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Physicians Know We Need Reform

America's physicians favor healthcare reform much more strongly than the general public does. In the wake of the AMA's pledge of support for Congressional reform proposals, a coalition of seven other physician organizations sent a letter backing reform to Senate Majority Leader Harry Reid last week. The medical societies, which included the American Academy of Family Physicians, the American College of Physicians, the American Academy of Pediatrics, and the American Osteopathic Association, said that they represent 450,000 physicians and medical students.

"In the best interest of our patients and this nation, we must pass strong and effective health care reform in 2009," these organizations declared. "Americans need affordable choices, and stable coverage. Not passing health reform will result in continued rising costs, poorer quality of care, and more people uninsured."

In contrast, recent poll results show that the percentage of all Americans who support reform is slipping. In mid-June, according to a Wall Street Journal/NBC News survey, the public was divided down the middle on whether President Obama's reform proposal made sense. In a new poll conducted July 24-27, only 36 percent of respondents supported the plan, while 42 percent said it was a bad idea. The percentage of those with private insurance who disliked the plan rose from 37 percent to 47 percent. A New York Times/CBS News poll yielded similar results.

Although the national cost of the proposal to cover the uninsured is a concern, the central fear of Americans--and especially of those with private coverage--is that under reform, the quality of their own care would decline, while their own costs would rise. People are specifically afraid that their treatment options and their choice of physicians would be limited.

The physician societies, however, expressed the opposite view in their letter: "Some people believe that patients are better off in today's disorganized insurance market. We believe that the health care our patients receive will be better within a reformed system. As physicians and future physicians, we stand in firm support of the patient-centered changes being outlined in Congress. We are confident that the reforms being proposed will allow us to provide better quality care to our patients, while preserving patient choice of plan and doctor."

Note that the physician organizations aren't being specific about which parts of the reform proposals they support and which they don't. Many doctors, for example, are opposed to the idea of a public plan that would pay them at Medicare rates. But they strongly support some kind of reform and are, in effect, warning of dire consequences if reform doesn't pass.

The medical societies involved include most of the country's primary-care physicians, who have a bigger stake in change than do better-rewarded specialists. But they also include many internal-medicine subspecialists, and the AMA represents many surgeons and specialists. So it's fair to say that America's physicians favor reform as a whole--although they may disagree on the details.

Considering how much influence physicians still have with their patients, they have a great opportunity to put Obama's reform campaign over the top. What they need to tell patients is that, even if the system is working for them right now, someday they might be seriously ill, unemployed, and uninsured. So while we need smart health care reform, the status quo is not an option.

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