AAFP Statement: Family Physicians to President Bush: Call for Improved Health Access is Only One Step to Comprehensive Reform

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

The American Academy of Family Physicians is pleased that President Bush’s State of the Union address signaled his interest in improving access to health care. In doing so, the president has helped advance the debate about health system reform.

Improving Americans’ ability to pay for health care is but one step in helping create a health system that provides care to all, ensures the financial viability of those who provide those services and reins in the spiraling cost of health care. But providing health coverage to every American will not repair the broken system.

Regardless of how a person pays for health care, the system’s reform must grow from a foundation of primary care provided in what is called a medical home, where patients receive comprehensive, whole-person services that help them maintain their health, prevent chronic conditions, efficiently manage those conditions if and when they develop, and ensure access to subspecialist care when appropriate.

For years, the primary health care foundation has been crumbling from neglect. Annual threats of slashing Medicare reimbursement for services rendered – and the private sector plans that pin their reimbursement on Medicare’s example – discourage medical students from entering primary care and encourage practicing physicians to retire early. Today, our nation is grappling with a primary care physician shortage that is predicted to worsen with time.

That fundamental fissure threatens the future health care for all Americans, and they are beginning to recognize it. Poll after poll have demonstrated Americans’ concerns over access to and cost of health care. Most recently, Gallup reported Jan. 24 that 72 percent of Americans are dissatisfied with the cost of health care. Health care remains one of the four “most important” problems facing our nation today. Equally important, the Commonwealth Fund this month reported that 86 percent of people age 19 and older said presidential candidates’ views on health care reform “would play a very important or somewhat important role” in their choice for president.

It’s no wonder that Americans list health care among their greatest concerns. They experience the fragmented, duplicative system that costs more money, provides less preventive and comprehensive chronic care management and, increasingly, requires longer waits for appointments.

Americans want change. They want a health care system that builds on the foundation of a personal physician who provides comprehensive and coordinated care. They want the medical home concept, where their doctor helps them stay healthy, coordinates services if they develop a chronic condition and helps them overcome illness or injury without a confusing array of medical appointments and bills.

This system can evolve only when national leaders support appropriate payment for family physicians’ expertise, recognize that our medical educational system must encourage and assist young people in becoming family physicians, and commit themselves to ensuring that Americans have access to care.

President Bush and Congress need to respond to Americans’ concerns with comprehensive reform that not only helps Americans gain access to health care coverage, but also fosters the medical home concept and medical education initiatives that encourage students to enter family medicine and national health policies that reinforce primary care.