October 4, 2010
Dear Former Speaker Gingrich:
Thank you for your kind invitation to the “2010 Champions of Medicine” Ceremony in Washington, D.C. I will not be attending this ceremony, and in point of fact I am rather surprised at my inclusion into what you have called an “exclusive” event. I would be honored if you would take the time to hear a bit of my story, so that you may understand why.
I am a family physician, serving along with three colleagues a large, sparsely populated area in rural western Kansas. I am an active and very proud member of the American Academy of Family Physicians, which this year was instrumental in helping to pass the Patient Protection and Affordable Care Act. I am also proud to represent my state as a Director in Doctors for America, a coalition of physicians who are actively trying to change our system for the better health of our patients and communities.
In no way do I believe that Congress, nor President Obama, wishes to “dismantl[e] the world's greatest healthcare system and replac[e] it with the failed model of socialized medicine,” as you assert. The law does not go nearly far enough to dismantle or socialize our broken system; rather, it puts into place some necessary checks on the insurance industry for the protection of patients like the ones I see in my office every day. Your letter mentions these difficult economic times, and the people I serve are certainly not immune. Insurance companies, on the other hand, have suffered very little in the way of economic losses. The PPACA, in my view, evens the playing field so that insurance companies must use fairer business practices when dealing with people whose lives are at stake.
Mr. Gingrich, if we have the greatest healthcare system in the world, why have you “worked tirelessly over the course of [your] career” to reform it? The World Health Organization, which has no interest in any American political party, ranks our great nation #37 in terms of producing health for its citizens. This is no number to boast of. You may have an argument if by “greatest” you mean the most technologically advanced, the most specialty-oriented, and the most expensive. However, research has shown again and again that a system with a strong bedrock of primary care is the only kind of system that produces greater quality and quantity of life. How else should we measure the greatness of a nation’s health care?
My primary care colleagues are justified in their concern about the large numbers of newly insured patients we expect to see in 2014. We are 40,000 doctors short of being able to supply the care these people need. Congress, no matter which party is in power, cannot fix this deeply rooted problem quickly. It takes seven post-graduate years to train a family physician, primary care internist, or general pediatrician. Had you and your fellow representatives acted in the 1990’s to begin strengthening our primary care workforce, perhaps the crisis in access that we are now facing would have been significantly abated. Instead, since that time an ever-larger percentage of my colleagues have chosen the more lucrative sub-specialty fields, because to them, being a primary care physician in America is simply not worth the trouble.
Mr. Gingrich, doctors like myself have worked hard in these difficult times, and we do appreciate it when someone in a position such as yours takes the time to honor that work. However, my work is not difficult because of anything Washington has done since 2008. Rather, my ability to make and keep people healthy is hampered because those who benefit most from the current system hold a great deal of power and are working every day to maintain their advantage. The PPACA has its flaws and limitations, but on balance I believe it is a step in the right direction. I hope that we can all work together now to move forward for the benefit of every American’s health.
Yours sincerely, Robyn Liu, MD, MPH, FAAFP