Throughout the health care debate, the GOP relied on the doctors in their caucus to deliver the Republican talking points on reform. Rep. Tom Price (R-GA), Sen. Tom Coburn (R-OK) and John Barrasso (R-WY) became the party’s most prominent spokespeople against health care legislation, regularly referencing their medical credentials to pad their arguments. Coburn and Barrasso even hosted a twice-weekly internet doctors show to explain how reform would undermine patient care.
It’s unclear, however, how this strategy paid off. The rhetoric of Coburn, Barasso and Price was so extreme and contrasted so sharply with the tone of their professional organizations, it may have undermined the GOP effort. Consider, for instance, today’s appearance by Price on ABC’s Top Line:
PRICE: It will be destructive to the privately paying physicians. The doctors that you and I and virtually every American across this land sees for their routine challenges, for the specialty care that they receive, it will be destructive to the relationship to patients and the families of those doctors because the patient will not know any longer whether the doctor is doing what he or she believes is in the best interest of the patient or whether they’re doing what the government is telling them to do.
Listening to this, one wonders how long it took Price to memorize these arguments, because it’s hard to believe that he actually believes any of them. If you get the one bit of substance out of the way — the charge that the government will be making treatment decisions (which, as I’ve pointed out, is a gross interpretation of the provisions about comparative effectiveness) — his claims fall under the weight of their sensationalism. They’re also contradicted by almost every other group in the medical community.
The AMA, for instance, supports the bill for its expansion of coverage, new regulation of insurers and affordability measures. Doctors back the increase in payments to primary care providers under Medicaid, the loan forgiveness programs for primary care physicians who practice in undeserved areas and the increases in funding for the National Health Service Corp. They may be disappointed that the SGR fix isn’t part in the legislation or argue for stronger tort reform provisions, but they’re certainly not reading conspiracy theories about comparative effectiveness research or turning their backs to the significant access expansions.
This morning, Doctors for America — a group of over 16,000 physicians — held a march on Washington, calling on the Senate to finish the job and pass the reconciliation package. The event began with a kickoff and rally in Freedom Plaza and continued with a white coat and scrubs march to the White House. The doctors argued that the Senate bill, along with the reconciliation package, provided an important foundation to reforming the existing health care system and stressed the important role physicians can play in the process. “I think we are doing is we are re-making the fabric of our profession and we are doing it conversation by conversation, meeting by meeting, letter to the editor by letter to the editor,” Dr. Vivek Murthy, the groups’ founder, said. “I believe what we have done over these last few years, is usher in a new generation of practitioners…that is defined by spirit and vision.”
Indeed, we can only hope that future reforms will be informed by physicians who are doctors first and partisans second. Republican doctors have bombarded the health care debate, and it’s time for the “new generation of practitioners” to have their voices heard.
We as a nation—and in particular those of us in medicine—now have work to do to defend and deliver on this promise and to address the legitimate concerns about costs while making health care better for everyone. But that is the remarkable thing. We have finally been given the work to do.