Health care reform from the inside out

One of the problems with the current health care system is the national fee schedule used to provide cost updates to physicians does not keep up with inflation. This means physicians are paid less and less each year for providing the same care.

For years, the members of the American College of Cardiology (ACC) and others have been calling upon our elected officials to develop a reimbursement policy that reflects doctors' cost of delivering care, but lawmakers just haven't gotten the job done.

Now, the problem simply grows worse and is rapidly reaching a point where the quality of care is in jeopardy.

That said, payment reform is just one part of a larger, much-needed health system reform.

Our current system offers patients uncoordinated, inconsistent care, and gives physicians misaligned incentives to offer more care, not higher quality care.

Physicians across the country continue to struggle with high medical malpractice premiums.

Meanwhile, the rising cost of providing care is outstripping society's ability to pay. Combine these factors with 47 million uninsured Americans, and you have a system primed for reform.

The ACC has launched a campaign called Quality First, with the goal of transforming health care from the inside out.

The college firmly believes that health care providers should be the key players in driving reform because we know what's best for the health of patients, and we know the cost of providing high-quality care.

Universal access to basic care and some sort of public/private financing system to help stabilize the ever-increasing costs of health care are givens.

Payment reform is also necessary. The federal government and insurers need to devise better ways of compensating physicians for providing quality care.

Additionally, reforms need to be driven by a focus on quality and outcomes.

The ACC is already leading the way in this area. Not only does the college boast the largest national cardiovascular data registry, it is also a leader in the development of clinical guidelines and appropriateness criteria to guide cardiovascular professionals in their treatment decisions.

The ACC's preemptive efforts at improving patient care can and should be viewed as models for reform.

The entire health care community must play a critical role in shaping the future system. We know what's best for patients, and we know what it costs to provide high-quality care.

Kim A. Williams

Chicago