"It is amazing how much you can get done-when you don't care who gets the credit."--President Gerald Ford

Ford's quote is a good description of the results of the Orange County Healthcare Reform Committee's solicitation to doctors, asking them to provide ideas for healthcare reform.

The OCMA formed the committee during its Strategic Planning Session in January. It was created in response to a request by Joe Dunn, the new CEO of the California Medical Association. Dunn recommended that the OCMA consult with Orange County physicians and get their input on healthcare reform in California. Ideas and suggestions from doctors countywide were compiled in February for possible inclusion in the healthcare reform plan under development by the CMA.

As physicians are keenly aware, the entire debate on healthcare reform is fraught with sinkholes. Special interests are all at the table, and certainly physicians fall into that category. As a former state senator, Dunn is aware of the politics surrounding the debate and has worked hard to ensure that the CMA is a key player as reform is discussed. The CMA has purposely pursued a strategy that is positive and constructive.

It is important to understand that the governor's proposal is just one of many, and the ideas are meant to initiate the discussion. OCMA Editor Lytton Smith, MD, shared in his February column that the best approach is not to get sidetracked by the reform elements physicians don't like, but to look toward a goal that serves all patients.

The OCMA undertook the request from Dunn with gusto, understanding that as invested members of organized medicine, we have a voice that will be heard. Physicians from around Orange County, whether they were OCMA members or not, were asked to provide input on the healthcare reform debate, and the response was significant. The committee reviewed each suggestion and sought to determine whether it met the standards outlined by Dunn--sound on merit and politically feasible.

There were common threads among the ideas received:

- Doctors want to have all Californians covered by health insurance;

- They want to see doctors' costs and liability reduced;

- They want to eliminate the need to practice defensive medicine;

- They want insurance abuse and fraud addressed; and

- They don't want to be taxed to pay for their patients' insurance.

While there was general agreement on the primary goals and objectives, the thoughts suggested for achieving them were as varied as the number of spec-
ialties and subspecialties in medicine.

Richard Pitts, DO, an OCMA board member, referred to the important role that the OCMA and CMA will play in the process for reform when he said: "It is clear to me that without organized medicine, physicians will not have a seat at the negotiation table on important medical matters."

This discussion and the resulting measures will shape our practices in the next decade and beyond. Thanks to those of you who contributed ideas. We continue to make a difference.