Grappling with a leviathan
Right to contract provides needed counterbalance to government power in healthcare The reform law has given the federal government too much power over healthcare decisions.
The Coalition of State Medical and National Specialty Societies—which represents more than 85,000 physicians—does not believe that the new health reform law is what’s best for patients and physicians.
The coalition includes the Medical Association of the State of Alabama, the Medical Society of Delaware, the Medical Society of the District of Columbia, the Florida Medical Association, the Medical Association of Georgia, the Kansas Medical Society, the Louisiana State Medical Society, the Medical Society of New Jersey, the Mississippi State Medical Association, the South Carolina Medical Association, and the Tennessee Medical Association. It also includes the American Academy of Facial Plastic and Reconstructive Surgery, the American Association of Neurological Surgeons, the American Society of General Surgeons, and the Congress of Neurological Surgeons. And it includes three former presidents of the American Medical Association— Daniel Johnson Jr., Donald Palmisano and William Plested III.
We collectively believe that the Patient Protection and Affordable Care Act has given the federal government too much power when it comes to the decisions that are made surrounding our healthcare. What’s more, it is not financially sustainable.
We are convinced that a critical mass of the rank-and-file physicians who practice medicine in this country—across both geographic and specialty lines—share our belief that the key to preserving patient access to care is reforming the nation’s medical payment system, which is a message we have been delivering to as many stakeholders as possible for a year and a half now.
As the largest government-run healthcare program, Medicare represents a glaring example of the need for change. It is becoming increasingly difficult for physicians to accept Medicare patients as a simple economic matter as the gap between payment rates and the cost of running a practice grows wider.
The good news is that, at our urging, the AMA House of Delegates took an important step in the right direction when it passed a resolution during its meeting in Chicago in June with overwhelming support that read:
“Resolved, that our American Medical Association immediately formulate legislation for an additional payment option in Medicare fee-for-service that allows patients and physicians to freely contract, without penalty to either party, for a fee that differs from the Medicare payment schedule and in a manner that does not forfeit benefits otherwise available to the patient. This legislative language shall be available to our AMA members no later than Sept. 30, 2010.”
We believe that patients and physicians should be free to privately contract without bureaucratic interference or penalty. This change would empower patients as they make important healthcare decisions, including the source and cost of their medical care.
Private contracting—which is a touchstone of American freedom and liberty—is the only realistic way that we can achieve budget certainty while remaining free of the heavy hand of government (e.g., deciding who gets healthcare and how they are treated and at what cost).
And because it’s a free-market business model that bypasses price controls, the right to contract will address the nation’s growing physician shortage in an organic way by creating a more favorable and sustainable practice environment.
Individual patients should be free to spend their own money on their own medical care as they see fit—regardless of thirdparty payers. Unfortunately, that’s not a given with government-run programs such as Medicare, which generally dictate treatment and payment terms.
We believe that we can close the divide between government programs and the real cost of healthcare by restoring the patient’s right to privately contract with his or her physician using the patient’s individual circumstances as the baseline for that discussion.
We are resolute in our belief that the right to contract provides the optimum remedy. It is a sustainable and patient-centered solution for the medical payment system that will ensure that Americans have access to the physicians they want to see in their hour of need. Moreover, it serves as a rational model for every third-party payment system.
The members of the coalition further believe that the determination of the quality of medical care must be made by the profession of medicine—not by the government or other third-party payers. We also believe that Medical liability reform that’s based on proven policies is an essential part of any healthcare reform.
These are the key principles that we believe will help ensure that Americans have access to quality healthcare that’s affordable. And that ultimately means that they will enjoy greater safety and security and peace of mind.