Take Pride in AAFP's Role in Health System Reform

Family physicians can be proud of the AAFP's lead role in creating and promulgating the "Principles for Reform of the U.S. Health Care System" today by 10 major medical associations. The principles are the capstone of an AAFP-initiated process that started in 2004, when Academy leaders realized the logical and necessary next step in health-system reform had to be development of general principles that would garner a broad base of support throughout medicine.

That year, the AAFP asked several of medicine's largest and most influential associations to come to the table -- and kept them meeting until they hammered out 11 mutually agreeable principles for reform. Kudos go to AAFP Past President Mary Frank, M.D., of Mill Valley, Calif., for shepherding the group to success.

Kudos, also, to the representatives of the other associations at those meetings, who helped keep the work of the group at the "20,000-foot level." When the temptation flared to insert specifics into the general principles -- a prospect that threatened to torpedo the process several times -- the people around the table kept one another focused. They collaborated to help patients, instead of wrangling over divisive details. In the end, only one participating association was unable to support the resulting principles.

The AAFP's leadership role in this effort isn't surprising. The Academy has pushed for health care coverage for all and system reform for nearly two decades.

In 1989, an AAFP position statement on access to health care for the uninsured was adopted. At that time, the number of uninsured Americans was estimated at 37 million. The year 1992 brought AAFP's "Rx for Health: the Family Physicians' Access Plan"; then, 38 million were uninsured. In 2001, the Academy pushed again for adoption of a plan to cover everyone; that year, uninsured Americans numbered 40 million. Last fall, the AAFP held its first Capitol Hill Rally. Family physicians formed a "sea of white coats" on the lawn of the U.S. Capitol and delivered a clear message to Congress: Take action on issues that threaten access to health care for all Americans. It's sobering to note that at that time, more than 46 million Americans were uninsured -- 9 million more than in 1989, and nearly equal to the number of people in the entire state of Georgia.

This alarming rise underscores the urgency of system reform. Congress now knows where most physicians stand on reform because they, through their professional associations, support these principles. Awareness of that support should make it easier for Congress to enact meaningful reform -- and harder for Congress to make excuses if it doesn't.