Health reform is coming; let's work for a good outcome

In the many talks I give across the nation to physicians, patients and community leaders, I frequently ask them whether our nation is ready for a health care system revolution. Without hesitation, they answer, "Yes, we are." I agree.

It is human nature to fear change, and also to fear losing what one has now. But a recent worldwide study of physician attitudes revealed that U.S. physicians are by far the unhappiest, compared with physicians in other developed countries. So let's not fear a change in the status quo (about which we're unhappy), or let ideological differences keep us from participating vigorously and enthusiastically in the crafting of a new health care system -- hopefully one that will better serve our patients and give us more joy in our work.

There are a number of efforts going on right now to craft a better system. In those efforts, there are many "unlikely bedfellows" who haven't worked together very often (if at all) and who may not like each other very much. But they are present and participating because all will be affected by the outcome -- none more so than physicians and patients.

Some of you may be overjoyed by the recent election results in your state and in the nation. Some of you may be disheartened and discouraged. We need the help of every one of you, because health care should not be a partisan issue. Approaches will differ, of course, and we must always adhere to the strong ethical principles that sustain our profession.

But it's time now to focus on getting a good outcome, and to that end let me outline a few instances where your AMA has engaged with the Obama transition team, Cabinet nominees, Congress and other key stakeholders on health system reform.

Prior to Thanksgiving, I met with Obama health transition team leader Tom Daschle (nominee for secretary of the U.S. Dept. of Health and Human Services) to outline AMA priorities for health system reform. It was a very positive discussion and established a promising start with the incoming administration.

Former Sen. Daschle has reached out to select stakeholder groups to better understand their views and potential areas of common ground for health system reform. He has a keen grasp of health policy issues and is likely to be the lead Obama administration official on health system reform initiatives.

The AMA also met with Obama transition officials to expand the dialogue with the new administration. The meeting included Board of Trustees Chair Joseph M. Heyman, MD; Chair-elect Rebecca J. Patchin, MD; Senior Vice President for Advocacy Richard Deem; and myself. Attending this meeting was Jeanne Lambrew, PhD, co-author with Daschle of Critical: What We Can Do About the Health-Care Crisis, who will serve as deputy director in the new White House Office of Health Reform.

The AMA advocacy team also has been busy interacting with congressional offices preparing for a major push on health system reform. This includes providing feedback to the staff of Senate Finance Committee Chair Max Baucus (D, Mont.) on his comprehensive white paper on health system reform.

AMA staff continues to participate in a series of stakeholder meetings convened by Sen. Edward Kennedy's (D, Mass.) Health, Education, Labor and Pensions Committee staff. Discussions at these meetings have focused on public/private options for expanding coverage, improving quality and reforming delivery systems.

In addition, the chief of staff for House Ways and Means Committee Chair Pete Stark (D, Calif.) met with the AMA Council on Legislation prior to the Interim Meeting. Subsequently, there have been multiple interactions with his committee staff on health information technology, Medicare physician payment and health system reform issues. Our staff also has sat down with Speaker Nancy Pelosi's (D, Calif.) top health adviser.

The AMA is also a member of the Health Reform Dialogue Group, a diverse group of stakeholders that is attempting to develop a consensus framework for health system reform. This group includes employers, patients and other health organizations. The goal is to reach an agreement on a consensus document that can be shared with the Obama administration and the new Congress early in 2009.

It was a very busy period, both before and after the November 2008 elections. Now there is a new Congress. There is a new administration. It appears that health system change is coming.

Let's embrace the effort and become a major contributor. We want to make sure the outcome is one that is better for patients and allows us to return to serving those patients with the joy and dedication that brought us to medicine in the first place.