- The Washington Times - Thursday, July 23, 2009


We have the best health care system in the world. Most Americans live within an hour’s drive of a world-class medical facility filled with expertly trained individuals and state-of-the-art technology delivering medical miracles every day.

But today, as our government attempts an overhaul that will significantly restructure and restrict the way in which doctors provide care to their patients, the health care system that so many Americans depend on is at risk. Currently, more than 250 million Americans have health insurance and the vast majority of them are satisfied with the coverage they have and the doctors they see.

Why, then, is government trying to upend the entire medical system? The government claims the reason is cost and quality. But the government plan increases the cost and gives a dystopic future of rules that stifle innovation and diminish quality through long waits for care and rationing.

What’s more perplexing is the American Medical Association’s (AMA) recent letter of support of the House health care bill (H.R. 3200), which ignores or violates many of AMA’s most important legislative priorities and implements a government option that could restrict doctors’ ability to provide patients with the care they need.

While we strongly support the AMA as an organization, we do not support this latest action.

The AMA’s tacit endorsement of the public option in H.R. 3200 is in direct conflict with its long-standing policy, approved by the AMA House of Delegates, of reducing government interference with the work that goes on in a doctor’s office or an operating room and is antithetical to what most doctors in America support. A government-controlled health care system, as we’ve seen in countries around the world, will lead to patients losing their current coverage and choice of doctor, long waiting lines for care, and a government formula to ration medical treatments.

In a land founded on liberty, it is wrong that the federal government would dictate to doctors what medical treatments can, or worse, cannot be given to their patients. Unfortunately, in nations around the world, this is already happening.

Take, for example, these comments from the then-chairman of the British Medical Association in 2003 as he characterized his nation’s government-controlled health care system as “the stifling of innovation by excessive, intrusive audit … the shackling of doctors by prescribing guidelines, referral guidelines and protocols … the suffocation of professional responsibility by target-setting and production line values that leave little room for the professional judgment of individual doctors or the needs of individual patients.”

The House health care bill also ignores two of the AMA’s top advocacy priorities: the right of patients and physicians to privately contract with each other without government interference or penalty, and the addition of proven medical-liability reforms.

Presently, it is illegal for doctors who accept Medicare payments to waive copayments if a patient is unable to afford them, unless the doctor gets out of Medicare for two years. The rising cost of health care will never be solved without such right of private contract, placing the patient back in control with the physician as trusted adviser.

As physicians, we have spent our adult lives caring for patients and advocating what is in their best interests. We’ve each had the privilege of being president of the AMA. But, instead of endorsing the government plan of health care contained in H.R. 3200, we believe the current health system reform must focus on three key points.

First, we should expand the choices of types of plan and access to primary and specialized care.

Second, every American should have the opportunity and the responsibility to choose and own the insurance plan that meets their needs and those of their family, with the periodic right to change if dissatisfied with the previous choice. Because the beneficiary owns the coverage, it is totally portable and not locked to specific employment.

Third, whoever puts up a subsidy (defined contribution) for the purchase of the insurance should put up the same subsidy, no matter what choice the person makes.

Thus, these reforms allow beneficiaries to become prudent purchasers of insurance, and beneficiaries become accountable since they are ultimately in control of the financing system, rather than the employers and/or the government.

At some point in our lives, we’re all patients, and the way to strengthen our system, to control both cost and quality, is to empower the patient. If the federal government is allowed to expand its role in medicine, our country will see the long waiting lines for care, patients will lose trust in their doctors, and the medical discovery and innovation that has saved and enhanced lives across the country will end.

That’s something patients — and doctors — should not allow to happen.

Dr. Daniel H. Johnson Jr., Dr. Donald J. Palmisano and Dr. William G. Plested III, are all former presidents of the American Medical Association.

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