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ACP Implores Action on Essential Health Reforms

In 'State of the Nation's Health Care' briefing, Dr. Stubbs says 'now is the time' to stop the decline

A highly partisan and protracted debate over health-reform legislation has diverted attention from the dire need to implement essential changes and improve health-care delivery in the United States, leaders of the American College of Physicians said Wednesday.

In its annual "State of the Nation's Health Care" briefing, held at the National Press Club in Washington, D.C., ACP urged Congress and the Obama administration to move forward on health reform.

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  The struggles of patients who no longer have jobs or have jobs without health benefits -- forcing people to forego needed care -- cannot wait any longer, said ACP President Dr. Joseph W. Stubbs, who practices in Albany, Ga.

"Unnecessary amputations, other unnecessary, avoidable complications of diseases and unnecessary deaths are tragically occurring every day," he said. "This growing American calamity needs to be fixed urgently."

ACP's review of the evidence suggests that the state of the nation's health care is "unfortunately in decline," Stubbs noted.

If current efforts at health-care reform fail, spending on health care will rise to 25 percent of the nation's gross domestic product by 2025 and close to 50 percent in 2082, according to Congressional Budget Office projections.

Without health reform, the rising cost of health care will put affordable care out of reach for tens of millions more Americans, ACP said. An analysis by the Commonwealth Fund found that the average premium for family coverage could nearly double by 2020 -- to $23,842 from $12,298 in 2008 -- if premiums for employer-sponsored insurance grow in each state at the projected national rate of increase.

At the same time, millions more Americans would join the ranks of the uninsured, ACP said. U.S. Census Bureau figures show that, in 2008, 46.3 million people in the United States lacked health insurance coverage -- a number that is projected to swell to more than 60 million, or one in five Americans.

"The consequences of putting off health reform for another five, 10 or 15 years are close to being unimaginable," said Bob Doherty, ACP's senior vice president of governmental affairs and public policy.

Though acknowledging the difficulties in resolving philosophical differences and achieving consensus, ACP leaders urged Congress and the president to press ahead. ACP's report offers specific recommendations for advancing health reform.

First, it says, Congress and the president should reach agreement on a "legislative pathway" to enact a final bill that builds upon and improves the bills passed by the House of Representatives and the Senate.

ACP urges lawmakers to retain key elements of reform. A final bill should provide a means for providing affordable coverage for all Americans, it said, including workforce and payment policies that ensure a sufficient supply of primary care physicians and other specialties facing shortages. The bill also should provide for acceleration of pilot-testing and adoption of innovative payment and delivery models, including the Patient-Centered Medical Home.

ACP cautioned against breaking out key policies into separate bills. "Small bills are likely to achieve Swiss cheese reforms that don't work in practice," Doherty said.

Scrapping the existing legislation and starting again is also not the way to go, in ACP's view. The existing bills, though far from perfect, have enough good policy and reforms with broad bipartisan support to serve as the basis of a final agreement, the report says.

The report includes other recommendations:

  • President Obama should seek bipartisan proposals to reduce the costs associated with the nation's medical liability tort system.
  • Congress should give preference to funding programs that will improve outcomes and slow the growth in health spending. As an example, ACP urged Congress to expand funding for primary care health professions training under the National Health Service Corps and Title VII.
  • Congress must end the untenable cycle of Medicare physician payment cuts caused by the sustainable growth rate formula.
  • The Obama administration should use its executive authority to reduce barriers to primary care under all federal programs and among private contracts, to accelerate pilot testing of the Patient-Centered Medical Home, to ensure the appropriateness and accuracy of physician payments and to require health plans that contract with the federal government to reduce administrative interactions that take time away from patient care.
Despite the prevailing "gloom and doom" in Washington, Doherty said he is encouraged that the president remains committed to meaningful and comprehensive reform and sees the upcoming White House summit as an opportunity to re-engage legislative leaders in advancing health reform.

If health reform collapses this year, Stubbs said that he believes it would be difficult for the president to revive the issue during his tenure.

"I think now is the time," Stubbs said.

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