While vacationing in Maine last week, Dr. Daniel E. Fass was off the beach and instead, to his wife”™s irritation, on the phone in his recently adopted public role.
His caller was U.S. Sen. Charles Schumer. Fass, a radiation oncologist with a practice in Rye and a home in Greenwich, Conn., hoped to arrange an event that would bring together the senior Democratic senator from New York and area physicians to exchange views on health care reform.
Two weeks earlier, Fass assumed an active role in Americans”™ highly charged debate over proposed health care reform legislation by joining Doctors for America. A national grassroots organization that was an outgrowth of the Obama presidential campaign, Doctors for America seeks to engage physicians in the reform effort and have their views and experiences help shape a solution to the health care crisis. The group”™s reform mission is focused on affordable coverage, expanded access to care, high-quality care and creating practice environments that allow doctors to focus on patient care.
Fass came to his new role as both a physician and a small-business owner. The former head of the radiation oncology department at Greenwich Hospital, he is in private practice as director of the Institute for Image-Guided Radio Therapy, a tenant in the Westchester Medical Group center in Rye. With two physicians and a technical staff of 10, “It”™s a small business,” he said.
As a business owner, group health insurance coverage “has been a problem,” Fass said. “We have an employee with a pre-existing condition” ”“ for which insurers regularly deny coverage ”“ “and we have to figure that out.” Fass said he also has a family member with a pre-existing condition for whom it would be difficult to find another insurance carrier.
The various reform proposals in Congress would prohibit insurers from denying coverage to persons with pre-existing conditions. Fass was confident that provision will remain in a final bill enacted by the House and Senate.
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Fass also wants reform legislation to level the health care field for small businesses so that their costs match those of large companies. For small businesses, administrative overhead costs for health care now are three times greater than that of large employers, he said.
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The nation”™s health care system “is unsustainable; it”™s too expensive,” he said. “Clearly we can”™t keep spending more and more on health care and remain competitive in the world.”
Fass said the country is faced with an impending shortage of primary care physicians, whose numbers have been thinned by attrition and a lack of replacements. “It just doesn”™t pay,” he said. “Overhead is too expensive and reimbursement is too low.”
“If you are a sole practitioner on a salary, it”™s a business. If you can”™t pay the bills, you”™re out of business.” A reform bill must increase reimbursement rates for primary care, he said.
The physician left for vacation amid reports that the Obama administration and Democrats in Congress might withdraw their controversial proposal for a public health insurance plan to compete with private insurers and substitute a nonprofit cooperative program. Fass was uncertain what impact that would have on reform.
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“In politics, perfection is the enemy of good,” he said. “You don”™t always end up with what you want. But this is the best chance we have had in 50 years for comprehensive health reform.”
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As part of the Doctors for America campaign, this month Fass hosted an event at his Fairfield County home that brought together Rep. Jim Himes, the freshman Democrat from Greenwich representing Connecticut”™s 4th congressional district, with 15 to 20 physicians and about 10 other health care professionals from Connecticut and Westchester County in a question-and-answer session.
“I think it was really mutually beneficial because physicians, after many years of apathy, really want to be involved, they want to know what”™s going on and they want to be heard in Washington. I think the congressman heard the concerns of doctors and doctors left with a better understanding.
“That”™s one of the problems that physicians have historically had ”“ that we argue among ourselves and its a family feud. So we really don”™t get heard outside.”
Amid the din of pundits and shouting opponents at town hall meetings, Fass and some 14,000 other supporters of Doctors for American are trying to change that.
“I don”™t think there”™s been as much interest by the general public in legislation in my memory,” he said.
