Will we have a bipartisan health solution? (Does a chicken have lips?) Senate Democrats met with President Obama at the White House before they headed home to continue discussions of health care reform. The President is still strongly urging a bipartisan bill, but apparently he acknowledges that may not happen. The only chance for bipartisanship left seems to rest in the secretive deliberations of the 'gang of six' Senate Finance Committee leaders, mainly driven by Sens. Max Baucus and Chuck Grassley. As if to illustrate Obama’s point that we may not get a bipartisan solution, members of the Republican camp are planning to redouble their efforts at ad campaigns and angry outbreaks at all meetings on reform to discourage the plans designed by the Democrats.

HHS Secretary Kathleen Sebelius has begun visibly helping the president to promote his agenda. Sebelius held a Webcast Friday (see ACC's live "tweeting" for more coverage) to discuss how health reform will benefit all Americans and to announce the release of a series of new state-by-state reports on the topic. "These reports show how health insurance reform will help Americans save money, get better care, strengthen their insurance if they already have it, and afford insurance if they don't," said Sebelius. "Every American will benefit when we pass health insurance reform.” She's also pushing the bipartisan nature of health reform -- the status quo brings both parties to their knees economically. But the proposed solutions do get very party line oriented, especially still over how to pay for reform, and over the "public option."

Sen. Kent Conrad (D-N.D.) in an apparent effort to avert the demise of the entire proposal based on one element of the plan, signaled before leaving for home that reform legislation should include health care co-ops rather than a government-run single-payer system (a.k.a. public option). In a USA Today op-ed, Conrad says his plan “opens the door to getting the votes we need to pass health reform that reins in skyrocketing health cost growth, expands coverage and improves quality.” The House Dems aren’t buying it yet though.

There still has not been enough talk about delivery system and payment reform, and no one in the Senate seems committed to paying for eliminating the SGRrrr, as the House bill heroically does. The AMA is right to push that aspect of the House bill -- that SGR albatross needs to be lifted from our necks, not simply dragged down the road for two years to the next payment crisis.

House of Medicine Food Fights
But, the food fights and party line divides are NOT just in Congress. It’s beginning to get frustrating in terms of the self-centered splits among physicians and specialties, weakening our message and making it very tough to have a physician presence at the table. ACP, despite representing cardiology, oncology and many other specialties, has supported the Medicare Rule as it is, undermining specialists! How unfortunate -- it provides only a token increase for primary care. We need a bigger primary care solution as part of the access expansion! Then some surgery and ER groups are bad mouthing the medical home concept. Divisiveness will only hurt the profession. The ACC needs to get our specialty colleagues together right after Labor Day to bring us all back to a more sane and unified position on payment and delivery reform. The AMA may want to help with that, and the larger states could also be involved.

We need to get focused on what’s right for patients first. There should be a consensus there; and then we can work on how to seek compromises that do not undermine the profession’s necessary and important role in this process.

< Back to Listings