email from Dr. Epperly, AAFP President

Dear Colleague,
In less than three weeks, I will have the distinct privilege of installing Dr. Lori Heim as the 63rd president of the AAFP. As my time serving you as president winds down, I want to take this opportunity to talk with you one last time about the important efforts your Academy is taking to help ensure reform of our health care system.

What a year of change for our country! What a year for health care reform! I think we can all agree that we need to reform our ailing health care system. What kind of health care reform we want becomes the key question. As we have all witnessed, this debate over needs versus wants has left the arena of thoughtful discussion around policy and has entered the arena of major league "Politics" with a capital "P."

There are several pieces of legislation in play, and these bills are under rapid evolution. Before the August recess, they were literally changing by the hour. We don't have a finished product in either chamber of Congress. That's why we see this evolving process as being a critical time to be "at the table, so we don't end up on the menu." We want to help shape the debates around the critical principles and values that we hold dear as family physicians.

So what principles am I talking about? Where does the AAFP stand on health care reform? It's really quite simple. We believe that the key to designing a new health care system is to reemphasize the centrality of primary care by:
• Ensuring health care coverage for all and aligning financial incentives to support this system;
• Increasing payment for primary care services ;
• Redesigning the manner of primary care delivery modeled on a ‘patient-centered medical home' ; and
• Reinvigorating the primary care workforce

In addressing all of these principles, our approach has been one of "Yes, if." "Yes, we will support certain provisions, if the following principles are present." The health care system we have is unacceptable and not financially sustainable long term. The rapidly growing health insurance premiums and cost sharing measures (like higher co-payments and bigger deductibles) are making more of our patients limit their access to their family doctors. The status quo is not acceptable to us or to our patients.

I want you to know that we will stay at the table and continue to help shape a better health care system for our country. It's the right thing for us to fight for on behalf of our members and our patients. We will not get everything we want and there will undoubtedly be elements of the final reform proposal that we won't like. But I can guarantee the result will be much better for our having been so fiercely involved.

In this vein, your AAFP leaders have been busy recently, talking face-to-face and via conference call with members of the Obama administration and Congress to stress the need to enact health care reform legislation that improves health care quality, enhances patient access and lowers costs via a primary care-based system.

I met with Nancy-Ann DeParle, director of the White House Office of Health Reform, and others in August. During this meeting, I told them that the AAFP continues it's commitment to the major principles of health care reform, including providing health care for all and the importance of better payments for family physicians and other primary care physicians. I stressed that adequate payment is key to building a primary care infrastructure in this country and that we must invest in the education and training of the primary care workforce so we have enough family physicians in our country.

In addition to the White House face-to-face meeting, I have participated in several conference calls with the White House, along with representatives of several other physician organizations, including the American College of Physicians, the American Osteopathic Association, the American Academy of Pediatrics and the American Medical Association. We discussed what we could do collectively to move health care reform along. I am very optimistic and encouraged by the discussions with the White House and with our colleague organizations, and believe we need these exchanges to get good, solid, factual information to our members.

I also have been part of six town halls where I've had a chance to represent the AAFP to both members of Congress and to you. I have seen the fear, heard the concerns, and witnessed much about the character of America. It is important that America is having this dialogue. The AAFP must stay engaged in the health care reform process. Now is not the time to walk away from the table, if anything now is the time for us to be more engaged and to advocate for the way the health care system needs to be reformed.

The AAFP is going to continue to be engaged and advocating every second for the good of health care for this country. I would ask of you to do the following:
• Stay optimistic. Keep focused on changing our health care system for the greater good of our country.
• Use the AAFP's web page and the "Connect for Reform" icon in the upper right hand corner to join and have a front row seat as this debate and process unfolds.
• Download the AAFP-developed one page information sheet for your patients . Please distribute this as you see fit. Included are links to two historically bipartisan fact check sites where you and your patients can learn about which statements about health care reform are true and which are not.
• Please help settle down all the rhetoric, fear, and confusion that exist with your patients, colleagues, and communities.

I would like to just end with this. We have never been closer to meaningful health care reform in the history of our nation than we are right now. I remain optimistic that we will step forward as a nation for the good of health care for all. I wish you all the best as we move forward.
Regards,

Ted Epperly, M.D., FAAFP
President
American Academy of Family Physicians


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