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Dark cloud gathers over health care
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Shortly after he passed his new health care reform bill into law, President Barack Obama poked the measure’s critics with a sharp stick by pointing out that the day had come and gone without a single asteroid smashing into planet Earth.

Yes, he proclaimed, the birds were still chirping. People were still strolling down the street. And, he assured, “People still have their doctors.”

As someone who represents more than 6,000 physicians in Georgia, I’d suggest the president go out onto the White House balcony and take another, closer look at the horizon. He might not see any asteroids, but he will surely see a dark cloud that’s forming over every man, woman and child.

That dark cloud is being fueled by a practice environment that grows worse for physicians with each passing day. These are the same doctors who serve as the foundation for the best medical care in the world.

As patients, we face the very real risk of losing the safety, security and peace of mind that comes with knowing that our doctors are going to be there for us and our family members in our hour of need.

There are a number of interminable factors that have slowly-but-surely eroded the practice environment, including the back-breaking administrative burden that’s placed on physicians as they contend with a parade of third party payers — including the government and the insurance industry.

But in 2010, we collectively face more pressing concerns.

Congressional leaders went home for their two-week spring recess without taking the action that was needed to avoid a 21 percent cut in Medicare payment for physicians (i.e., the Sustainable Growth Rate, or SGR) on April 1. Not addressing the Medicare payment formula in the health care reform bill that just passed was irresponsible — and letting the April 1 cut go into effect is indefensible.

In the end, this comes down to the government fulfilling the promise it made to American seniors when it instituted the Medicare program in 1964.

And in a recent development that hit closer to home, the Georgia Supreme Court just struck down a portion of the state’s 2005 tort reform law that put a $1 million limit on the noneconomic damages that are associated with “pain and suffering” in medical malpractice lawsuits. (There is no cap on economic damages for lost wages, past and future medical expenses, etc.)

More than a thousand new doctors had come into Georgia to care for patients in the state since Senate Bill 3 became law. Medical liability insurance premiums are down by 18 percent since 2005. There are now 17 insurance carriers writing $1 million or more in medical liability insurance policies in the state, while there were just three in 2004. Claims are down by 30 percent since 2004. It’s not hard to connect the dots.

With its decision, the high court all but guaranteed that health care costs will continue to spiral out of control. Physicians will order more tests to protect themselves from frivolous lawsuits. Other doctors will simply move to states such as Texas that have put out the welcome mat with a cap on noneconomic damages. Without this kind of safety net in place, the costs and the risk of litigation are simply too high.

The bottom line is that it’s going to be increasingly difficult to find a doctor — especially in rural areas and when it comes to specialists like obstetricians and surgeons.

So starting with Medicare, our congressional leaders need to demonstrate some leadership in fixing the nation’s broken medical payment system.

And state leaders need to take a more active and strategic role in training, recruiting and retaining physicians — keeping in mind this, the nation’s ninth most populous state, ranks just 39th in the number of physicians per 100,000 people, according to a 2008 report.

No, Mr. President, we might not lose every physician in every specialty with the instantaneous and sensational flair of an asteroid. But unless we take some immediate steps to create a more favorable climate for physicians, that dark cloud is going to come to a sudden and permanent stop over the place we call home.

David A. Cook is the executive director of the Medical Association of Georgia