Commentary
Physicians have a front-row seat to the health care system, and we have seen for years that it needs reform. We’ve seen patients who we know how to help, but who can’t get treatment because they are uninsured. We’ve seen our colleagues burn out as they cope with a system that doesn’t reward quality of care and that at times gives too much power to insurance companies.
These changes are what drove President Barack Obama to work with a broad coalition of health care providers, insurance companies, employers, and patients to do what presidents have been trying to do for nearly a century – sign comprehensive health reform into law. Many people told him that the time wasn’t right. But he knew that healthy economies require healthy people and that access to affordable health care was a foundation for a strong middle class.
(Click here for a counterpoint on the 2012 election.)
Dr. Vivek Murthy
While it is not a perfect solution to all that ails our health care system – no law could be – the Affordable Care Act represents a giant step toward a system that works for patients and physicians, which is why it was endorsed by many physician organizations, including the American Academy of Pediatrics, American College of Physicians, American Academy of Family Physicians, and the American Medical Association. Two and a half years after its passage, the law is making a difference for millions of Americans:
• 105 million people no longer have a lifetime cap on their coverage.
• Preventive care is covered without cost sharing.
• 13 million Americans got more than $1 billion in rebates from their insurance companies.
• 3 million more young adults have coverage because they can stay on their parents’ plan until they are 26 years old.
• Up to 17 million children with preexisting conditions can’t be denied coverage.
• Medicare patients are getting free preventive care and discounts on medication as the doughnut hole is closed.
• Medicare overpayments to insurance companies are being eliminated and we are extending the life of the Medicare Trust Fund by 8 years.
• Small businesses are getting tax credits to make health insurance coverage more affordable.
This is also a time of tremendous excitement across the health care system as we move toward new models of delivering and rewarding good care. For decades, we have been saddled with a system that rewarded quantity over quality, a system that didn’t recognize the value of time we spend with patients.
Dr. Kimberlydawn Wisdom
This is precisely why it has been so exciting to see the response to the delivery system reforms in the ACA. All over the country, health care providers are working together to form accountable care organizations, implement bundled payments, and reduce health care–associated infections and preventable readmissions. We have started to see increases in Medicare and Medicaid reimbursements for primary care providers, general surgeons, and mental health providers. And thanks to the Recovery Act, we have made unprecedented investments in electronic health records to make our systems more efficient and safe.
The initial results are promising: We are reducing central line infections and saving lives; we are witnessing superior care coordination across our health care system; and we have seen 3 years of record-low growth in our national health expenditures. While these changes have required hard work, they represent critical steps to move our health care system forward.
President Obama knows that the health care law is a beginning and not an end. He believes we need a permanent fix to the cuts in reimbursement called for by the sustainable growth rate formula. He supports medical malpractice reform. He wants to take the lessons we learn from implementing the health care law and build on them to improve our system further.
Dr. Bob Kocher
The president also recognizes that building a better health care system requires the leadership and partnership of physicians. His administration has worked hard to collaborate with physicians, and this partnership will remain central to his efforts in a second term.
Gov. Mitt Romney (R-Mass.) offers a radically different vision for the future of our health care system. He has pledged to repeal the ACA, which would give insurance companies more control, eliminate efforts to cover 30 million Americans, and weaken the physician work force. He and his running mate, Rep. Paul Ryan (R-Wisc.), stand behind a plan to block grant Medicaid and slash its funding by a third – leaving an additional 14 to 27 million of the most vulnerable Americans uninsured. Their budget could mean drastic cuts for everything from the National Institutes of Health to the National Health Service Corps. They have also pledged to transform Medicare into a voucher program in which guaranteed benefits would be replaced by a voucher people could use to buy private insurance or traditional Medicare. However, with no guarantee that the voucher keeps up with health care costs, their plan would leave people paying thousands of dollars more every year.
President Obama fought for the ACA not because it was good politics – but because it was good for patients and the country. The law isn’t perfect, but it represents a powerful step forward that will help millions of patients.
President Obama knows we can’t afford to go back to a broken health care system and to fight the political battles of the past again. At a time when we’ve started to see progress and when we have so much more to do, we need a president who will work with us and move the country forward. That is precisely what President Obama will do.
Dr. Murthy is an internist at Brigham and Women’s Hospital in Boston. Dr. Wisdom is the senior vice president of Community Health and Equity at Henry Ford Health System in Detroit and the former Surgeon General of Michigan. Dr. Kocher is the former Special Assistant to the President for Healthcare and Economic Policy and is a guest scholar at Brookings Institution in Washington. They are volunteer advisers to Obama/Biden 2012.