By Richard Vetter
GRAND FORKS -- As the health care reform debate intensifies, the North Dakota Academy of Family Physicians, which represents almost 300 North Dakota family physicians, wishes to outline its position.
The academy supports the goal of bringing affordable, high quality health care to all North Dakotans. Improved health for all our citizens is possible if Congress passes legislation that gives everyone access to a patient-centered medical home, where their primary care provider will ensure they get the care they need, when they need it and where they need it.
We need well-trained primary care providers to keep people healthy, provide early treatment for the most common health problems and coordinate comprehensive and seamless care when subspecialty attention is needed.
The problem, however, is a growing shortage of primary care physicians to meet that need. The reformed system must value primary care if we want medical students to choose careers as primary care physicians. In order to attract and retain high-quality physicians, we need to provide enhanced payment for primary care services.
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Our congressional delegation has been right to press for payment reform in Medicare geographic payment inequities. North Dakota is among the most cost-effective in the country in caring for Medicare patients but is assigned some of the lowest Medicare reimbursement rates, because of the Medicare formula method known as Geographic Practice Cost Index adjustments.
This is simply unfair.
We believe that any meaningful health care reform legislation should include:
** The extension of coverage to all Americans through health insurance market reforms.
** An end to coverage denials based on pre-existing conditions.
** Additional funding for primary care services and coordination of care.
** Initiatives to address physician work-force concerns with increased funding of medical training for additional primary care physicians.
** Fundamental Medicare reform, including a repeal of the flawed Medicare Sustainable Growth Rate physician payment formula.
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** A new look at tort reform and a continued cap on noneconomic damages in medical liability lawsuits in North Dakota.
** The simplification of administrative burdens for physicians and patients.
** Rewarding the delivery of quality and efficient patient care.
We believe that these reforms will improve the health of all North Dakotans while continuing our history of providing low-cost, high-quality care to the citizens of our state. We appreciate the work of all of those involved in advancing these principles.
Dr. Vetter is president of the North Dakota Academy of Family Physicians.
