A step forward for health care, thanks to Supreme Court

A message to all physicians from AMA President Jeremy A. Lazarus, MD.

By — Posted July 30, 2012.

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Validation of the health system reform law’s individual mandate and confirmation that 21st-century health problems will be addressed with 21st-century care. These were the big takeaways from the Supreme Court’s recent decision upholding the Affordable Care Act.

Because millions of Americans now will be able to get the health insurance coverage and care they need, the AMA was pleased with the decision.

But important and historic as it is, the Supreme Court decision is only another step in the right direction. And before we’re finished, there will be many more steps. Achieving true reform will be a long process, far more like a marathon than a sprint. And it is going to take both time and great effort to truly transform our present health system.

The recent Supreme Court decision has given us all confidence to plan for the future — but it didn’t get us there. That is why the AMA’s three-part strategic direction is so important. So in the days, months and years ahead, physicians will have the tools, information and resources to be successful and care for patients in the best way they know how.

AMA efforts already have played a considerable role in bringing us to this point. As I read the Supreme Court decision, I realized once again how many parts of the legislation cover subjects that first surfaced in long-ago House of Delegates debates. It also was gratifying to know that throughout, the law has been modified many times — for the better —— as a result of AMA efforts to protect patients and physicians.

Over the years, the AMA has pushed for many things that have become parts of the new law. Things like the administrative simplification that will eliminate billions of dollars in unnecessary costs. Things like increasing Medicaid payments for primary care physicians, removal of Medicare/Medicaid enrollment fees and physician representation on health insurance exchanges. And more flexibility in graduate medical education, a reform we long sought.

Today, the AMA’s new strategic direction has positioned us well to offer leadership as new provisions of the health law are being implemented. The three-part strategy is focused on:

  • Improving health outcomes.
  • Accelerating change in medical education.
  • Enhancing physician satisfaction and practice sustainability by shaping delivery and payment reform.

All of these are key to reforming our health system.

Already the rich portfolio of the AMA-convened Physician Consortium for Performance Improvement performance measures, which span 46 clinical areas and care coordination, are being used in health plans and voluntary physician reporting programs. And many of those measures are now the basis for “next-step” research on clinical and patient-reported outcomes.

In concert with the AMA Council on Medical Education and our sections on medical schools, medical students, and residents and fellows, we are working with medical schools and health care delivery systems to reshape physician education in the U.S. Our aim is to accelerate needed changes in medical education that would close the growing gap between current education standards for students and residents and those skills needed to make medical education more relevant to the environment in which the medical students are going to be practicing. This includes providing more emphasis on outcomes, team-based practice and coming changes in the structure and financing of health care.

In recent months, the AMA played an important role in securing access to startup funds and the removal of legal barriers so that physicians more easily can assume leadership roles in accountable care organizations. And today, as other new practice models are being developed, the AMA is working in research partnerships to assess and identify those models that provide both high-quality patient care and physician satisfaction. There is growing recognition of the connection between the two.

Many of you know that I spend a lot of my free time in running shoes. Running is big in my life, and I know that the long important races like marathons demand a lot of upfront time planning and training. Like running a marathon, reforming our entire health system is not something that we should expect to happen instantly. But we have begun.

Today, thanks to the Supreme Court’s ratification of the Affordable Care Act, we can seriously strategize about wellness programs and preventive screenings for people who heretofore could not afford to see a doctor. As a psychiatrist, I now can be assured of better mental health opportunities for patients who need them, because starting in 2014, all health insurance plans will have to cover a set of comprehensive services which include mental health. And with the increasing variety of options open to physicians, we can consider what sort of working environment will be the most comfortable and offer the most personal and professional satisfaction.

And as we have been in the past, the AMA is well positioned to help shape the changes that are coming.

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