Stream Praises Candidates for Addressing Health Care, Continues to Call for Payment Reform

Although both candidates in the Oct. 3 presidential debate recognized health care reform as a major issue for the United States, AAFP President Glen Stream, M.D., M.B.I., of Spokane, Wash., says more needs to be done.

"Tonight's debate focused attention on a health care system that, without reform, continues to be bogged down in fragmented, duplicative and often unnecessary services that hinder access to quality care and impose unnecessary costs on both individual patients and the nation," said Stream in prepared comments.

"We welcomed the discussion (in the debate) about reforms that encourage coordination of care, (and) ensure preventive services for Americans and payment for the value of care rather than the number of procedures." The candidates' comments, he noted, "point to progress in our nation's efforts to improve access to, and quality of, health care for all Americans."

The AAFP has called for health care coverage for all for the past 20 years, said Stream. Only by ensuring health care coverage for everyone can the U.S. health care system prevent disease and complications from chronic conditions, a major driver of health care costs, he noted.

The candidates talked about the need to control health care costs, and Stream pointed out that one of the keys to controlling costs and improving quality is access to primary care services.

The "AAFP has long supported health care delivery reforms that build on the patient-centered medical home," said Stream. The PCMH allows patients to have a long-term relationship with their primary care physician, as members of the health care team work together on the patient's behalf.

"By providing and paying for comprehensive, coordinated services -- a concept both candidates mentioned during the debate -- we can improve the health of our patients, avoid unnecessary medical interventions, ensure seamless care when it is needed and help restrain the cost of health care," said Stream.

He added that he was disappointed neither candidate addressed the Medicare sustainable growth rate (SGR) formula during the debate. Physicians are facing a 27 percent reduction in the Medicare physician payment rate on Jan. 1 unless Congress acts to block the cut.

"This failed formula jeopardizes elderly and disabled Americans' access to needed health care and is unsound fiscal policy for the Medicare program," Stream said. "Only by stabilizing Medicare physician payment -- including a higher payment rate for primary medical care and by paying for quality of care -- can we build a health care system that serves both the individual and the nation."

Making reform possible and meeting projected demand means that the nation's Medicare payment system "must end the annual threat of devastating cuts to physician payment," called for by the SGR, Stream said.

He added that regardless of who wins the November election, health care reform will continue to be enacted. "The AAFP calls for reforms that ensure Americans' access to health care by building the primary care physician workforce, lay a path that enables all Americans to have health care coverage, and improves the quality and lowers the cost of health care services."