OPINIONShifting our paradigm (I hate that word!)AMA Leader Commentary. By Richard F. Corlin, MD March 18, 2002. A message to all physicians from AMA President Richard F. Corlin, MD. I spoke recently at a Labor and Management meeting in Florida to an audience of administrators, trustees and directors from health and welfare funds. These funds purchase the services of preferred provider organizations and other forms of managed care. I was very impressed with how much their groups understood about the problems that are associated with managed care, and how seriously they take what they hear from their members and employees. We would agree with almost everything said at this meeting. This type of audience, however, needs to be made aware of physician concerns about a wide range of issues -- from Health Insurance Portability and Accountability Act to violation of prompt payment laws to tort reform. The group in Florida really sat up and took notice when I told them that doctors and hospitals don't pay malpractice premiums. All we really do is take the money straight from the employers, employees or union trust funds and pass it along to the liability insurers. It's really those employers and trust funds that bear the brunt of these costs. We need to meet with this type of audience regularly so that we can impress upon them that they have an oar in the water when it comes to tort reform -- and get them to join this fight. We need to do the same thing with patients, who are increasingly affected by the skyrocketing costs of professional liability insurance. Our nation's health care delivery system is made up of three groups: The payers, the intermediaries and the providers (another word that I hate). The payers are those who pay the premiums, not those who pay the claims. The intermediaries are just that, functionaries who do nothing more than collect the premiums and pay the claims. The providers are all of us who deliver the care.
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