First, do no harm. In the practice of medicine, that's the prime directive physicians are charged to live by. But it truly applies to all healthcare providers and certainly administrators. Everyone has a stake in the mission.
That also must apply to members of Congress, and even more so for our physician lawmakers, who have unique insight into the healthcare apparatus from many sides of the operation and have the opportunity to bring those experiences to bear in their decisionmaking.
This week's cover story puts these physician politicians in the spotlight—17 House members and three senators in all. More than a dozen of them agreed to share their views on how having a clinician background impacts the way they serve, their opinions on the healthcare reform law and some top legislative priorities.
What's immediately clear from statements by several of the Republican representatives is how little the rhetorical tone seems to have changed since last month's election. Regarding the Patient Protection and Affordable Care Act, they apparently believe that members of Congress who voted to enact the law are guilty of legislative malpractice, since based on some of their responses, the continued rollout of the ACA will bring only more harm to the nation.
Listen to the words of Rep. Tom Price (R-Ga.), an orthopedic surgeon who has been in Congress since 2004: “The Obama administration will continue to implement the president's healthcare law by imposing spending we cannot afford, tax increases and bureaucratic boards that will effectively deny care. The law will collapse from its own weight—though many people will be harmed before that happens.”
His sentiments are echoed by a fellow Republican from Georgia, Rep. Paul Broun, a general practitioner who first won his seat in 2007. “Obamacare was designed to fail. It's going to fail. It's a question of how quickly that will happen. … Hopefully, we can repeal and replace it with something that makes sense.”
On that issue, post-election, it's safe to say that the repeal-and-replace movement has an extremely weak pulse. It's time to move on.
Another common theme among the GOP doc lawmakers is the fervent belief in the saving power of medical liability reforms targeting “frivolous lawsuits” and “the practice of defensive medicine that costs billions of dollars annually,” according to two of the lawmakers.
Rep. Phil Roe (R-Tenn.), an OB/GYN who has served in the House since 2008, says that under current law, “too much money goes to trial lawyers and too little goes to injured patients.” He cites legal system reforms in his state, saying “that with reforms we can compensate injured patients and also lower malpractice premiums, which drive up the cost of care.”
The jury is still out on the ability of such reforms to drive down healthcare spending. Looking at the experience in Texas, often touted as a model for tort reform, a study published in June by researchers including a professor from the University of Texas, found no dip in Medicare expenditures after a 2003 state constitutional amendment began limiting payouts in malpractice suits. Previous studies have delivered similar findings.
Public opinion on healthcare policy, especially the Affordable Care Act, continues to be divided, but according to findings of the Kaiser Health Tracking Poll taken immediately after the election, healthcare placed third among issues of top importance to voters. The poll also showed a record low 33% of respondents now support full repeal of the ACA.
Plenty of healthcare issues will need the full attention of Congress, especially Medicare and Medicaid funding. Physician payment policy is another sticky problem in need of a long-term fix. These are the areas where America can truly benefit from having some doctors in the House.
David May, Assistant Managing Editor/Features