Public confidence, support growing for AMA positions

In recent weeks, I've had the opportunity to meet not only with large numbers of physicians, but with journalists and local business leaders. In all these meetings, I've noticed a growing awareness of AMA's leadership role on health care issues and an appreciation for our position.

I have carried the AMA message of concern about the limited access to care our senior citizens face should Congress allow Medicare physician payments to be cut by 5% next year. News organizations listen and report sympathetically what we have to say. Many were unaware of the issue but, when told about it, share our concern.

And they do something about it, printing our side of the story and finding little to oppose us other than the inertia of Congress, the unwillingness of our elected officials to act.

The press and public are just as interested in other health care issues and anxious to learn our positions. In one interview, the editor wanted to know our ideas about attracting more medical students into primary care, and into serving rural and inner-city America.

And the press also wants to know about our ideas for helping 47 million Americans without health care insurance. When I point out that many uninsured actually can afford insurance and should be required to buy it, the editors agree. And they concur with the point of view that those who need help should get help for basic services, but that we need not tax people to pay for those who can afford to pay themselves.

Slowly but surely, we are closing the information gaps, alerting the nation to the impending shortages of physicians available to see new Medicare patients and rallying support for solutions to the problems of the uninsured.

Change happens slowly, but momentum seems to be growing on our behalf.

Not only is there a growing concern in the public for the inactivity in Washington, there is a growing outrage when one health insurance executive can drain $1.2 billion in stock options out of the economic system.

Public inaction and private misdeeds serve only to support the credibility and authenticity of the voice of medicine.

Will Congress listen and act responsibly? At this writing, there is no way to predict.

But the physicians of America are acting responsibly -- as they always have -- and America is paying attention.

Will health insurers be policed more closely and obscene profits become a thing of the past? Again, the jury is out. Literally. But the physicians of America continue to earn and enjoy a reputation for integrity, honesty and putting the patient first.

No physician I've talked to wants to see fewer Medicare patients. No physician I've talked to wants to deny care to anyone for any lack of insurance. That our elected officials can and should take steps to help us goes without saying.

The truth is, politicians have promised what they cannot deliver and are looking around for someone to blame.

In all too many cases, blame is falling on innocent physicians and the 20% to 22% of the health care dollar spent on physician services. Meanwhile, others are receiving increasing payments as doctors are paid, in constant dollars, what they were paid in the early 1990s.

Fortunately, when we tell the media and the public what the facts are, their common-sense reaction is to agree with us and support us.

All of which reinforces the responsibility the AMA has to be the best, most vocal, most logical voice for medicine in leading America back to reasonable, rational payment systems and a health care system that truly serves -- not physicians and certainly not politicians -- but the patients of America.

So long as that remains our primary concern, we will not fail.