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Let Us Now Praise Physicians of Conscience

Let Us Now Praise Physicians of Conscience

August 19, 2005

It was supposed to be a fixed game. Congress demands and the Bush Administration appoints a Commission with one mission -- find $10 billion in cuts to the nation's essential health care safety net for the poor, Medicaid. Yesterday's New York Times describes the first meeting, held two days ago. There were a few surprises:

"Michael J. O'Grady, a member of the panel who is also an assistant secretary of health and human services, said the higher co-payments would make beneficiaries more "price-sensitive" and would not impose an undue burden. ... Dennis G. Smith, a top federal Medicaid official, said that was not a large amount in the context of a program expected to cost the federal government and the states $2 trillion in the next five years. ..."

"But Dr. John C. Nelson, a former president of the American Medical Association who is a commission member, said: 'If we raise the co-payment, some people will not get the care they need. These are real people.' A person with chronic illnesses who forgoes medicine because of the higher co-payment could end up in a hospital emergency room, which costs much more, said Dr. Nelson, an obstetrician and gynecologist from Salt Lake City. ...

"Democrats have been leery of the commission, saying it would simply ratify budget cuts proposed by President Bush. But the panel made clear Wednesday that it would not rubber-stamp proposals by Mr. Bush or the National Governors Association.

"Dr. Carol D. Berkowitz, a commission member who is president of the American Academy of Pediatrics, said that co-payments of $3 to $5 could quickly add up to substantial costs for a low-income family with four children. Another commission member, Julie Beckett, said that a $5 co-payment for each drug and doctor's visit is a lot if you have multiple chronic conditions and multiple needs.' Ms. Beckett is policy director of Family Voices, an advocacy group for children with special health care needs."

Here in Massachusetts, the Romney Administration is a loyal adherent to the Bush Administration policy of CPFA -- Co-Payments For All. New proposed changes to the Uncompensated Care Pool would impose cost sharing on all uninsured persons, no matter how limited their income. Just like in DC, we could use a few physicians of conscience here as well. If interested, let me know -- mcdonough@hcfama.org