House Bill Expands Access to High Quality, Affordable Health Care for Americans
WASHINGTON– Today, the American Medical Association sent a letter to House leaders supporting H.R. 3200, “America’s Affordable Health Choices Act of 2009.”
“This legislation includes a broad range of provisions that are key to effective, comprehensive health system reform,” said J. James Rohack, M.D., AMA president. “We urge the House committees of jurisdiction to pass the bill for consideration by the full House.” H.R. 3200 includes provisions key to effective, comprehensive health reform, including:
Coverage to all Americans through health insurance market reforms
A choice of plans through a health insurance exchange
An end to coverage denials based on pre-existing conditions
Fundamental Medicare reform, including repeal of the flawed sustainable growth rate (SGR) formula
Additional funding for primary care services, without reductions on specialty care
Individual responsibility for health insurance, including premium assistance to those who need it
Prevention and wellness initiatives to help keep Americans healthy
Initiatives to address physician workforce concerns
“The status quo is unacceptable,” Dr. Rohack said. “We support passage of H.R. 3200, and we look forward to additional constructive dialogue as the long process of passing a health reform bill continues. This is an important step, but one of many steps in the process. The AMA is actively engaged with Congress and the administration to achieve health reform that best meets the needs of patients and physicians. We are committed to passing health reform this year consistent with principles of pluralism, freedom of choice, freedom of practice, and universal access for patients.”
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The same tactic used to win the election again. Gain support from the many, who have less and take from those who have more. He got support of primary care docs, ie the AMA and pitted them against the relatively few who chose long difficult residencies, high stress, odd hour, high liability exposure medical careers (Surgeons, Anesthesiologists etc). We’re going to fix this all by giving primary care folks more income and “save money” by paying less to the “greedy” specialists, who drive up costs, and, by the way, taxing the crap out of their income they have. Well, as someone who spent many extra years of training and now sweats through long complicated surgeries on the sick elderly for about $80/hour, I’m soon done. Yes, the rate of “reimbursement” for Medicare is about $20 per unit (15 minutes of time). Anesthesiologists got royally screwed when they calculated the relative value scale, and even the Government admits it. Most specialties collect 80-90% of insurance rates for Medicare patients, we get about 33%. My income has stagnated or gone down in the last 15 years while the cost of living here has skyrocketed. I can no longer affort my mortgage payment, in addition to college tuition. I pulled my other kids from private schools (thank God we have good public schools here) and we essentially quit the country club. We can’t afford a vacation this year. So someone please tell me why I’m still staying up all night taking care of laboring patients, busting my ass to keep old sick people alive while they have their hips replaced? My family and I no longer can enjoy any of the benefits I thought I secured while spending my 20’s studying and working while all my friends played. When I am forced to sell this house (the value of which just got crushed), I’m done in Medicine. Yeah, you’ll have insurance, you just won’t have the quality people you have now taking care of you. Have your primary care doctor or Michael Jackson’s doctor push your Propofol. I’ll be working on a dive boat in the Caribbean.
THE AMA SHOULD BE ASHAMED OF THEIR SELVES. THIS IS NOT THE KIND OF HEALTH REFORM THAT THE UNITED STATES NEEDS. JUST READ THE COMMENTS ABOVE.
I am deeply concerned that the current bill propogates the current bureaucratic and regulatory nightmare that has become my practice. Our overhead is approaching 60% and, as I analyze the reasons, I am dismayed at how much of the expense is for billing personel, malpractice, and most importantly documentation compliance. These latter components are now about 50% of my overhead.
I am dismayed, because even as the government invokes socialized medicine, it seeks to learn nothing about how medicine is practiced under such a system.
I am horrified that physicians have no place at the table, when we are the system’s principle cost center. We spend the money, but remain on the outside of the debate.
I cannot imagine anyone going into medicine today. Even at this point, it will be a tremendous financial stretch to buy into my practice.
