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TMA’S STATE AND FEDERAL AGENDA IS DEVOTED TO MAINTAINING AND CREATING AN ENVIRONMENT WHERE PHYSICIANS CAN BE PHYSICIANS AND NOT ASSETS OF SOME MEGA-CORPORATE SYSTEM.


Survey) found that the number of Texas physicians accepting new Medicare patients has dropped from 66 percent in 2010 to an all-time low of 58 percent in 2012. This is part of a de- clining trend in the physicians’ ability to see new Medicare or Medicaid patients. The reasons why physician participation in government- funded health programs is dropping precipitously are clear:


• Flat or declining payments for medical and surgical services,


• Growing and irrational regulatory and paperwork burden, • Health insurance technology requirements that punish rath- er than reward innovation, and


• The uncertain effects of PPACA on the quality and delivery of services.


The convergence of all these factors and the generally pes- simistic opinion of young physicians2


about the future of the


U.S. health care system portend an alarming impending short- age of physicians. Unless the positive and proactive steps outlined in TMA’s federal agenda are implemented, health insurance coverage may be available, but like the Canadian health care system to- day, there will be a desperate shortage of physicians to provide needed medical care services. Texas tort reforms passed in 2003 doubled the number of new medical licenses issued by the Texas Medical Board. Yet, Texas still ranks 42nd in the number of physicians per 100,000 populations.3


Thus, the convergence of an inadequate supply


and an overabundant demand for services would, under nor- mal economic conditions, result in increased payments and more utilization of only appropriate and necessary services. But, in a government-controlled system, market forces are all but irrelevant. Payments will continue to decline, paperwork will continue to sap time away from patient care, and demand for services will continue to increase at an alarming rate. New untested organizational and payment models, like ac-


22 TEXAS MEDICINE September 2012 REFERENCES


1. Goldsmith J. The Future of Medical Practice: Creating Options for Prac- ticing Physicians to Control Their Professional Destiny. The Physicians Foundation; June 2012.


2. Practice Arrangements Among Young Physicians, and Their Views Regard- ing the Future of the U.S. Healthcare System. The Physicians Foundation; March 2012.


3. 2011 State Physician Workforce Data Release. Association of American Medical Colleges; March 2011.


countable care organizations and bundled payments, will be offered as the “new and best” solutions. But, the answers and solutions rest with Ameri- can and Texas physicians. Only through a unified and mission- driven effort can health care fo- cus on what matters most: the best possible outcome for each patient, seen one at a time and not as a population! TMA’s state and federal agenda is devoted to maintain- ing and creating an environ- ment where physicians can be physicians and not assets of some mega-corporate sys- tem. Led by the TMA Board of


Trustees, chaired by Tomas Garcia, MD, and on behalf of our 46,000 members, TMA will actively and successfully pursue this federal agenda for our members to improve the health of all Texans.


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