AAFP Statement: Family Physicians Call for Health System Reform that Ensures Access to Care

Statement Attributable to:
James King, M.D.
President
American Academy of Family Physicians

Since 2001, as many as 165,000 Americans have died because they had no access to health insurance. This must end. It’s time our nation acted to prevent these “uninsurance deaths” – those caused when preventable illnesses take hold, then take over among people who missed doctors’ appointments, medications, or treatments because they had no insurance.

Our support for Cover the Uninsured Week April 27 to May 3 is part of an ongoing effort by the American Academy of Family Physicians to expand coverage to those who do not now have health insurance and to ensure they have access to the primary care physicians who can meet 90 percent of their health care needs.

Uninsured Americans are our friends, neighbors and family. They are America’s workers. Of the 47 million Americans who had no insurance in 2006, nearly 83 percent lived in families where at least one parent worked. The majority of these people lived on $30,000 or less each year, but a growing number of middle-income families are finding themselves unable to afford insurance coverage. For many, there is no option of health insurance because they cope with uninsurable pre-existing conditions.

But even if we issued insurance coverage to everyone in America, our system would fail. This nation does not have enough primary care doctors to meet the demand that universal access would create. After decades of neglect, the primary care foundation, on which all other health services depend, is crumbling. We already feel the early impact of a primary care physician shortage caused by the persistent undervaluing of preventive care and medical management of chronic illnesses.

This nation requires two health reforms:
-- Universal access to health care coverage, whether that be through employer-based insurance, the individual market or some combination of public and private coverage, and
-- A restructured system that focuses on meeting each patient’s need for a personal physician who provides comprehensive primary care in an accessible, efficient practice and that recognizes the value of preventive and chronic care management and pays appropriately for those services.

Combined, these health policies will expand access to health care by providing health care coverage for all and by rebuilding our primary care physician workforce. Fully implemented, these policies will improve each individual’s health and the community’s health. They will help end today’s extremely expensive, fragmented and duplicative system. And they will help rein in the cost of insurance coverage and ultimately, help save money for businesses, the government, and individual families.

America can end the plight of today’s uninsured by completely reforming our health care system. The American Academy of Family Physicians calls on Congress to pass legislation that
-- supports primary care education and grows the primary care physician workforce,
-- appropriately pays for the patient-centered medical home where patients have an ongoing relationship with their family doctor, where they get routine and preventive care, and where they go first for sick care.
-- ensures health coverage programs so every American has access to care.

This reform will take time, but we must begin now. Providing coverage for the uninsured is one step. But we must go farther and ensure that – once covered – Americans will have a primary care physician who can provide care.