Town Hall Meeting Sparks Lively Discussion on Health Care Reform

Health care reform legislation was on the menu during the town hall meeting at the AAFP's 2009 Congress of Delegates here. AAFP leaders and members engaged in lively discourse on Sunday evening regarding a variety of reform-related topics, including payment for primary care physicians, workforce issues and health care coverage for all.

AAFP President Ted Epperly, M.D., of Boise, Idaho, took the opportunity to reiterate the Academy's support for health care reform legislation. The major health care reform bills now circulating in the House and Senate would increase Medicare payments for primary care physicians and bolster the nation's supply of primary care physicians, said Epperly.

In addition, the pending legislation would move the country closer to a primary care-based health system, said Epperly, who was joined on stage by AAFP President-elect Lori Heim, of Vass, N.C.; AAFP Board Chair Jim King, M.D., of Selmer, Tenn.; and EVP Doug Henley, M.D. Speaker Leah Raye Mabry, M.D., of San Antonio, Texas, moderated the meeting, which was attended by more than 300 family physicians.

Several members expressed their concern about the current health care reform bills, saying that enactment of the legislation would result in an expansion of government power without doing enough for primary care physicians.

Epperly acknowledged that the current bills are lacking in some respects, but he described the legislation as a "step in the right direction" and far preferable to the status quo, which he described as "unsustainable."

"There is a lot of good in the legislation -- more good than bad," said Epperly.

He predicted that the House and Senate would pass their respective health care reform bills within the next month, possibly paving the way for final passage of a health care reform measure by mid-December.

Epperly also noted that during the past several months, the Academy has employed a "yes if" approach to health care reform, agreeing to support health care reform provisions if certain conditions are met. In most instances, the conditions are predicated on the Academy's Health Care for All initiative, which calls for everyone to have health care coverage and access to a patient-centered medical home, or PCMH.

The "yes if" approach has enabled the AAFP to remain at the table and, thus, to engage Congress and the White House on health care reform issues, said Epperly.

"Both the president and Congress are receptive to our message," he added.

According to Epperly, family physicians are on the front lines of health care reform, and he urged AAFP members to "stay optimistic, stay focused and stay engaged" by participating in the AAFP's Connect for Reform campaign (Members Only); contributing to FamMedPAC, the Academy's political action committee; and contacting their members of Congress in support of health care reform.

"Our voices are incredibly important," he said.

During the meeting, some Academy members described the PCMH as an essential building block of the nation's health care system, especially as the nation moves from a fee-for-service to a value-based health care system. But members said it has been difficult to convince their colleagues of the need to transform their practices into PCMHs without initial financial incentives. King said physician payment reform would address that issue and should act as a catalyst to convince more family practices to transform their practices into PCMHs.

Heim stressed, however, that family physicians need to start transforming their practices before payment reform takes place. "If we wait until payment is on the doorstep, it will be too late," she said.

During the latter half of the meeting, the discussion turned to the AAFP's new Consumer Alliance program and the program's initial partnership with the Coca-Cola Co., which is providing a grant to the AAFP for development of consumer education content on beverages and sweeteners on FamilyDoctor.org.

Heim said the Consumer Alliance program will enable the AAFP to develop and publish information to help consumers make choices about which beverages they consume. She emphasized that the AAFP has total control over the content, and there will be no product promotion.

Several members spoke of their concerns about the AAFP partnering with a company whose products have been linked to increased obesity, especially in children.

However, Heim said members should wait and see what is posted on the FamilyDoctor.org Web site before passing judgment. In addition, said Heim, revenue generated by the partnership will help the Academy engage in federal advocacy efforts on the federal level at a crucial time during the health care debate.

Epperly said member concerns about the partnership are valid, and the AAFP thought long and hard about it before proceeding with the partnership. The Academy will re-evaluate the partnership after one year to determine whether to continue with it, he added.