A doctor's perspective: Who stands for patients in the health-care debate?

by Marion Mass, M.D.

Published Jan. 23, 2017, 12:21 p.m. ET

Health care in America has been sick for decades, but the illness has progressed rapidly in recent years.

The well-intentioned Affordable Care Act doubled down on a failing system and has put many American families at a breaking point. Millions of people now have access to insurance, but many lack what's ultimately more important: access to care.

The law accelerated the financial chokehold on the middle class with skyrocketing premiums and deductibles, and fewer health-care choices. Small businesses purchasing insurance for their employees are paying higher taxes and premiums, too. And patients get less time with physicians pushed by hospitals and insurance companies to see more patients daily. As a doctor, I see these problems every day.

How did all of this happen?

Over the past 40 years, there have been a cadre of players who swooped in on the juicy health-care pie and jockeyed effectively for their piece. They have been gorging on that pie with little regard to the cost to the patient.

Take a look at the top lobbyist groups in America. Four are health-care related: Big insurance, Big Pharma, the American Hospital Association and the American Medical Association.

The result of this lobbying is a phenomenon that can be summed up in two words: administrative glut.

Since 1970, the number of physicians practicing in America has grown by roughly 200 percent. By contrast, the percentage growth of administrators in the same time period is over 3,000 percent. Health-care spending per capita has grown by 2,300 percent over the same time period.

Sadly, my own profession is complicit in several ways.

Practicing physicians have left our profession's advocacy to physicians that
have become professional politicians themselves. Their home is the American
Medical Association, whose membership has dwindled from
75 percent of practicing physicians in the 1950's to roughly 15 percent today.

If dues have decreased, where does the AMA get money to spend lobbying Congress? The answer lies in its relationship with Big Insurance.

The AMA owns the coding system that every doctor in America is required to use in order to be reimbursed by insurance; it makes a stunning $72 million off the program every year. It is in patient's best interests to reverse the trend of ever-increasing health insurance costs, but the AMA depends on the health-insurance industry for money.

The American people are the victims of a system so complex that even many practicing physicians have a hard time unraveling it. But they are certain that their patients' needs are suffering. Your physician, the one delivering or caring for your children, the one who guides you through your twilight years, has little voice and less confidence in this establishment, mirroring the feelings of frustrated Americans

There is hope.

Dozens of grassroots physician groups are working for real reform. We are aligned together and actively collaborating, to find real solutions to heal our sick system. United, we have a stronger voice to advocate for our patients. We see your suffering. It's personal for us, because medicine is personal. You learn that the first time you interview a patient and lay your hands on them for examination.

We believe reducing administrative glut and creating more choices of coverage are the two main components to increase quality access to care and reduce cost for all. The Health Rosetta Principles, formulated as a collaborative effort among entrepreneurs and visionaries in the health-care space, covers the basic tenants of our proposed changes. A specific, patient-centric representative plan has been developed by the Docs4Patient Care Foundation.

It's time for Congress and President Trump to let our nation's doctors help shape the future of healthcare. It's time for our government to listen to America's doctors, who have their patients' best interests at heart.

Patients need a navigable, transparent system. That can't happen until lawmakers cease listening to health-industry lobbyists and the profiteers of our current dysfunctional system. Big Insurance, Big Pharma, the AHA and the AMA have injected side effects into a system and have made it critically ill.

We have a chance to bring health back to American healthcare, benefitting the millions of patients who have been long awaited access to quality health care. The only question now is whether our lawmakers will perform a public service, and listen to the real experts—physicians- over the strenuous objection of those profiting without healing.

We are offering our help. We took an oath to heal. Please let us keep our promise.

Marion Mass, MD, is a practicing physician in Bucks County, Pennsylvania. She is on the board of Physicians Working Together, and she serves as an officer at the Bucks County Medical Society. She is helping to form the collaborative group Practicing Physicians of America.