Single-Payer Folks Swallow Bitter Bill

For leading single-payer advocates, the healthcare reform bill represents the first steps in a continued struggle
The Lund Report

March 25, 2010 -- For those who plan to continue the fight for single-payer healthcare or a public option, the reform bill signed by President Obama this week comes as a bitter pill that’s viewed more as a first step than a resolution.
No one fought harder in Congress for single-payer than Rep. Dennis Kucinich, and few activists did more to energize the country than the Mad As Hell Doctors, a group of mostly Oregon doctors who toured the nation for single-payer healthcare in October. To show his support, Kucinich was there when the group rallied in front of the White House.
Having blasted the bill for so many months, both now reluctantly say it’s a good first step. Had Dr. Paul Hochfeld, an emergency room doctor in Corvallis who led the group, been in Kucinich’s position, he said he would have done the same thing.
Kucinich opposed the first bill through the House and blasted the bill for not including a public option until last week when he announced his last-minute support because it made so many important reforms in his mind.
Like Kucinich, Hochfeld detested the bill because it kept health insurance companies in charge. Hochfeld said he has no problem that Kucinich supported the bill in the end.
“Had I been in Dennis Kucinich’s position where I had to vote on this thing, I would have done what he did, which is basically condemn the bill and say there are parts of it I really detest, but it’s better than nothing because it does a few good things,” Hochfeld said.
“The problem is, it doesn’t do enough to control costs,” he continued. “And it cements the insurance industry in their central role in the healthcare system. And the insurance industry doesn’t add anything to health. All they add is cost and complicate the lives of providers.”
During their cross-country road trip from Portland, Oregon to Washington, DC, Hochfeld learned the problem lies much deeper than just providing insurance coverage.
“Physicians are a much bigger part of the problem than most people are willing to talk about because there are lots of perverse incentives in the system,” he said.
The legislation signed by President Obama on Tuesday (March 23) does a few promising things to level the playing field among doctors. For example, it takes the function of determining how physicians are reimbursed through medical billing codes out of the hands of the American Medical Association and under the auspices of MedPAC, which advises Congress on Medicare issues. The new law also strengthens the powers of MedPAC as a whole.
“Primary care doctors are not going to be as undervalued as much as they have,” Hochfeld said. “They will be reimbursed better, not as much as specialists, but they won’t be getting totally screwed.”
For the OMA’s position for remaining neutral on the bill click here.
And here’s specific hospital-related reforms from the Oregon hospital association. 
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