The Mississippi State Medical Association (MSMA) does support health insurance for all Americans while stressing that the particular components of any national health system reform must follow six key concepts.

 

Expanded coverage - MSMA continues to lead the fight to expand access to health care for all. We want all patients to have health insurance, with subsidies (in the form of tax credits or vouchers) for those who can't afford it. A key example is the State Children's Health Insurance Program (SCHIP). We want patients and their physicians (rather than government or employers) to be in the driver's seat. Families and individuals should be able to choose from a variety of affordable health insurance options. Those choices should be more affordable than they are now, and insurance market reforms are needed to make that happen. It is also essential that patients retain the ability to choose their own doctor and be permitted to privately contract with their physicians. Medical decisions should be made by patients and their doctors, using the best possible information. No one should be denied health insurance because of pre-existing conditions. Portability is crucial so patients should "own" their health insurance even if it's financed through their employer. That way, the patient doesn't lose coverage when he changes jobs, the cost of the insurance is just paid for differently.

 

Prevention and Personal Responsibility – Every American should have the right – and the responsibility – to make healthy lifestyle decisions for themselves and their family. As the physicians who care for Mississippi, we want to help our patients reduce risky behaviors like poor diets, sedentary lifestyles, tobacco use and substance abuse. All of these are known factors that lead to heart disease, diabetes, obesity and other preventable conditions. Similarly, patients have the right to choose health insurance protection for their family, choose a personal physician, and to make and carefully document their wishes about end of life care. We want greater investment in wellness programs so preventable diseases, attributed to obesity and smoking, are avoided. This will lead to lower health care costs.

 

Quality Improvement -Through the American Medical Association's (AMA) convened Physician Consortium for Performance Improvement (PCPI), the medical profession continues to develop evidenced-based guidance for quality improvement. Providing physicians and patients with real time data for decision-making at the point of care should be the driving force for quality improvement.

 

Delivery Reform - We support efforts to improve care coordination and management of chronic disease, including the patient-centered medical home and greater support for primary care (but not at the expense of specialists). Current antitrust policies must be modified so small physician practices can pursue quality improvement, care coordination and health information technology initiatives to achieve greater clinical integration in the delivery system.

 

Reducing Costs – The AMA is working with policymakers and other health stakeholders to streamline the insurance claims processing system, reduce time and resources devoted to paperwork and lower costs for patients, physicians and payers. Doctors are doing their part to identify ways to reduce duplication without limiting diagnostics and rationing care. The PCPI would reduce utilization by focusing on services, treatments and conditions that entail high variation, high volume, and high cost, and have the potential for improving quality and efficiency of care. Medical liability reform must be a cornerstone for any national health system reform. As we have proven in Mississippi, tort reform works and national liability reform will reduce costs by reducing the practice of defensive medicine. We urge policymakers to authorize health courts, administrative compensation systems, early offer models, and "safe harbors" for physicians who follow best practice guidelines, and to adopt other proven medical liability reforms.

 

Fiscal Responsibility and Sustainability – National health system reform must be achieved in a fiscally responsible manner in order to maintain a sustainable health care delivery system.