They must be free to choose their health care providers.
Like most of our patients the ongoing discussions regarding health care reform have caused us a great deal of concern. We have devoted hours and hours in an effort to best discern what will or will not be enacted into law under the guise of health care reform. We have had the occasion recently to visit with nationally known health care economists, policymakers and consultants in Washington, D.C., Chicago, Ill., Madison, Wis., and other locations. We have also brought speakers to Washington, Mo., in an effort for us to better understand what is likely to take place. At the end of the day the only thing that all of these experts agree upon is that our health care system as it currently exists is not sustainable for the long run.

Accepting the fact that reform to health care must be made in order to protect our future generations, we believe that the best place to start is with those areas about which there is agreement. The concept we endorse was recently announced by the Mayo Clinic in its article titled "A Foundation for Health Care Reform Legislation" wherein a proposal for reformation of the current private health insurance system was outlined and included the following:

Require Americans to purchase health insurance;
Provide sliding-scale subsidies to help those in need to buy the insurance;
Prohibit pre-existing conditions exclusions;
Define a minimum health benefit package; and
Adjust risk levels among enrollees.

Not only is it necessary to reform the payment system, it is also necessary to reform the delivery system. It is our belief that this can be accomplished while at the same time strengthening the physician-patient relationship. Accountable Care Organizations are the key to this reformation. Through the use of Accountable Care Organizations physicians would be responsible for insuring that patients are provided with the most effective and efficient care available. We agree with Dr. Thomas Riechers' statement in his recent guest article in The Missourian concerning competition in health care. He stated that there was too much government regulation and that we should trust the marketplace with respect to health care as we do for other goods and services.

Overregulation by the government has not only contributed to the morass of problems in the payment arena but far too often it has rewarded inefficiency and has increased the cost of health care. Government should control and punish fraud but it should also allow the free enterprise system to work. The first place to address this area would be to eliminate regulations such as certificate of need legislation.

A new concept has been under discussion in certain sectors recently regarding how health care providers would be paid. This concept is of "bundled payments" where health care providers are paid a certain sum to provide for the needs of a given patient. The amount provided would be based upon benchmarks for the cost of similar care in the geographic area. We believe that this idea has a great deal of merit because the providers who provide the best care in an efficient manner will prevail. With the adoption of Electronic Medical Records reports could be generated to insure that proper protocols are followed. Physicians are the initial contact in the care process and they should be the entities charged with receiving the funds and insuring that other health care providers are paid appropriately.

We are proud to be part of the U.S. health care system and are dedicated to improving it. We hold sacred the trust which our patients place in us and are ever committed to our creed of putting PATIENTS FIRST!