AAFP President-elect Urges Support for Public Plan Option During Town Hall Meeting

More than 250 health care professionals called on Congress to pass a comprehensive health care reform bill that includes a public plan option during a town hall meeting here on June 26. The meeting was convened by Health Care for America Now, or HCAN.

"I have been in private practice, and I've had to fight with insurance companies to get my patients the care that they needed," said AAFP President-elect Lori Heim, M.D., of Vass, N.C., one of four representatives of the physician and nursing communities to address the town hall meeting. "I don't think (this system) has worked for you, for me, for our patients, for our nation."

HCAN is a national grassroots campaign that comprises more than 1,000 organizations in 46 states representing 30 million people who support comprehensive health care reform. The AAFP is a member of HCAN.

The campaign is a strong proponent of, among other things, a public health care plan option, which has emerged as one of the most contentious issues dividing congressional Republicans and Democrats. Most congressional Democrats support a public plan option, saying it will give consumers more choices and promote competition in the marketplace. Most congressional Republicans oppose a public plan, saying it will drive private plans out of the market and lead to a single-payer system.

Heim described the public plan as "a viable option that could help us, help our patients and help our nation."

Heim currently works as a hospitalist in Laurinburg, N.C., an extremely rural and impoverished part of the state. "Before that, I was in private practice, and before that, I was in the Air Force for 25 years, so I have seen a lot of different ways of doing things," she told the gathering.

She told a story about how the health care system failed one of her patients. As Heim explained it, she recently admitted a patient named Johnny into the emergency room who had severe, undiagnosed hypertension.

Heim described Johnny as a hard worker who lost his job a year earlier. "He had never had a primary care physician, and so he never knew he had high blood pressure," Heim said. "Guess what stage his heart failure was, and guess what his renal function was?"

She pointed out that medication, which costs only pennies a day, could have controlled and averted the complications of his hypertension. "He was a nice guy with a family, no drugs, no alcohol. He didn't bring this on himself. We and the system failed him," said Heim.

The need for more primary care physicians and the critical role they play in the health care system became an underlying theme of the town hall meeting. Several speakers said current payment policies need to be readjusted to pay primary care physicians more.

Ellen-Marie Whelan, N.P., Ph.D., a senior health policy analyst and associate director of health policy at American Progress, a Washington, D.C., think tank, and one of two moderators for the town hall meeting, said payers should reward providers for coordinating and managing care. She also said Congress should give primary care physicians a "pot of money" and the flexibility to manage patient care because they are adept at care coordination.

Sen. Debbie Stabenow, D-Mich., a member of the Senate Finance Committee, told the town hall meeting "we have to deal with payment levels as well as encouraging more people to come in and serve in underserved areas."

"We have to help those who are going into the medical profession to be able to come out and have some help so they don't have a (debt) equivalent to a mortgage," said Stabenow.

Stabenow described health care reform as a bipartisan issue. "When people get sick, it is not about Republicans or Democrats or Independents," she said. "This is an American issue. It is not about party."