TMA: Your Voice on Health System Reform

Dear Colleagues:

"Health system reform" is getting the kind of attention it hasn't seen in this country since Bill Clinton's first days in the White House. And for good reason. Everyone agrees there's no way we have the money or the physician workforce to continue to care for an aging population afflicted with chronic disease brought on by unhealthy lifestyles.

President Obama received a standing ovation from Congress last night when he said, "The cost of health care has weighed down our economy and our conscience long enough. So let there be no doubt, health care reform cannot wait, it must not wait, and it will not wait another year."

I am writing today to tell you that the Texas Medical Association is ready for that. We are engaged and on the job. We have a plan of action that will bring your voices – your hopes and your fears – to the nation's capital. Like no one else can, we will speak out for our patients … and thus for our profession. Many of us will be in Washington early next month to work with our senators, representatives, and Obama administration leaders.

Our goal, as physicians, is to make patient care better. No one else stands for our patients as we do.

We are armed with a set of guiding principles being developed by our Select Committee on National Health System Reform at the direction of the TMA House of Delegates. (The house will debate the final document at its annual meeting in May.) I am directing a new TMA Health System Reform Task Force to use those principles to vet and examine and measure every idea that comes out of Washington. Former American Medical Association President Nancy Dickey, MD, now the vice chancellor for health affairs in the Texas A&M University System, has graciously agreed to chair the Health System Reform Task Force.

Here's what we know so far. The economic stimulus bill passed. It's law. It contains some obviously good things for patients and physicians: more funds for Medicaid and the extension of COBRA benefits.

So much more of it is up in the air. How will it be implemented? What will the $21 billion for health information technology (HIT) mean to small practices in Texas? This is the first time the government has put new money into HIT, but is it enough? Will those systems talk to each other? Will this be an excuse for creating yet another government bureaucracy?

We are actively monitoring all of that and bringing TMA's tremendous resources and expertise to bear. As the details emerge, we'll be here to help shape the outcome and to resist bad public policy, while helping you and your patients get the most out of it.

Many of you have called and written about the $11 billion set aside for "comparative effectiveness research." Don't be mistaken. This research is going to take place. While we have some serious concerns about how the data could be used, we support this research as long as it is led and directed by physicians. Some propaganda mongers peddled an intentionally inflated view of this as a threat. The issues could indeed pose a threat. So let's be at the table and direct how the data is developed, implemented, and utilized so we can ensure that it will help us understand and direct the delivery of care.

Again, we don't know the details. It's still early. But we are part of the debate, and we are holding true to our principles. And one of those principles is the sanctity of the patient-physician relationship and the confidentiality of our patients' medical records. We are committed to protecting the integrity of our relationship with our patients.

I have much more I could write and many more examples I could give. But I'll stop with this final note: At the end of the day, anything that makes patient care better makes our profession better.

I welcome your comments, questions, suggestions, and concerns. Please contact me at president@texmed.org.

Sincerely,

Josie R. Williams, MD
President
Texas Medical Association

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Action Special Issue, Feb. 25, 2009


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