I think that physicians should look at their practices, see where their money is going, and band together. Lets take aim at the government, insurers, and “baby talking” malpractice lawyers.
M Worrall Onio
I have been an Insurance agent since 2001 who specializes in senior Medicare products. I’m a broker so I am not obligated to any insurance company. I have mixed emotions about this bill HR3200, what it would do to our great country, what freedoms we may lose in the hopes of gaining something that sounds good ” free health care” and I could not agree more with Dr Mumma’s response but I view this health care bill from a different angle. I offer Medicare Advantage plans known as Medicare part C and I offer part D prescription drugs also. These plans are controled by CMS or Centers for Medicaid and Medicare which is a government agency. When offering these plans an agent is at the mercy of CMS in every detail of offering the plan from how the client is contacted, how they are sold, they way they are sold, what words you must say to them at your meeting, what materials you must leave at your meeting, how you must tell them you are compensated for these plans, No saying this, no marking on materisls, no self made letters,no personal solicitation, no cross selling other products,you must schedule a seperate appointment for other products, you must have an “scope of appointment” letter signed by the customer prior to your coming to your appointment with the customer. My point is, they will wear you out with beuracratic rules as I have had a chance to experience four years of government control over my life and it is a nightmare. Oh did I tell you that CMS also controls the amount they allow the insurance company to compensate me for the sale? They even set the amount the insurance company could pay me. I’m a 1099 to the insurance companies not an employee. What do you think they will do to you if this bill passes they will decide how much you the doctor and the nurse will get paid, when and where you work and censor you right down to the scruples. I’m very dissapointed in the AMA president. We’ve all heard about Medicare and how the Medicare system will not be able to support the baby boomers yet somehow we are now talking about everyone on Medicare because we are all “entitled”. Our government sounds bipolar.
I’m also an incoming medical student and very hesitant about the future of medicine. I just signed my master promissory note yesterday for my school loans and wondered whether, if there is government healthcare, I’ll ever be able to pay them back. I don’t think people really understand how much sacrifice goes into becoming a doctor. I didn’t go drinking and partying as an undergrad because I was studying for organic chemistry. And while I really love working in medicine, I don’t want to have to deal with the bureaucracy of a government health care system nor do I want to deal with the crushing expense of increased taxes and medical school loans. I’ll be 28 when I start my internship and I’m very young. I can’t have a traditional family and forget children before 30 or 35. These are all huge sacrifices that a very few make because of our passion. If the government starts making our lives miserable, we will think the better of it and do something else. Supply and demand is a huge issue. Add 47 million people to the healthcare system and costs will increase because there simply are not enough doctors.
I think the key in the AMA’s decision to support the bill is the medicare payment reform. However, on my last reading of the bill, I understood that medicare rates would continue.
I think this whole thing is ludicrous. There’s a lot we can do to reform the health insurance system but this isn’t it!
No health plan should become law until EVERY congressman & senator has read the entire bill !
Too many bills are unread with last minute “pork” insertions. This is wrong! ! !
I agree with the previous comments. This bill is both too vague, and too long. Practicing physicians don’t have the time to read every page and unfortunately our organizations are not representing our views in Washington. Any deal that allows a public option, especially one preventing patients from switching from one private plan to another without being forced into the ” public option”, is designed to lead to a wholly owned and operated government health system. Patient choice will eventually be extinguished and with only one payor physician incomes can be adjusted at congress’s whim based on budget concerns, constituent lobbying and re-election demographics. Rationing and denial of care will be inevitable. I doubt senior citizens in our country want this kind of over-reaching government control of their lives.
As an incoming medical student, I couldn’t agree more with Dr. Mumma’s comments. I am getting extremely nervous (to the point that I’ve even been watching C-span!) about embarking on an 8-year debt-ridden journey when I have no idea how much this reform, if passed, will affect the future of physicians in this country. I have been reading the articles on Massachusetts’ current health care situation, and they aren’t doing too well from what I can see. In Boston, patients already have to wait almost two months to see a doctor. Why would the rest of the country show a different outcome?
