It isn't just Congress that's divided about how to fix health care; doctors are split too. Bob Doherty, who blogs for the American College of Physicians, gets it from all directions. Primary care docs who are mad at specialists. Specialists who are mad at primary care docs. Single payer backers; believers in unfettered free markets. Docs who like medical homes. Docs who hate medical homes. On and on. Doherty has had it. These fights all miss the point. The health care system is on the verge of collapse. Millions are uninsured. The time to fix it is right now.

Does anyone really believe that doctors and patients will be better off if health reform falters and we continue the status quo? If the ranks of the uninsured are allowed to grow? If insurance companies are allowed to continue to turn down or charge exorbitant rates to people with pre-existing conditions? If small businesses can't hire people and pay decent wages or even keep their doors open because of the rising costs of health plan premiums? If the Medicare trust fund is allowed to go broke? If health care reform dies, and along with it, our best chance to begin to restructure workforce and payment policies to support primary care?

I believe that the U.S. health care system is a train wreck in waiting, and that 2009 may be our best and perhaps only chance to put it on a safer track. We have within our grasp the chance to enact legislation to provide affordable coverage to most Americans, to make the cost affordable and sustainable for families and businesses, and to begin to rebuild the primary care physician workforce. Yes, I understand why so many internists are unhappy with the way things are, and distrustful of the changes being proposed to make things better. I also respectfully suggest that there will be far more reasons for internists to be discontented if health care reform is allowed to fail.