The following editorial by TMA Board of Trustees Vice-Chairman Charles Eckstein, MD, of Nashville, was featured in the April 12 edition of The Tennessean: 
 
The Rolling Hills Group proposal for health system reform contains many principles that physicians in Tennessee and across our nation can agree on. We are unified in our belief that the U.S. healthcare system needs reform if we expect to deliver the quality care that Americans demand and deserve without breaking the bank.
 
We need to change the way health insurance is purchased, close business tax advantages that work against the poor and uninsured, and discourage abuse of our system. Requiring everyone to have coverage and providing the mechanism to get coverage is good start, but we must realize that access to coverage does not always mean access to care.
 
We agree that reforms need to allow more resources for wellness, prevention and health maintenance, but we cannot simply take dollars from one sector of health care to fund another. Achieved savings through new efficiencies and premiums and co-pays by individuals contributing to their own care should provide these necessary resources.
 
Manpower is an area that needs immediate attention. We already have a shortage of primary care physicians being overwhelmed by a rapidly growing population in need of basic healthcare services and a medical home. We have to address the negative aspects of our system that discourage medical students from going into primary care and steer potential doctors away from medicine altogether. We also must ensure that the health care professionals who treat patients are adequately trained to diagnose and treat complex medical conditions and multiple diseases.
 
Administrative red tape, frivolous lawsuits, and burdensome mandates also need to be identified and removed because they take personnel and financial resources away from patient care. Plans are being developed to help pay for electronic health records which may help doctors share data with other providers to eliminate redundancies, lower costs and increase safety. With the creation of uniform standards, hopefully we will soon have a fully connected and interoperable health information technology network. Until then, mandating the use of these technologies will waste valuable funds and further complicate the sharing of health data.
 
Ensuring quality and value is another critical area. We must use comparative information to improve patient care, not simply penalize providers for non-conformance. Programs which allow patients to know how well physicians and facilities perform can have the unintended consequence of actually reducing access to care for sicker patients and this is unacceptable. Policymakers need to recognize that not every patient is the same and a system that pays to promote “cookie cutter” medicine will not improve care.
 
Properly managing expectations is probably the greatest need and challenge of any healthcare system in the future. Making the tough decisions regarding what our healthcare system can and cannot provide is the only way we can afford coverage for all. This will be the most difficult reform measure because it will be the most politically unpopular.