Responding to the American Medical Association’s recent rejection of a robust public health care plan that uses Medicare prices and Medicare’s leverage to lower health care costs, Matt Yglesias argues that “medical doctors don’t really have a big interest in making health care more efficient”:
After all, what looks like inefficiency to health care wonks looks like “income” to doctors. Defense contractors don’t like procurement reform, and when school systems try to reform their labor practices to better reward quality teaching, teacher’s unions tend to oppose it. Such is life. Incumbent stakeholders don’t like change, but when you have an inefficient system — like health care in the United States — it’s often very helpful to push change that incumbent stakeholders don’t like.
But some doctors have distanced themselves from the AMA’s statements. Doctors For America (DFA) — grassroots organization of doctors in all fifty states — issued a statement and hosted a conference call in support of a robust public option. Unlike the AMA, which has been steadily loosing power and currently represents “maybe 20% of physicians in this country,” DFA is “a grassroots organization” putting forth the views of “thousands of physicians” rather than “a small group of organizers.”
For these doctors, payment reform that prioritizes care quality and patient access to affordable coverage supersedes the issue of provider reimbursement. “What concerns physicians more than are they being paid enough is really what they’re being paid for,” DFA President Vivek Murthy explained:
You know, right now we have a system that rewards volume and procedures and doesn’t necessarily reward quality of care or the time that physicians take to spend with their patients. I think what’s a priority for all physicians — whether they’re a generalist, whether a specialist, whether academic physicians or private physicians — is that we restructure payment in a way that does reward quality and does reward time spent with patients, and that’s the kind of system that we’d be willing to support
Indeed, unlike a co-op or some kind of state based arrangement, a robust public option would not only drive down costs but also begin implementing payment system reforms that could help doctors deliver better care to their patients.