Will doctors join that list? Ardis Hoven, the new president of the American Medical Association, told me, in an interview conducted for C-Span's Newsmakers, that her group has been in talks with the Obama administration and will do "whatever we can in our power" to promote Obamacare. You can watch the full interview, conducted with Kaiser Health News' Mary Agnes Carey, above. What follows is a partial transcript of our discussion on the health care law and doctor shortages.
Mary Agnes Carey: Dr. Hovin, we'd like to talk first about the Affordable Care Act's implementation. There's no shortage of predictions here in Washington that things may not go as planned this fall when the exchanges, the online marketplaces, on October 1 and when the Medicaid expansion starts next January.
From your perspective, and that of the AMA, what is the Obama administration doing right on implementation and what is it doing wrong?
Ardis Hoven: Clearly there are many elements of the Affordable Care Act that already in play and that are working quite well and meeting the needs of the American public, which is what is so important to us, covering the uninsured.
Clearly we have to work through many of the initiatives. You mentioned the exchanges, how are they going to be run, what's going to be done. A lot of that work is in play right now and we're waiting to hear what will happen with those. We'll be informed and be able to inform our patients as to what to expect from these exchanges, how to be enrolled, what they can expect and move forward on this.
So I think there is work underway, which is very meaningful and will get us to the place that we need to be. Clearly we need to continue with transparency, communication, making information available to individuals so that they can access the exchanges and get the health insurance coverage that they need.
Sarah Kliff: To follow up on the point of providing information to your patients, has the White House approached the AMA or approached you about any sort of partnership between doctors and the administration on getting the word out on the Affordable Care Act?
AH: Not directly, but we have been in communication with many, many individuals in the administration about our role as physicians in this, and what we can help them do, and what we can do to help our patients get the kind of information they need. We will keep working with the administration to do whatever we can within our power to make this happen.
SK: What's the role of doctors in the Affordable Care Act? It's obviously a pretty polarizing law and I'd imagine you have some membership that doesn't necessarily support it. So what do you see in as the role of doctors in doing outreach and enrollment for the administration, or in partnership with the administration?
AH: I think clearly as we move forward with this, our responsibility as physicians will be to our patients. My job as a doctor will be to communicate with my patients and their families going forward as to what they can expect with the exchanges or any other pieces of the Affordable Care Act.
Physicians come together on many things. The American Medical Association has brought doctors together through our house of delegates. We set policy there, and out of that body has come good work about outreach, good work about transparency, and good work about how we can help our patients access the kind of care they deserve and need.
MAC: Is your advice to physicians who don't like the Affordable Care Act basically this is the law of the land and they should do what they need to do to get people coverage?
AH: That's a very good point. Again, there was decision making on both sides. Some supported, some did not support it but at the end of the day the American Medical Association and its policy body, the House of Delegates, came together in support of the Affordable Care Act.
It is the law now. As I mentioned earlier, there are tings in play now which are helping the American public. Our job as physicians will continue to be to get our patients the type of care they need at the right time, at the right place, with the right provider.
SK: I know there's worry about a doctor shortage and what happens when we add millions of people into our health insurance system. I was curious if you could talk a little bit about what patients should expect and how you all, as doctors, are getting ready to add millions of people into the health insurance system.
AH: It's important to realize those patients already exist out there. They are already in the health care delivery system and when they now have insurance coverage in their hands, they will hopefully, and our job will be to teach them, how to use health care insurance, how to get prevention and wellness care on the front end, how to be healthy and stay healthy. This is very important.
This is work not only physicians need to be involved in, but communities need to be involved in, and we're going to have to work together both publicly and privately to get this to happen.
As far as shortages, there are shortages of physicians now, there were shortages of physicians before the Affordable Care Act, there are shortages of nurses, there are shortages of other allied health professions. What we must do in our country is we must work together in teams, physician led teams. We must utilize all health care providers at their highest level of competency and training.
MAC: What about the Medicaid expansion? That may bring in millions of people who don't access the system on a regular basis. While the Medicaid reimbursements will be raised for a period of two years, and then states can make that decision, will there be enough doctors for those Medicaid patients?
AH: Again, I think there will be enough doctors. We will have to practice in team-based care. We are going to have to be more efficient in how we work in teams. We're going to have to let people work together in a meaningful way, using their highest level of training.
That's what patients want. They want this sort of care. They want to be able to access a nurse practitioner for an appropriate issue, they want to be able to access their physician. Eighty-five percent of them want to get their care in a physician-led team.
SK: Do you expect wait times to increase under the Affordable Care Act?
AH: It's hard to know now. Again, we have to look at that, we have to be very careful how we work at getting patients into our practices. Again, we need to utilize the infrastructure in our practices, whether they be small or big, to allow patients to get the kind of care they need and want in a timely manner. We've got to make a conscience effort to make it happen. I'm confident we'll be able to manage the new folks who will have health insurance.