I can attest that I am not alone in having my doubts in entering medicine as a result of this very legislation. I genuinely believe that after this bill becomes law, fewer and fewer college students will be drawn to the field, which only ultimately hurts the health care system as a whole. I have read blogs from physicians in Canada and the UK saying that many of their doctors have moved to the US to practice because in their countries the cost of practicing has become far too financially burdensome. I have no reason other than to believe that this will, too, become the case for physicians here. This is why I’m especially nervous about my future.
And as Dr. Mumma has already pointed out, this legislation can only hurt the current shortage of physicians in this country. Common sense tells us that if someone is entitled to something, they have no reason to NOT utilize it, be it financial assistance, or, in this case, access to a physician. Therefore, we have every reason to believe that more and more of the public will suddenly be knocking on physicians’ doors for care as time ensues, which only leads to the situation already being seen in Massachusetts (and Canada, for that matter).
Bottom line, don’t let the AMA’s sudden (belated) support of this Bill fool you or anyone into thinking that physicians across the country are fully behind HR 3200. I would be hard pressed to believe that this support wasn’t without a lot of behind-the-scenes deal making going on between the AMA and Congress. Three days ago, I read an article saying AMA was against it; only to read this article, published yesterday, saying that they had suddenly changed their minds. What gives?
As long as HR3200 contains a government option, the AMA – of which I am a member – does not speak for me. I’m sure the bill cleverly puts off the day the government plan starts overwhelming all private plans due to its ability to undercut on price – and I’m sure it puts off the day we will all – including the middle class – be paying the large increase in cost of this program. But that day will come if this bill is passed. Has any government run program ever cost anywhere near what the initial estimates were. Don’t we learn anything from history???
Another topic that I have not heard addressed – we are already short on primary care docs. Where do they come from when 50 million new souls suddenly want primary care from those docs? Even adding all the para-medical personnel available, care can not be given to all.
I don’t think most people realize that a doctor is generally close to 30 years old before he or she has finished his or her training – and most are in debt. If they are headed toward just being government employees, how many docs will want to travel that difficult and expensive path?
Health reform is needed, but lets lay out the various plans the congress is passing and give all parties, including the public a chance to understand them. What is the rush? Could it be the administration and congress want to slip something by all of us because they know it would be rejected if understood. I have heard it said that the mistake Hillary Clinton made in trying to pass her health plan was explaining it to the public in advance of passage. And President Obama does not plan on making that mistake!
One final request. I want the members of Congress, the administration and all government employees to take an oath that they will obtain their personal and family health care under whatever plan they may pass. I’m sick of them – both parties – never having to live under their own rules.
John V. Mumma, MD
VERY GENERAL AND VAGUE STATEMENTS THAT LEAVE TOO MANY LOOPHOLES FOR THE GOVERNMENT BUREAUCRATS TO INSERT ANYTHING THEY WANT,UNLESS VERY SPECIFIC,CONCISE AND CLEAR POLICIES ARE INTRODUCED AND IMPLEMENTED.
THIS LEAVES TOO MUCH ROOM FOR CHANGES THAT HAVE FAILED AROUND THE WORLD WHEN TALKING ABOUT “SOCIALIZING A PROFESSION LEAVING THE REST OF “THE BUSINESS” UNTOUCHED AND “BAILED OUT”.
NOT MUCH COMMON SENSE IN ALL OF THESE, EVENTHOUGH WELL INTENDED.
REMEMBER THAT IS NOT THE FIRST TIME, IN MORE THAN 60 YEARS THAT AMA IS ON THE “LIBERAL” SIDE OF THE MEDICAL EQUATION.NOT THE RIGHT APPROACH!!
I HAVE EXPERIENCED THESE SYSTEMS…AMERICA HAS NOT!!!
GOD SAVE US ALL !!
Dr.JOSE G MONSALVEZ