Must health reform discussions always be so unhealthy?

U.S. Representative Martin Heinrich (D-NM) met with Albuquerque physicians Saturday, October 2, for a luncheon of local organic produce and a discussion of health care reform.

Heinrich spoke about the Affordable Care Act, while revealing a personal passion for healthy lifestyle habits and illness prevention. Physicians expressed concerns about the dire impact of frivolous malpractice suits, physician shortages, and medical students now graduating with about $200,000 in debt. They also served up homemade bread and baklava, along with herbed chicken with organic produce grown by the son of physician Helene Silverblatt, M.D.

More than two dozen physicians and interested parties attended this event moderated by Ellen Cosgrove, M.D., a dean of education at the University of New Mexico School of Medicine. Dr. Cosgrove also crafted baklava from honey grown in the backyard of another dean, Eve Espey, M.D. I am not a dean, but I helped organize the event, and I enjoyed making the eggplant dip among other dishes.

Cosgrove began by speaking of Heinrich’s integrity, and the diversity of perspective he brings to congress, as an engineer and scientist.

Heinrich emphasized the importance of the doctor-patient relationship, that allowing physicians to have time with patients, say, more than 15 minutes, can have a huge impact on outcomes.

In response to Dr. Carol Larroque’s question about whether a single payer system is still possible, Heinrich said that given the complexity of health care delivery, we must build upon the health care system already in existence.

The ACA will bring improvements, he said. Once health insurance exchanges are in effect by 2014, patients will have more choices, and this will drive the quality and accountability of insurance. At the same time, new regulations will decrease costs, by capping the profits of insurance companies at a reasonable level. Physicians remarked that spending one-third of health care dollars on administration and profit, is simply too much, especially since many countries with good medical systems spend only 2 to 5 percent of their medical dollars on administration.

Internist Richard Todd, M.D., baked bread and brought his four year old son (who played with Heinrich’s young sons). He spoke emotionally about a frivolous lawsuit filed against his wife, a dedicated pediatrician. The suit consumed two and a half years of their lives, and his wife considered quitting medicine, which would have left our medically underserved state with yet one less physician. That frivolous malpractice suits drive up costs, drive physicians to sleepless nights of distress, and drive physicians out of medicine, was echoed by several physicians, including emergency physician David Sklar, M.D., and hospitalist David Garcia, M.D.

Heinrich said that it was important that physicians “doing the right thing” not be subject to the excesses of the legal system. At the same time, patients who suffer medical errors should have the right to recourse. The key will be to impose reasonable steps, before a case can be brought to court. The ACA addresses this.

Notably, Heinrich expressed an appreciation for the importance of healthy lifestyle habits toward preventing illness. He spoke with dismay about children spending too much time in front of “the tube,” and neighborhoods now configured so that walking to school or anyplace, is impossible for children. At the same time, their diets are increasingly rich in corn-based sweeteners. As a local City Councilman prior to his election to congress, Heinrich was known for championing the creation of infill housing near schools and shops, that would promote walking, while decreasing the tremendous usage of gasoline and time currently spent on commuting. Albuquerque residents know the Heinrich family as health-oriented and environmentally conscious. Heinrich enjoys hiking with his wife, Julie, and sons, Carter and Micah. The family grows vegetables in their backyard, and raise chickens who recycle leftovers into eggs.

Dr. Cosgrove echoed the importance of prevention, and responded that the UNM School of Medicine has just instituted a public health program for medical students, with courses taught by Cynthia Arndell, M.D., and Bob Williams, M.D.

Educator and psychiatrist Jeffrey Katzman, M.D., spoke about medical students graduating with $200,000 in debt, and feeling compelled to avoid primary care in favor of better compensated specialties. Steve Kanig, M.D., a delegate to the American Medical Association, proposed lowering Medicare eligibility from age 65 to 55, since citizens over age 50 are having trouble finding jobs in this economy, and are terrified about health insurance coverage. Jason Cohen, M.D., spoke of his concern that 80 percent of medical resources are spent in the last two weeks of lives.

Internist Jill Slominski, M.D., concluded by asking Heinrich, “Clearly, you’ve taken time to understand this issue. How many politicians in Washington actually understand the incredibly complex issue of health care?”