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Physicians Divided on Healthcare Reform

Elyas Bakhtiari, for HealthLeaders Media, August 27, 2009

I didn't realize at the beginning of the summer just how divisive the debate over healthcare reform would ultimately become. As the rhetoric has heated up, it has sharply divided the country, Congress, and even the nation's physicians.

The House healthcare reform bill cleared a major hurdle when it secured the endorsement of the AMA—it is the nation's largest physician group and has been a vocal opponent of healthcare reform efforts (including the creation of Medicare) in the past.

But the AMA's endorsement has drawn a backlash from some physicians who oppose current reform proposals, particularly the public option. The AMA decided that eliminating the thorny Sustainable Growth Rate formula that keeps doctors on the brink of perpetual reimbursement cuts was worth the tradeoff. Not all physicians agree.

A group of 17 state medical societies and specialty groups has publicly dissented from the AMA's position, citing the creation of a public option as its main objection, and a few other physician groups have taken aim at the association as well.

A decent chunk of the difference of opinions between physicians (and everyone else in the debate, for that matter) can probably be attributed to politics and ingrained ideological differences. But beyond politics, there are real questions to be answered:

  • Will reform ultimately help physicians more than it hurts?

  • Will a public option decrease the burden of uncompensated care or pay so poorly that it doesn't matter?

  • How will physicians fare if nothing changes?

These questions are difficult in part because reform won't affect all physicians equally. In thinking about different physician opinions concerning today's reform efforts, I'm reminded of a survey I wrote about last year that measured physician opinion on the more generic prospect of universal healthcare.

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