AAFP-Led Coalition Urges Congress to Enact Health System Reform Based on Group's Principles
By Leslie Champlin
1/11/2007
An AAFP-inspired group of 10 medical associations has called on Congress to implement comprehensive health system reform that abides by 11 principles, including access to health care, medical liability reform and management of health care costs.
The group of medical associations (see box below), which includes primary care and subspecialist organizations, first came together in November 2004 at the behest of the AAFP under the leadership of then-President Mary Frank, M.D., of Mill Valley, Calif. (See related editorial. [Members Only])
The document -- dubbed the "Principles for Reform of the U.S. Health Care System" -- represents the first time so broad a swath of medical specialists have spoken with a unified voice, according to AAFP President Rick Kellerman, M.D., of Wichita, Kan.
"Doctors want Congress to take action on health system reform this year," he said. "Physicians are coming together to support these principles because they want the best care for their patients, and if these principles are adopted, patients will be the main beneficiaries."
Organizations Signing Onto Principles for Health System Reform
Ten medical specialty associations signed onto the "Principles for Reform of the U.S. Health Care System." They are
American Academy of Family Physicians
American Academy of Orthopaedic Surgeons
American College of Cardiology
American College of Emergency Physicians
American College of Obstetricians and Gynecologists
American College of Osteopathic Family Physicians
American College of Physicians
American College of Surgeons
American Medical Association
American Osteopathic Association
American Academy of Family Physicians
American Academy of Orthopaedic Surgeons
American College of Cardiology
American College of Emergency Physicians
American College of Obstetricians and Gynecologists
American College of Osteopathic Family Physicians
American College of Physicians
American College of Surgeons
American Medical Association
American Osteopathic Association
Moreover, the principles offer a solid foundation on which Congress can craft comprehensive health system reform, according to Frank, who chaired meetings of the organizations.
"Congress doesn't have to worry about infighting among the groups who support the principles, especially since the groups represent the majority of physicians in the United States," she said. "Not only are they (the principles) comprehensive, but they don't put the onus of the solution on any one group. That makes it more palatable to a legislator -- that we say 'We're willing to step up to our part of responsibility, you step up to your part and we expect others to assume their part of the responsibility.'"
AAFP EVP Douglas Henley, M.D., agreed. "The group represents a huge percentage of the physicians in this country," he said. "It recognizes the need for system reform, not just providing health care coverage to people."
According to the principles
"Congress doesn't have to worry about infighting among the groups who support the principles, especially since the groups represent the majority of physicians in the United States," she said. "Not only are they (the principles) comprehensive, but they don't put the onus of the solution on any one group. That makes it more palatable to a legislator -- that we say 'We're willing to step up to our part of responsibility, you step up to your part and we expect others to assume their part of the responsibility.'"
AAFP EVP Douglas Henley, M.D., agreed. "The group represents a huge percentage of the physicians in this country," he said. "It recognizes the need for system reform, not just providing health care coverage to people."
According to the principles
- health care coverage for all is needed to ensure quality of care and to improve the health status of Americans;
- the health care system in the United States must provide appropriate health care to all people within U.S. borders, without unreasonable financial barriers to care;
- individuals and families must have catastrophic health coverage to provide them protection from financial ruin;
- improvement of health care quality and safety must be the goal of all health interventions, so that we can assure optimal outcomes for the resources expended;
- in reforming the health care system, society must respect the ethical imperative of providing health care to individuals, the responsible stewardship of community resources and the importance of personal health responsibility;
- access to and financing for appropriate health services must be a shared public/private cooperative effort, and a system which will allow individuals/employers to purchase additional services or insurance;
- cost management by all stakeholders, consistent with achieving quality health care, is critical to attaining a workable, affordable and sustainable health care system;
- less complicated administrative systems are essential to reduce costs, create a more efficient health care system and maximize funding for health care services;
- sufficient funds must be available for research (basic, clinical, translational and health services), medical education, and comprehensive health information technology infrastructure and implementation;
- sufficient funds must be available for public health and other essential medical services to include, but not be limited to, preventive services, trauma care and mental health services; and
- comprehensive medical liability reform is essential to ensure access to quality health care.
The principles came together during 18 months of negotiations and were approved by the 10 medical organizations' boards of directors. Several of the principles build on long-term AAFP policy and advocacy efforts. For example, the Academy has called for health care coverage for all since 1989 and has consistently advocated payment reform and improving health care quality. In 2006, the AAFP co-founded the Healthcare Administrative Simplification Coalition, established to simplify the burden and costs of administrative paperwork in medical practices.
The AMA lauded the principles for their focus on providing health care coverage to the uninsured. That goal, said Jeremy Lazarus, M.D., AMA board member, "is a top priority" for his organization. "We are proud to join together with other physician organizations to present a cohesive set of principles to guide reform of the U.S. health care system," he added.
Likewise, the American Academy of Orthopaedic Surgeons, or AAOS, "strongly supports the 'Principles for Reform of the U.S. Health Care System' for its multifaceted approach to significant lapses of access and funding," said Richard Kyle, M.D., AAOS president. "These principles reflect the mandate we feel as physicians, and we are committed to making certain that all Americans enjoy the health care they deserve, no matter their economic resources."
Thomas Russell, M.D., executive director of the American College of Surgeons, or ACS, agreed. The ACS "sincerely supports these principles and the future efforts of the coalition to provide Congress with viable options for providing all Americans with quality care," he said.
Each of the 10 medical specialty organizations now will create its own opportunities to use the unified principles in discussions with lawmakers, health policy-makers and other health system stakeholders.
The AMA lauded the principles for their focus on providing health care coverage to the uninsured. That goal, said Jeremy Lazarus, M.D., AMA board member, "is a top priority" for his organization. "We are proud to join together with other physician organizations to present a cohesive set of principles to guide reform of the U.S. health care system," he added.
Likewise, the American Academy of Orthopaedic Surgeons, or AAOS, "strongly supports the 'Principles for Reform of the U.S. Health Care System' for its multifaceted approach to significant lapses of access and funding," said Richard Kyle, M.D., AAOS president. "These principles reflect the mandate we feel as physicians, and we are committed to making certain that all Americans enjoy the health care they deserve, no matter their economic resources."
Thomas Russell, M.D., executive director of the American College of Surgeons, or ACS, agreed. The ACS "sincerely supports these principles and the future efforts of the coalition to provide Congress with viable options for providing all Americans with quality care," he said.
Each of the 10 medical specialty organizations now will create its own opportunities to use the unified principles in discussions with lawmakers, health policy-makers and other health system stakeholders.
