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Monday, Aug. 10, 2009

AMA's aim is care for everyone

UK PHYSICIAN TO GUIDE GROUP'S QUEST FOR REFORM

Although her official term as chair of the American Medical Association's Board of Trustees doesn't start until next year, Dr. Ardis Hoven already is helping shape health care reform.

In an interview with the Herald-Leader, Hoven, an infectious disease and internal medicine expert at the University of Kentucky who is also director of the Bluegrass Care Clinic, said reform is needed, a significant plan is likely to emerge but there is plenty of work to do. Hoven, who has long been active with the iconic physicians group, said the need for reform shouldn't be overshadowed by the ever-increasing rhetoric.

"There has been some very mean-spirited stuff going on and I think for the American people that makes them uncomfortable. It makes me uncomfortable," she said. "We've somehow got to get past the politics of it and get on with doing what really needs to be done."

Question: What are some of the key points you are focusing on as you talk to people about this reform?

Answer: One of the things that we have been working on for a long time is covering the uninsured. The issue of universal access is something we feel is extremely important. That probably is one of the cornerstone issues — the cornerstone issue — of health system reform from the AMA perspective.

When you've now got 48 million uninsured, we are not talking about those who are Medicare or Medicaid eligible. We are talking about adults, 80 percent of them have jobs but they can't afford their health insurance. We are looking for the mechanism whereby these individuals can, a.) afford to buy health insurance either through their employer or, b.) be given tax credits so they can go out and buy their own insurance.

Q: Why do the words "universal health care" send shivers down so many spines?

A: So many people equate that language with systems that are seen in other parts of the world, in the United Kingdom, the Canadian system and that sort of thing. What we want to do is get as many people covered as possible. And the best language for that is "universal."

Q: How would the American version differ from those in other parts of the world?

A: One of the premises the president has made very clear is let's build on the system of health care in this country, parts of which we know work very well. Let's fix the stuff that isn't working well. Let's make the correction. And in this country, freedom of choice is a very important thing to all of us. Being able to have a choice to pick the doctor you want, to pick the health insurance you want, to pick the hospital where you get care are all important to the American people, thus we would encourage that we build on a system that provides good care but make improvements.

Q: What part of the system works well?

We have technology, we have science, we have, believe it or not, access to quality health care in this country that is not the same in other parts of the world. What we need to improve on, however, are making sure that those individuals who are uninsured, that they get care when they need it. They are just not getting the preventative care that they need. We know how to do it. We do it well, we just need to make sure these folks get into the health care system so they can get the preventative care that they need.

The important piece is the relationship between the physician and the patient.

Q: One of the common complaints about the system is that physicians have been stretched so much that it is getting harder to create relationships with them.

A: Right now a physician's office is burdened by an excessive amount of administrative stuff that we have to handle, the bureaucracy, the astronomical paperwork that we have to do. If you are talked about being taxed or stretched that's where the problem is. What we need to do is administratively simplify what goes on in my office. Free up some of that time to deliver care to the patient.

Q: There is so much rhetoric being thrown around about health care reform, it's hard for individuals to get a feel for what it is going to mean to them.