AAFP positions on physician payment and the physician workforce each got a significant boost when the AMA House of Delegates voted that comprehensive health system reform "be of the highest priority" for the AMA.
Academy Positions on Payment, Workforce Gain Steam at AMA Meeting
By Leslie Champlin
6/27/2006
The AMA action came during the June 10-14 annual meeting, when delegates approved Resolution 613. The resolution calls for comprehensive health care reform, a report recommending action on increasing primary care physicians' payment to increase interest in primary care careers, and another report that recommends tax incentives and assistance be used to require individuals and families to obtain health insurance.
Health System Reform
Hailed by AAFP delegates to the AMA as a success for primary care, the House of Delegates' action put the AMA squarely in the corner of comprehensive health system reform that includes dramatic changes in the workforce, medical liability laws and physician payments.
"There was no debate about whether the health care system needs reform," said Dale Moquist, M.D., of Houston, chair of the AAFP delegation to the AMA. "It's interesting to see how the focus has changed in the past two or three years. Physicians of all specialties are frustrated with how the system is going, with how the number of uninsured people is going up, not down. There's much more stress on physicians and hospitals because we're all being expected to do more with (fewer) resources."
In fact, a June 22 report from the Center for Studying Health System Change found all physicians -- particularly primary care physicians -- suffered falling incomes. "Losing Ground: Physician Income, 1995-2003," found a 7.1 percent decrease, adjusted for inflation, in physician incomes between 1995 and 2003. Primary care physicians fared the worst, with a 10.2 percent decrease for that period, followed by surgeons, who saw an 8.2 percent decline in income.
The medical community "is frustrated with a dysfunctional system," said Moquist. "Primary care physicians get exposed to the problems many times before our subspecialist colleagues see it. We act as a kind of buffer for them. But now it's harder for them to ignore the problems."
AAFP President Larry Fields, M.D., of Ashland, Ky., has pointed to payment, liability and workforce reform as the foundation for ensuring access to medical homes and high-quality health care for patients.
"Those are the three legs of personal medical homes and health care coverage for all," he said in recent speeches to participants at the AAFP Congressional Conference and the Annual Leadership Forum and National Conference of Special Constituencies. "Unless we have a sufficient workforce that provides medical homes to people, we can't afford health care coverage for all. If we don't change the liability system, if we don't change the payment system, if we don't change the workforce system, health care coverage for all is a pipe dream."
AMA delegates apparently agree. "Even if everyone were insured, a broken Medicare payment system will not allow physicians to keep their doors open, thereby limiting access to care," say the findings of Resolution 613. "The equally broken medical liability system threatens the underpinning of our entire health care system."
"There was no debate about whether the health care system needs reform," said Dale Moquist, M.D., of Houston, chair of the AAFP delegation to the AMA. "It's interesting to see how the focus has changed in the past two or three years. Physicians of all specialties are frustrated with how the system is going, with how the number of uninsured people is going up, not down. There's much more stress on physicians and hospitals because we're all being expected to do more with (fewer) resources."
In fact, a June 22 report from the Center for Studying Health System Change found all physicians -- particularly primary care physicians -- suffered falling incomes. "Losing Ground: Physician Income, 1995-2003," found a 7.1 percent decrease, adjusted for inflation, in physician incomes between 1995 and 2003. Primary care physicians fared the worst, with a 10.2 percent decrease for that period, followed by surgeons, who saw an 8.2 percent decline in income.
The medical community "is frustrated with a dysfunctional system," said Moquist. "Primary care physicians get exposed to the problems many times before our subspecialist colleagues see it. We act as a kind of buffer for them. But now it's harder for them to ignore the problems."
AAFP President Larry Fields, M.D., of Ashland, Ky., has pointed to payment, liability and workforce reform as the foundation for ensuring access to medical homes and high-quality health care for patients.
"Those are the three legs of personal medical homes and health care coverage for all," he said in recent speeches to participants at the AAFP Congressional Conference and the Annual Leadership Forum and National Conference of Special Constituencies. "Unless we have a sufficient workforce that provides medical homes to people, we can't afford health care coverage for all. If we don't change the liability system, if we don't change the payment system, if we don't change the workforce system, health care coverage for all is a pipe dream."
AMA delegates apparently agree. "Even if everyone were insured, a broken Medicare payment system will not allow physicians to keep their doors open, thereby limiting access to care," say the findings of Resolution 613. "The equally broken medical liability system threatens the underpinning of our entire health care system."
Support in Council Reports
Augmenting the impact of Resolution 613 was the House of Delegates' approval of the AMA Council on Medical Education Report "Impact of Increasing Specialization and Declining Generalism in the Medical Profession." (MS Word file: 25 pages/142 KB. More info about downloading files.) That report recommends that the AMA "encourage physician reimbursement changes which would make generalist physician practice more attractive."
Of equal importance, said Moquist, was approval of the AMA Council on Medical Service Report, "Individual Responsibility to Obtain Health Insurance." (MS Word file: 19 pages/115 KB. More info about downloading files.)
That report recommends that the AMA support a requirement that individuals and families earning more than 500 percent of the federal poverty level obtain coverage for catastrophic health care and evidence-based preventive health care, using the tax structure to achieve compliance. A system of tax credits or other subsidies would help people obtain insurance when they earn less than 500 percent of the poverty level. In effect, said Moquist, such a requirement would increase patient access to health care by ensuring coverage for all Americans.
Of equal importance, said Moquist, was approval of the AMA Council on Medical Service Report, "Individual Responsibility to Obtain Health Insurance." (MS Word file: 19 pages/115 KB. More info about downloading files.)
That report recommends that the AMA support a requirement that individuals and families earning more than 500 percent of the federal poverty level obtain coverage for catastrophic health care and evidence-based preventive health care, using the tax structure to achieve compliance. A system of tax credits or other subsidies would help people obtain insurance when they earn less than 500 percent of the poverty level. In effect, said Moquist, such a requirement would increase patient access to health care by ensuring coverage for all Americans.
