Geraldine McGinty, MD, MBA, FACR, chair of the ACR Board of Chancellors, contributed this post.

The ACR’s core purpose is “To serve patients and society by empowering our members to advance the practice, science and professions of radiological care.” As I said in my November 2019 JACR® column, “empowered imaging professionals’ practice of medicine is structured to support them in delivering the highest standard of care to the patients in whose diagnosis or treatment they are privileged to participate.”

What is critical to empowering our members is the ability to have a voice in the regulatory process that governs our practice and the reimbursement that sustains it. The decision that your American College of Radiology® (ACR®) leadership made to participate in the Partnership for America’s Health Care Future was predicated on the imperative to preserve that voice.

Our US health care system can, for some, be the best in the world, and yet we know that for others it is far from that. The debate on how to reform how we deliver and pay for health care is not new, but has taken on new momentum with the discussion of a more comprehensive role for the government variously called “single payer” or “Medicare for All.” As we trend towards spending 20% of our national output on a system that does not always deliver the outcomes we might hope for, we need to do better. Opinions, not surprisingly, vary on how to do that. What is critical is that we as radiologists continue to be part of the decision-making process.

As such, after much thought and a unanimous vote of the ACR’s Board of Chancellors, the decision was made to support and participate in the Partnership in May 2018. That decision has been reviewed since and will likely be reviewed again as we get closer to the election, and pending any discussion on the Council floor at the Annual meeting. ACR participation followed extensive discussion and deliberation, and has been discussed in the press, on social media and on the ACR website.

The Partnership, comprised of stakeholders throughout the American health care system, is a coalition pledged to support federal policies that build on the strength of employer-provided health coverage, a delivery system based on our current multi-private payers, while preserving federal programs such as Medicare, Medicaid and other proven solutions that hundreds of millions of Americans depend on. All in the Partnership are committed to legislative solutions to fill in the gaps where they exist — to expand access to affordable, high-quality coverage for all Americans.

The ACR and its members work to provide for the best radiologic care possible, and we support policies that expand access to these services. Like any nonpartisan health care association, the ACR advances policies to benefit patients and members without allegiance to a single political party or a party’s specific policy platform. The ACR wants to work together with other stakeholders to lower costs, protect patient choice, expand access, improve quality and foster innovation. For these reasons, we have worked for decades to ensure the appropriate utilization of diagnostic imaging services.

Polling shows that a single payer system is actually not attractive to the public once they learn the specifics of its cost ($32 trillion) and the potential for increased patient wait times and provider reimbursement cuts — estimated by CMS (figure 1) and others at 40 percent vs private plans. Studies and news reports have discussed the widely accepted view that the services and hospitals likely most affected would be in rural and underserved areas.

We are on the brink of an exciting era, when artificial intelligence (AI) and machine learning will empower advancements that all Americans must be able to access. However, advanced technologies may be rationed in a single payer system — stifling the ability to improve patient care with innovative tools and treatments.

As our specialty demands unique expertise and touches virtually every part of patient care, radiology must take a leadership role. This involves engaging with other stakeholders in many venues — including The Partnership.

ACR leadership, chosen by College membership and tasked with executing the policies voted on by Council, welcomes and relies on member involvement and good faith input to represent the best interests of our members and those they serve.

We are all in this together — as we consider our ongoing involvement in The Partnership — and the myriad challenges we will face in the months and years to come.

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