Member of the Month

  • Steven_Kramer_MoM.jpg
    Steven Kramer, MD
    Chief Resident
    O'Connor Family Medicine Residency Program (San Jose)

Health Care Reform


On March 21, 2010, history was made when the US House of Representatives passed the Patient Protection and Affordable Care Act (HR 3590).  Among other measures, the bill would: expand health coverage to 32 million uninsured, increase primary care payment, improve access to preventive care and implement patient protections against insurance company policy cancellations. The US House of Representatives has prepared a timeline of when the bill's wide-ranging provisions will be implemented.

CAFP President Tom Bent, MD was among 11 health care leaders quoted regarding health care reform in the March 23 edition of Health Leaders. Read these comments here.

AAFP launched it's Health Care Reform 2010 page, where members can find all the information they will need to understand how health reform will effect them, their practices and their patients.

You can also view a one-page document that the AAFP Contact Center staff is sending to members who contact the Academy with general questions about the legislation that was signed in to law. The document is a quick summary of the Patient Protection and Affordable Care Act - what it does for physicians and patients - and areas that we are still working to address.

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The Academy worked hard to ensure that the voice of family medicine was heard loud and clear during the health care debate. The CAFP Board of Directors voted to endorse HR 3962, one version of the health care reform bill. The American Academy of Family Physicians (AAFP) and the American Medical Association (AMA) also endorsed this approach. 

Meanwhile, the Senate approved HR 3590 on December 24th. A series of parliamentary procedures were undertaken to reconcile the House and Senate approaches.

Along with the Council of Academic Family Medicine, AAFP wrote to House and Senate leaders outlining priorities for the final health care reform package. These recommendations included: improvements to a residency slot reallocation plan; expansion of medical home demonstrations to all patients rather than limited patient populations; and payment issues related the Sustainable Growth Rate formula and bonuses for primary care.  

Resources


Terry Schroeder - 27 Aug 2009

Physicians Health Insurance Reform

Submitted by Terry Schroeder on Thu, 08/27/2009 - 01:00.
1) Why not support HSAs, give tax credits to people who purchase health insurance, and allow individuals to purchase healthcare insurance across state lines in order to increase competion? 2)No governmental program has ever lowered the cost of any provided services. Why should Americans entrust 17% of the private GDP to governmental bureaucrats known for runaway spending?
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Robert Bourne - 27 Aug 2009

HSA's and "government programs"

Submitted by Robert Bourne on Thu, 08/27/2009 - 07:34.
HSAs are not precluded as the bill is written now, but they’re not mandated either. CAFP has given support to HSAs in the past as one way of helping keep down the cost of care. One well known government program, Medicare, has very low administrative expense – lower than ANY privately run health plan – so it can be done.
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Samantha Malm, MD - 17 Aug 2009

HR 3200

Submitted by Samantha Malm, MD on Mon, 08/17/2009 - 09:40.
I read an excellent summary of HR 3200. It's not a quick read, but given this opportunity for significant reform, I think it's imporant that we educate ourselves about what is really in the bill- not just what the media, or even the AAFP/CAFP think about it. The webpage is http://www.kff.org/healthreform/upload/healthreform_tri_full.pdf. My biggest concern is that, although HR3200 will expand coverage, it won't necessarily provide medical care for all. In order to do that, they need to do something to insure that physicians will participate in the government plan. Take one look at MediCal and you can see the problem. Sure, the poor have insurance, but how many physicians are willing to see them? Not many. As for the notion that the option of a government plan will destroy the current insurance industry, there will always be a market for the rich who want their coronary calcium scans and other cutting edge procedures that actually drive up the cost of medicine.
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Carla Kakutani MD - 18 Aug 2009

HR 3200 safeguards

Submitted by Carla Kakutani MD on Tue, 08/18/2009 - 08:51.
One key point about the "public option", if it comes to pass, is that there is no mandatory participation for physicians, just like there is no mandatory participation in Medicare, Medical, Cigna, Healthnet etc. So like those other programs, where the program sets its reimbursement will determine if it can muster a reasonable panel of doctors to participate. All the insurance options for patients to choose from will be competing on price and service for patients, and on rates and service for physician participation. In places where the insurance options have dwindled down to 1 or 2 choices, the public option might potentially be a step up for physicians. No mandatory participation was a key element for AAFP in deciding to support the bill. PS Thanks for the excellent link. I also use kaiserhealthnews.org as a good clearinghouse of information. Carla Kakutani AAFP Commission on Governmental Advocacy
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Steve Green - 15 Aug 2009

HR 3200

Submitted by Steve Green on Sat, 08/15/2009 - 03:59.

CAFP sent out an all-member email yesterday in the hope that providing some facts about HR3200, the main health care reform legislation moving through Congress, along with the rationale for CAFP’s and AAFP’s support of the bill, would help educate our members so they could educate their patients, allaying fears that have developed because of misinformation being spread by opponents. I am surprised to read some of the comments in response to the email because some re-state some of the very untruths about the legislation we were trying to dispel! Members have the right to disagree with this approach to health care reform. But, it ISN’T socialized medicine OR single payer; it DOESN’T force physicians or patients to participate in a public option plan (if such a plan is ultimately adopted); it DOESN’T dismantle the health care system as we know it. Tort reform was not a consideration in the Board’s decision because California enjoys the best professional liability protections in the country at this time.

 

Steve Green, MD 

CAFP Board of Directors

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Michelle Quiogue, MD - 14 Aug 2009

HR3200

Submitted by Michelle Quiogue, MD on Fri, 08/14/2009 - 23:06.
Although my day to day practice will remain the same and this bill falls short of dismantling the current health care system, it makes perfect sense for the CAFP to support HR3200 because of the important steps this bill takes the country towards improving access to primary care for the group of patients who are currently left completely out of the insurance system. Making sure every American can afford insurance will increase preventive services and improve chronic care management. Evidence and experience show that when a pt does not have insurance, they delay care. Those patients who are currently ineligible for insurance because of preexisting conditions or because they are self employed entrepreneurs who cannot afford the premiums of comprehensive private insurance plans or because their income is too high to qualify for Medicaid, these patients will finally have a chance to get into a patient centered medical home.
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Randall Winslow - 14 Aug 2009

HR 3200

Submitted by Randall Winslow on Fri, 08/14/2009 - 05:51.
I am very dissapointed that CAFP has chosen to support this bill. It is fatally flawed and would be disasterous to health care in this country. Rather than addressing, and trying to fix, the problems in our health care system, it will completely dismantle it. I can not support this legislation and I can now no longer support the CAFP.
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Jim - 20 Aug 2009

hr 3200

Submitted by Jim on Thu, 08/20/2009 - 06:22.
randall, i think it is personally reasonable to have debate about such an important issue as hr 3200. but i would encourage you not to give up on cafp so quickly. surely it deserves your support, even if you disagree on this one political issue. we as a country, and within smaller groupings such as cafp, need to get along without being entirely rigid and dogmatic in our thinking. by all means work in a civil way against hr 3200 if you think that's the right thing, but stay in touch with cafp.
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Seth - 25 Jun 2010

I agree with Jim

Submitted by Seth on Fri, 06/25/2010 - 06:34.
The cafp might not be quite as bad as you are thinking. There are going to changes that still need to be made. This is the case with all of the various Medical Insurance reforms. I'm not inclined to believe we won't have the ability to still make some changes to these large-scale reforms moving forward.
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