The ACP Advocate Blog
by Bob Doherty
Wednesday, April 22, 2009
Democrats and Republicans don't seem to agree on much ... except primary care
Yesterday, the Senate Finance Committee convened a roundtable to get ideas on improving the health care delivery system. Senator Max Baucus (D-MT), restated his commitment to getting a bill through his committee by June to reform health care delivery and provide affordable coverage to all Americans. Senator Charles Grassley (R-IO), the committee's ranking minority member, expressed his commitment to working with Senator Baucus to achieve bipartisan health reforms.
The hope though that Republicans and Democrats will be able to agree on a bipartisan bill was called into question, when the committee took a break from the roundtable to vote on the nomination of Kathleen Sebelius as secretary of the Department of Health and Human Services. Every Democrat on the committee voted to recommend that the full Senate confirm Governor Sebelius, but all but two Republicans voted no. The only GOP "yes" votes were from Senator Pat Roberts, who supported his home state nominee, and Senator Olympia Snowe (R-ME). Senator minority whip Jon Kyle (R-Arizona) said he opposed Sebelius' nomination because she wouldn't commit to prohibiting the use of comparative effectiveness research in making Medicare coverage decisions.
Now, for the good news: Republicans and Democrats alike sang the praises of primary care and their shared commitment to federal policies to recognize and support the value of primary care. One way to tell what was on the Senators' minds is to go to the C-SPAN video library archive of yesterday's roundtable, click on "watch" and then the "search text" feature, insert primary care into the search window, and see how often it popped up in the Senators' remarks and the comments from the invited experts. You can use this feature to listen to, or read, the transcript of the roundtable and the specific discussion of primary care.
One of the invited experts was ACP's own Chief Executive Officer (CEO) and Executive Vice President. Dr. Tooker was the only representative of a physician membership organization invited to participate in the roundtable, an indication of the high regard that Senator Baucus and Senator Grassely have for Dr. Tooker and ACP.
Dr. Tooker was specifically asked to by Senators Snowe and Orrin Hatch (R-UT) to address the crisis in primary care and potential solutions. Click on this link to listen to or read the transcript of Dr. Tooker's response to Senator Snowe. Dr. Tooker made several key points on ACP's behalf, including the demonstrated value of primary care in improving outcomes and reducing costs and the need for comprehensive reforms - including a national workforce policy and reforms of physician payment systems - to increase the numbers of primary care physicians in the United States. (Click on this to read ACP's written statement for the record, the opening remarks of Senators Baucus and Grassley, and the testimony of the other invited witnesses.)
It is highly encouraging that national policymakers "get it" when it comes to the critical role of general internal medicine and other primary care physician specialties in creating a better performing health care system. Republicans and Democrats have deep disagreements on issues ranging from comparative effectiveness research to offering the public the choice of enrolling in a Medicare-like public plan, but not on the need to have more primary care physicians in their communities.
It is also encouraging to note the enormous credibility that ACP has earned by the quality of our policy analyses and recommendations. No other organization is in as good a place as ACP to influence the health reform to help ensure that it meets the needs of internists and their patients. I wonder though how much more effective we could be if every internist belonged to the ACP.
Today's questions: Do you think Congress will deliver on the bipartisan support for primary care? And how can ACP get the word out to ACP members and non-members alike on how well regarded and well-positioned the College is to influence health reform to create a better future for internists and their patients?
About the Author
Bob Doherty is Senior Vice President, American College of Physicians Government Affairs and Public Policy; Author of the ACP Advocate Blog
Email Bob Doherty: TheACPAdvocateblog@acponline.org.Follow @BobDohertyACP
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