American College of Physicians: Here's how to reduce health care spending in a socially and fiscally responsible manner

(Washington) – Recommendations to reduce federal health care spending in a socially and fiscally responsible manner while maintaining quality have been made in a letter to the Congressional Joint Committee on Deficit Reduction from the American College of Physicians (ACP).

The letter recommends that a national initiative be established to increase the use of high value care and reduce low value care (i.e. care that has little or no benefit to patients), modeled on ACP's own High Value, Cost Conscious Care Initiative; to preserve and broaden Graduate Medical Education (GME) financing by requiring that all payers participate in its funding while allocating funds strategically based on workforce needs; and to preserve funding for key programs supported by ACP.

Is such a thing possible? Proponents of nationalized health care note that spending is high in America. Opponents argue that countries with socialized medicine have long waits and denials for procedures deemed optional by a committee and contend the highest quality people will leave. Doctors are afraid not to require unnecessary tests because of the kind of runaway lawsuits that made politicians like Sen. John Edwards rich.

It also offers specific suggestions for changes in Medicare, federal health care tax policy and other reforms, "generally consistent" with ACP policies, which the Congressional Budget Office, National Commission on Fiscal Responsibility and Reform, Bipartisan Policy Center, Commonwealth Fund, and other experts have said could achieve hundreds of billions in budget savings.

ACP said that it believes that physicians need to show leadership by contributing to the discussion on options to reduce spending on Medicare and other health programs. A cornerstone of ACP's proposal is to establish a national initiative to reduce the estimated $700 billion spent annual on care of little or no value to patients, by providing patients and their physicians with information on comparative effectiveness; redesigning incentives for clinicians and patients, and reducing the costs of defensive medicine.

Virginia L. Hood, MPPS, MPH, FACP, president of ACP, noted that "ACP's letter shows that it is possible to promote high value care, reduce the federal deficit, permanently repeal the failed Medicare SGR formula and allow for continued funding of critical programs to expand access and ensure a sufficient supply of physicians. We stand ready to assist Congress in developing such a plan."

Something has to give. It would be terrific to implement 'high value care' but who can afford the resulting malpractice insurance?