We just did a short post on the AMA's endorsement of the House health reform bill -- and wnt to say more about why it matters. It's hard for critics of reform to jump up and down and shout that it's going to "destroy the patient-doctor relationship" when patients and doctors are for it. Then we spent 30 minutes searching online for the story or blog post we could have sworn we read earlier this week on how some state medical associations were grumbling more audibly (or audaciously) about the AMA's growing embrace of reform. We never found the story we were looking for, so you'll just have to take our word for it,  but kudos to the AMA for coming out so unequivocally at a time when it counts. We can't wait for tomorrow's headlines: "Comprehensive Health Reform Gets Huge Boost From Nation's Doctors."

Just a few days ago, we linked to a post on the American College of Physicians blog on how doctors should stop complaining about this or that aspect of health reform, and keep focused on the big picture. You can find it here, but the money quote was: "Does anyone really believe that doctors and patients will be better off if health reform falters and we continue the status quo?"

Skeptics may note (OK, skeptics will note, that's why they're skeptics) that the House bill gives doctors a lot of what they were looking for (Medicare payment fix, etc) without pushing hard enough for some of the changes we need to make in health care delivery. It's only fair to note that the bill also has some things that the AMA was not particularly thrilled about, like a robust public health insurance option.

The AMA, historically not an ally of reform, has come far. It's immediate past-president was uninsured herself when she was a graduate student with young kids. Her pediatrician used to give her free samples of antibiotics when the kids got sick. She apparently remembered the lesson; free samples for sick kids is not a comprehensive system of health care. It's depending on the kindness of doctors. 

The AMA letter to the House Ways and Means Committee was not lukewarm.  It was enthusiastic. The AMA cited a lot to like in the House bill, which:

• Promises to extend coverage to all Americans through health insurance market reforms;
• Provides consumers with a choice of plans through a health insurance exchange;
• Includes essential health insurance reforms such as eliminating coverage denials based on pre-existing conditions;
• Recognizes that fundamental Medicare reforms, including repeal of the sustainable growth rate formula, are essential to the success of broader health system reforms;
• Encourages chronic disease management and care coordination through additional funding for primary care services, without imposing offsetting payment reductions on specialty care;
• Addresses growing physician workforce concerns;
• Strengthens the Medicaid program;
• Requires individuals to have health insurance, and provides premium assistance to those who cannot afford it;
• Includes prevention and wellness initiatives designed to keep Americans healthy;
• Makes needed improvements to the Physician Quality Reporting Initiative that will enable greater participation by physicians; and
• Initiates significant payment and delivery reforms by encouraging participation in new models such as accountable care organizations and the patient-centered medical home.

Yes it included that phrase about "further constructive dialogue" which is Washington-speak for "there's some stuff  we're still going to give you a hard time about" but the tone was constructive. Very constructive: "We pledge to work with the House committees and leadership to build support for passage of health reform legislation to expand access to high quality, affordable health care for all Americans."