‘If you’re not at the table, you’re on the menu’ – why doctors need to get involved in health care policy

© lazyllama - stock.adobe.com

The Affordable Care Act and Medicare Advantage are two large-scale federal programs that affect the daily lives of physicians and their patients. Not every doctor, patient and lawmaker likes them – but they are examples of why physicians need to get involved in the legislative process.

Rep. Earl L. “Buddy” Carter (R-Georgia) is a career pharmacist and small business owner of Carter’s Pharmacy Inc., which dispensed medicines to patients of south Georgia.

In Congress, he is a member of the House Energy & Commerce Committee, where he chairs the Subcommittee on Environment, Manufacturing, and Critical Materials, and the House Budget Committee. He also has been a critic of Obamacare, calling for its repeal and the restoration of free market principles into the U.S. health care system. Patients and health care providers must be put back in charge of health care choices, and health care delivery needs a comprehensive approach with health care professionals supporting physicians, according to his official website.

Carter spoke with Medical Economics about Obamacare, Medicare Advantage, and his call for primary care physicians to inform legislators about vital issues in health care.

This transcript has been edited for length and clarity.

Medical Economics: Medicare Advantage is growing in popularity, but there have been reports critical about Medicare Advantage plans, ranging from overcharging taxpayers, to improper denial of care for patients, to lack of transparency to regulators. There's a broad mix of opinions about what should be done with Medicare Advantage. What would you like to see?

Rep. Earl L. “Buddy” Carter (R-Georgia)

Rep. Buddy Carter: There's no question that Medicare Advantage needs to be updated. Some of their policies and their programs are out of date and antiquated and need to be updated. I would like to see us take a comprehensive look at reforming Medicare Advantage. It needs to have a total review of what the original intentions and goals and purposes were, and how and if it is achieving those now. It's not just Medicare Advantage. We need to be doing that with a number of different programs. There's so many government programs out there that have not been reauthorized. In fact, I was in a committee meeting this morning, we were talking about that, that so many different agencies, so many programs that in some cases have never been reauthorized, and they need to be and this is an example of one that needs to be.

Medical Economics: In February a KFF poll found about 62% of adults hold a favorable opinion of the Affordable Care Act, known as Obamacare. About 37% hold an unfavorable view. You've been outspoken about your views of Obamacare. Can you talk about those views, and do you still support repealing Obamacare?

Rep. Buddy Carter: I do support repealing Obamacare, but let's face it, we don't have the votes. I mean, it's just not going to happen now, at least not in the makeup of this current Congress. And it would have to be a significant change in the makeup of Congress for that to happen. So, what we have to do is to make it the best we can and that means reforms within Obamacare. Obviously, I was an independent provider, and that is very important to me, and that's what we need more of. I think that Obamacare from the beginning was flawed, and that's why I believe we need to repeal it and start all over. I'm not one who's in favor of one-payer system. I think Obamacare is going lead us to a one-payer system. We need competition. If we're ever going to bring healthcare prices down, we need competition.

Medical Economics: Our main audience is primary care physicians. What would you like to say to them, or what would you like them to know?

Rep. Buddy Carter: Well, I appreciate you giving me the opportunity to answer that question because it is extremely important. Keep in mind that Congress is a citizen legislature. I'm a pharmacist. We have a doctor's caucus, we've got a number of doctors, we've got number of dentists, a thoracic surgeon, neurologist, dermatologist, and that's great. But in Congress, we have people who have no idea about health care. We’ve got new car salesmen, we've got farmers, we’ve got preachers, we’ve got way too many lawyers. It is a citizen legislature and that's where advocacy comes in. That's where educating members of Congress comes in. Every day I have someone a member of Congress come up to me and say, I didn't know you were pharmacist. I had someone my office of the day says you got a letter and I need to get signed on to and I will have my staff call your staff to get on that letter. That's what we need. We need people out there advocating and sharing your experiences. Let them know what is impacting your practice. To think that the government and that policies don't have any effect on your practice at all, is erroneous. It does and I think most physicians understand that now. But we need them to be involved. Get to know your congressman, get to know your senator, get to know their staff, and be a resource for them. Invite them to your practice setting. Show them the value you bring to health care because you do bring value to health care, your patients depend on you. They need to understand that. And listen, I always say, if you're not at the table, you're on the menu. So, you need to be up here at the table.