The Doctor is Deployed - LLM Publications

Special MessageHealth Care Reformand the OMAMarch 30, 2010Dear Colleague,Peter A. Bernardo, MDImmediate Past President,Oregon Medical AssociationThe OregonMedicalAssociationis a decidedlynon-partisanorganization.We have to be.“Health care reform” has been a major local and national issue over the last threeyears. The Oregon Medical Association has been deeply involved in the discussion.The OMA has not supported any one proposal or bill. Rather, we have supported keyprinciples including health insurance coverage for all Americans, supported broadly bysociety in a fiscally sound manner. We have pushed hard for resolution of the Medicaregeographic disparities and correction of the SGR formula, as well as increased Medicaidreimbursement for all physicians.Covering the uninsured is important, but 35% of Oregon citizens already have difficultyaccessing care in spite of having government-sponsored insurance. The OMA hashighlighted the physician shortage in Oregon. Inadequate insurance coverage will notguarantee patients timely access to care, especially if we do not have enough doctorsto provide the care. And finally, we have talked extensively about the costs of defensivemedicine and the need for medical liability reform.The OMA has had plenty of opportunity to bring these principles to our politicalleaders. The state of Oregon has been working on many of the same issues that havebeen discussed in the national forum. The Oregon Health Fund Board, formed as aresult of 2007 legislation, developed a plan for insuring all Oregonians. That plan cameto the 2009 Legislature as HB2009. The formation of the Oregon Health Authority, thetaxes on hospitals and insurers, and the expansion of the Oregon Health Plan coveragefor children and the working poor are all a direct outgrowth of health care reform activityin Oregon.At the national level, we have had close interaction with our delegation. SenatorWyden has been working on national health reform legislation for over four years. Weconsistently partnered with him, providing input, particularly on workforce issues. OurFederal Delegation has been well educated by the OMA on the Oregon health caresystem. OMA leadership even met with each of them in Washington, D.C., the weekbefore the final health care vote.Our message nationally has been clear: reform must be fiscally prudent, broadlysupported by all of society, and must not disadvantage Oregonians. In particular, theMedicare reimbursement system must be fixed, and Medicaid cannot be expandedwithout infusion of additional federal dollars.There is no comprehensive fix of the Medicare system in the current legislation, though itdoes address one of our most important priorities, the fixing of the geographic paymentdisparities. We were working with our Congressional delegation to secure this importantprovision up until the day of the vote. As to the larger problem of the sustainable growthrate, there is no certainty of change. Most distressing, there is no substantive liabilityreform, only support for projects to test solutions.6 • Medicine in Oregon