The voters speak -- health care is their top concern

AMA Leader Commentary. By D. Ted Lewers, MD, chair of the AMA Board of Trustees. Sept. 4, 2000.

AMA LEADER COMMENTARY

A few words about current events in medical practice

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A message to all physicians from D. Ted Lewers, MD, chair of the AMA Board of Trustees.

I recently picked up a copy of the Washington Post and was very pleased to see the results of a national poll that confirmed what you and your patients have been telling us all year:

That health care is the No. 1 issue on the minds of voters going into the November elections.

More than the economy, education or crime, the critical need to improve our health care system is the defining issue of the 2000 campaign.

Of course, this is the message we've been delivering to both the press corps and Congress through our National House Call program -- calling for a meaningful patients' bill of rights, health care coverage for all Americans and true Medicare reform.

Americans agree. In the Post poll, health care came out as "most important" among all issues. Sponsored by that newspaper, Harvard University and the Henry J. Kaiser Family Foundation, the poll indicated:

Of registered voters polled, 52% said health care or Medicare was an important issue in their presidential vote. AMA's National House Call has been claiming that fact since it was launched in December 1999.
Of all eligible voters, 44% rated health care the top issue, surpassing such traditional gut-level issues as the economy, crime, jobs, the budget and even education. Again, we've been telling the candidates, the media and the American voter just that.
Some form of a patients' bill of rights is supported by 81% of registered voters. We can only wonder why the U.S. Senate refuses to agree with the House of Representatives on the Norwood-Dingell bill.
Of registered voters polled, 93% said they believe helping families with the cost of care for elderly or disabled family members was very important or somewhat important. The AMA has advocated significant Medicare reform -- and will continue to do so -- to accomplish just that.

The Harris poll earlier in the summer found that 50% of Americans believe the health care system is getting worse. One in four Americans said "a lot worse." And 63% said they thought HMOs, PPOs and other managed care plans were becoming less responsive to them as customers. Asked if managed care plans would contain health care costs, 53% said no.

In short, the massive tide of public opinion is running -- and it's running in the direction to which the AMA has pointed for as long as I can remember.

That is why it is absolutely imperative that we push hard in these days and weeks before Congress adjourns.

That is why the AMA National House Call continues operating in key states.

That is why the AMA's 10-second message flashed every five minutes for 19 hours a day on a 32-TV-screen billboard at the Republican National Convention, saying, "Senate GOP: Pass a REAL patients' bill of rights."

That is why these days before adjournment, you should talk with your patients and write or e-mail your senator or representatives and all the candidates.

Maintain the pressure. Push hard for meaningful rights for our patients. Push hard for meaningful reform of the antitrust statutes to give physicians an equal footing with their taskmasters in negotiating fees, not to line our pockets but to ensure that there are physicians available when any American needs care.

We need to continue to have our voices heard -- at the grassroots level, in the halls of Congress, in the media.

American voters don't want radical surgery. They want improvement. The July poll "found little appetite for major government reforms and diminishing levels of dissatisfaction with the health care system."

And that, too, equates with the AMA positions over the years: adjustment not abandonment, evolution not revolution and, above all, action not analysis paralysis.

Even the most amateur political scientist knows the American voter is slow to anger and unstoppable when committed to a course of action.

It is clear the American voter is fed up with high-handed bureaucrats -- either in Washington or in an insurance company office. It is equally clear that candidates in this election year ignore the American voter at their peril.

I have said on many occasions that, should a meaningful patients' bill of rights fail to pass in the 106th Congress, we'll be back in the thick of the fight in the 107th. I have said, too, that what we seek is manifestly obvious -- the well-being of our patients.

Seldom in the history of political advocacy has any organization approached the government with less selfish interest.

To the extent our requests represent any interest, it is our patients' interest. To the extent our requests benefit physicians, it is a secondary benefit.

Way back in 1952, the former president of General Motors and later secretary of defense, Charles E. Wilson, said, "What is good for the country is good for General Motors, and what's good for General Motors is good for the country."

Critics howled and pundits wrung their hands. The sentences became a verbal symbol of corporate greed.

But, understood in its most fundamental meaning, the expression is one of obvious truth. The nation prospers because its citizens prosper. And its corporate citizens are no different from other law-abiding citizens, even when it comes to paying taxes and obeying sometimes uncomfortable laws and regulations.

I'm not ready to say that what's good for the AMA is good for the country. I am ready to say that what's good for the country is good for the AMA.

Right now, what's good for the country is good for its elected officials -- and its would-be elected officials.

To listen to the voice of the voter.

To get it right when it comes to health care.

Tell me what you think. E-mail me.

Dr. Lewers of Easton, Md., a nephrologist and internist, was AMA board chair during 2000-01.