent would not accept any patients on a new government plan. Interestingly, more than 60 percent of the doctors in this poll described themselves as moderate, somewhat liberal or very liberal; only 18 percent labeled themselves as “conservative.”
ASMD Chairman Dr. Alfred O. Bonati, said of the poll: “Any doctor who has ever dealt with Medicare knows that government coverage severely limits our abilities to deliver care that best fits the needs of the patient. We know that government coverage does not allow for flexibility, creativity, or, sometimes, even compassion.”
The ASMD has also offered a compelling rebuttal to the president’s claim that a government insurance plan would merely “compete” with private insurers, pointing out that the “public plan’s lower rates would be an incentive for businesses to eliminate their existing coverage and shift their employees into the public plan. Once participation in the public plan reaches a certain critical mass, private insurance options would disappear and the government would be left as the sole provider of health care in the United States.” Such concerns rest on solid evidence: The respected Lewin Group has calculated 119 million will lose their private coverage and be steered into the public option.
The discontent among doctors at the prospect of a government insurance program goes beyond a single poll. More than 1,000 physicians from all 50 states converged on Capitol Hill on August 9. Clad in lab coats and scrubs, they carried an urgent message to the president: “Stop meddling in medicine!” The lobbying event was co-sponsored by the Association of American Physicians and Surgeons (AAPS). The doctors traveled at their own expense for the Washington rally, not only to press their views on lawmakers supporting the administration’s overhaul but also to meet with members of Congress who are doctors.
Prominent among them is Oklahoma senator and doctor Tom Colburn. Colburn has been pushing his own alternative to ObamaCare, known as the Patients’ Choice Act. The Patients Choice Act of 2009 would encourage increased coordination of federal prevention efforts; require the Centers for Disease Control and Prevention (CDC) to wage a national campaign using science-based strategies; equip Supplemental Nutritional Benefits recipients with information about nutritional foods and limit food stamps to healthy food choices; invest $50 million a year in increased vaccines; and provide incentives to states to cut chronic disease rates.
The legislation would also create state health insurance exchanges so Americans could compare policies; give citizens the same health benefits provided to Members of Congress; assure that no one would be turned down based on age or health; reward insurers that encourage prevention and wellness and cover pre-existing conditions; let states ban together in regional pooling arrangements to cover “uninsurables”; restore fairness in the tax code by providing tax credits; improve the operation of Health Savings Accounts (HSAs) and let HSA owners contribute more to their accounts.
Colburn is also focusing on preventive care for five chronic diseases – heart disease, cancer, stroke, pulmonary disease, and diabetes – that cause two-thirds of American deaths. “Treatment of these largely preventable diseases makes up 75 percent of total health care expenditures,” says Colburn.
Despite opposition from doctors, some medical organizations have lined up behind the administration’s plans for reform. The largest organization of doctors, the American Medical Association (AMA), first opposed the administration’s health care plan, then endorsed it after the president delivered a speech to the organization. The AMA represents about 29 percent of the nation’s doctors and relatively few are physicians in specialty areas.
The AMA’s backing for ObamaCare prompted a stinging dissent from their fellow doctors. “The AMA’s endorsement was bought and sold, at the expense of patients, and the expense of the profession of medicine,” according to Dr. Michael Schlitt, a Seattle physician, the article said. Schlitt was quoted as adding, “I couldn’t stand by without telling Congress and the public that they (AMA) don’t represent me, or most of the doctors that I know. And that it’s time Congress listens to real doctors from the frontlines.” Meanwhile, the AMSD released additional results of its poll on government insurance showing that 86 percent of specialty doctors believe that the AMA “has become too political and has lost touch with the doctors it is supposed to represent.”
“This is not a political issue–it is a medical issue,” says spinal surgeon and ASMD Chief Alfred Bonati. In particular, Bonati worries about the expanded government role in health care, pointedly asking whether government officials will “begin to take the Hippocratic Oath in addition to their traditional oath of office?” As the administration forges ahead with its controversial reforms, many doctors are asking the same question.