Interviews with health leaders -Another Interview

I like to interview important national figures in the know because I always learn from them. A few days ago, I interviewed Donald Palmisano, MD, JD, a New Orleans surgeon who served as President of the AMA in 2003-2004.

Among doctors and executives in organized medicine, Palmisano is considered to be an articulate icon. For good reasons. He speaks his mind, he speaks forcefully, and he speaks plainly.

In our interview, which will appear sooner or later in ModernMedicine.com, he said American health care had reached a watershed.

Either we speak out now for patients and ourselves, or government will take control. He fears present government policies will be disastrous – driving up costs, depriving patients and doctors alike of their autonomy, depriving physicians of freedom to privately contract, and dramatically lowering patients’ access to care.

Physicians, Palmisano asserts, will simply be unable to afford to see patients because lower reimbursement from third parties will not meet costs of doing business. Price-fixing by third parties will force physicians to stop seeing new Medicare, Medicaid, and certain HMO/PPO patients because they can’t afford to see them. Price-fixing has never worked, and it will not work now.

Furthermore, doctor will be unable to pay high medical liability premiums and their staff, further limiting physicians ability to see new patients from low-paying third party programs.

Palmisano believes solutions lie in market-based solutions with patients and physicians making the fundamental clinical decisions, This can be made possible by tax credits for all, an array of choices, tort reforms, low-cost health savings accounts, high deductibles with catastrophic lids, coverage of pre-existing conditions rendered feasible through large voluntary associations, defined contributions for Medicare recipients with vouchers.

To make these things happen, he says doctors must speak out to their Congressional Representatives and Senators, tell them the negative consequences of the present system, encourage their patients to do the same, and elect new members of the House of Delegates and new President of the AMA from grunts on the ground, not from current members of the AMA establishment.