AAFP Statement: America’s Health Future Act Holds Promise

Attributable to:
Ted Epperly, MD
President
American Academy of Family Physicians

“Meaningful health system reform must ensure health insurance to patients, a physician workforce that provides high quality, efficient care, and a financial structure that can be sustained.

“The America’s Healthy Future Act of 2009, approved by the Senate Finance Committee today, takes important steps in the direction of addressing the overarching challenges that face Americans in today’s health care system.

“This legislation promises to provide health care coverage to at least 94 percent of all Americans. We hope it is more than that, and we support requirements that insurers provide coverage regardless of pre-existing conditions, to continue coverage without an arbitrary financial cap after an illness develops.

“We’re also pleased the legislation refocuses health care on comprehensive primary and preventive services through provisions such as eliminating copayments for preventive services and creating a demonstration program for the patient-centered medical home into Medicaid. Together with the 10 percent bonus for primary care services, these provisions move toward a health care system built on a foundation of primary care and away from one that leaves us with our currently fragmented, procedures-based system.

“Finally, the America’s Healthy Future Act lays the groundwork for a robust primary care physician workforce. The AAFP commends the Senate Finance Committee for emphasizing primary care physician education with provisions that reallocate residency training slots to primary care specialties and that amend rules for training residents in community settings.

“These are valuable elements in health system reform. But they don’t ensure comprehensive, sustainable reform. As the Senate debates this measure, the AAFP would offer additional recommendations.

“The Senate can ensure continued stability in the Medicare system by replacing the broken payment formula known as the sustainable growth rate. We regret that the current proposal contains yet another one-year patch to prevent drastic cuts in Medicare payment for physician care and call on Congress to implement a permanent solution based on quality and outcomes.

“Family physicians support the concept of an independent Medicare commission with authority to stem the growth of Medicare payments. But we urge the Senate to clarify that the commission’s decisions would be based on costs in the entire health care community. Hospitals, skilled nursing and hospice care represent more than one-third of Medicare spending. Holding physicians — particularly primary care physicians — accountable for institutional spending decisions over which they have no control would do little to encourage our best and brightest to become physicians at a time of a worsening primary care physician shortage. We also are requesting that the commission members include representation of primary care physicians and of Medicare consumers. It is important that the decisions of this commission have the benefit of the patients who will be affected by cost containment measures and of the physicians whose practices are the ones most Medicare patients use. Finally, there should be a public comment period after draft recommendations are issued.

“The AAFP looks forward to working with the Senate to ensure this legislation will meets its goals of providing comprehensive, meaningful and sustainable reform that offers security to all Americans and enables them to get the care they need, when they need it, from the most appropriate physician.”

Editor’s note: To arrange an interview with Ted Epperly, MD, contact Leslie Champlin, at 800-274-2237, Ext. 5224, or lchampli@aafp.org.