Time to Move to Next Level in Solving Health Care Problems

Family medicine is in a prime position to guide health care policy, and FPs must help craft issue-specific solutions to the problems plaguing America's health care system. Those were the key "take-away" messages from March meetings the AAFP Board of Directors held with health policy leaders, according to AAFP President Larry Fields, M.D., of Ashland, Ky.

Board members met with HHS Secretary Michael Leavitt; Rep. Pete Stark, D-Calif.; and Newt Gingrich, former Speaker of the U.S. House and founder of the Center for Health Transformation. Many Board members also grabbed the opportunity to huddle with their individual U.S. representatives and senators during the March meeting.

These policy leaders want physicians to offer solutions to problems that beset America's health care system, said Fields. "The Academy needs to take the next step and start formulating solutions to the problems and present them, in total, to people inside and out of government.

"We learned from our meetings that both parties are looking to us as experts in content issues" involving health care, he said. "They are open to us proposing solutions. They said, 'You're the experts. Bring us solutions, and we'll consider them.'"

Fields pointed to the conversation with Stark as an illustration. A supporter of a single-payer health care system, Stark told the Board he was receptive to private sector solutions to the growing number of uninsured Americans. "He's open to the Academy and medicine as a whole coming up with solutions," said Fields. "He's open to letting the private sector take the first shot before letting government step in."

Fields said Stark also expressed interest in amending antitrust rules to allow hospitals, health plans and others to provide health information technology equipment to physicians to help ensure interoperability.

In a separate meeting, Board members urged HHS' Leavitt to fully support the Relative Value Scale Update Committee's recommendations to update the relative value of evaluation and management reimbursement codes, according to Fields. The codes have not been updated in more than five years, a situation that has effectively reduced payment for much of family physicians' patient care services.

Board members also explained the link between funding Section 747 of Title VII in the Public Health Services Act and full medical staffing for community health centers. The Bush administration has called for expanding the centers since 2001. The federal Health Center Initiative, which passed in 2002, established a five-year, $780 million program to create new or expand existing CHCs in medically underserved areas. However, the latest Bush budget calls for eliminating funding for Title VII, a federal program that provides funds to academic departments and programs to increase the number of primary care professionals

"We pointed out that they can put millions of dollars into the bricks and mortar, but if they put nothing into people, they won't have medical staff" to provide services in the centers, said Fields. "(Leavitt) said he had not made that association before."