Rebutting AMA, Doctors Speak Out In Support Of A ‘Robust Public Option’
Rebutting AMA, Doctors Speak Out In Support Of A ‘Robust Public Option’
Responding to the American Medical Association’s recent rejection of a robust public health care plan that uses Medicare prices and Medicare’s leverage to lower health care costs, Matt Yglesias argues that “medical doctors don’t really have a big interest in making health care more efficient“:
After all, what looks like inefficiency to health care wonks looks like “income” to doctors. Defense contractors don’t like procurement reform, and when school systems try to reform their labor practices to better reward quality teaching, teacher’s unions tend to oppose it. Such is life. Incumbent stakeholders don’t like change, but when you have an inefficient system—like health care in the United States—it’s often very helpful to push change that incumbent stakeholders don’t like.
But some doctors have distanced themselves from the AMA’s statements. Doctors For America (DFA) — grassroots organization of doctors in all fifty states — issued a statement and hosted a conference call in support of a robust public option. Unlike the AMA, which has been steadily loosing power and currently represents “maybe 20% of physicians in this country,” DFA is “a grassroots organization” putting forth the views of “thousands of physicians” rather than “a small group of organizers.”
For these doctors, payment reform that prioritizes care quality and patient access to affordable coverage supersedes the issue of provider reimbursement. “What concerns physicians more than are they being paid enough is really what they’re being paid for,” DFA President Vivek Murthy explained:
You know, right now we have a system that rewards volume and procedures and doesn’t necessarily reward quality of care or the time that physicians take to spend with their patients. I think what’s a priority for all physicians—whether they’re a generalist, whether a specialist, whether academic physicians or private physicians—is that we restructure payment in a way that does reward quality and does reward time spent with patients, and that’s the kind of system that we’d be willing to support
Listen:
Indeed, unlike a co-op or some kind of state based arrangement, a robust public option would not only drive down costs but also begin implementing payment system reforms that could help doctors deliver better care to their patients.
6 Responses to “Rebutting AMA, Doctors Speak Out In Support Of A ‘Robust Public Option’”
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After all, what looks like inefficiency to health care wonks looks like “income” to doctors. Defense contractors don’t like procurement reform, and when school systems try to reform their labor practices to better reward quality teaching, teacher’s unions tend to oppose it. Such is life. Incumbent stakeholders don’t like change, but when you have an inefficient system—like health care in the United States—it’s often very helpful to push change that incumbent stakeholders don’t like.
Change? Try applying coherent management theory. Pay people fairly and do everything possible to keep doctors and teachers focused on quality. That means no “pay for performance” for doctors or teachers.
Learn profound knowledge, from the teachings of the world’s quality guru, Dr. W. Edwards Deming.
Ignorance is as ignorance does.
June 12th, 2009 at 5:58 pmRewarding quality kills it. Extrinsic motivators destroy cooperation necessary for improving complex processes. They also kill intrinsic motivators.
Doctors need to learn about quality, what makes it and what suboptimizes it. The Obama plan will suboptimize quality as it claims to improve it.
Obama and Orzag needs to learn about theory of variation, systems, psychology, knowledge and their interactions. His Green Bay talk shows they don’t understand.
June 12th, 2009 at 6:03 pmThis is not a theory, this is people’s lives (to commenters not Matt). What we have now is a national embarrassment. What do you suggest the appropriate ratio of billionaires to uninsured/underinsured would merit trying out public health care?
June 13th, 2009 at 2:19 amFirst and foremost stop the pilfering of Medicare and Medicaid. Put all of those crooks in jail for 20 years, then the systems will start to pay for itself. This is the only logical system for the uninsured.
June 13th, 2009 at 9:35 amProviding quality coverage for the indigent and working poor is not an insurmountable problem.
Tax property at 26 cents on the $100 of value. Gather $$ for eligible care from Medicare and Medicaid.
That system works for Dallas county, which has a huge working poor, un-insured population, and a huge population of immigrants. The system has yielded one of the lowest infant mortality rates in the USA, the best trauma survival rates in the US, and is wildly popular with the county citizens. They vote to fund it every time they get a chance.
June 15th, 2009 at 8:42 amThis is not a theory, this is people’s lives (to commenters not Matt). What we have now is a national embarrassment. What do you suggest the appropriate ratio of billionaires to uninsured/underinsured would merit trying out public health care?
June 15th, 2009 at 12:58 pm