It took Congress over a year to compile and construct it. It took creative maneuvers to pass it into law. Already unfounded fears are sticking doctors in the middle of what it means to their patients. Now comes the hard part. The Obama Administration now has to turn 2400 pages of words into changes in Health Care. Here’s the latest on the teams that are supposed to do it:

  • Jay Angoff, consumer advocate, known nemesis of the insurance industry, heads up implementation of the regulation of insurers and insurance markets.
  • Jeanne M. Lambrew comes back with experience from the Clinton administration to work on expanding coverage.
  • Phyllis C. Borzi, a top Labor Department official, is assigned to ensure that employers are following the rules for some 150 million American insured persons.

These three have been asked to turn that legislation into reality, and encouraged to involve the private sector in the transformation. But, after so much antagonistic dialog between the insurance companies and other special interest groups, is that even possible? As Joseph Antos, economist with the American Enterprise Institute questions, “… will officials be able to calm down enough to be able to talk to the industry and the experts who will be running the new system? You need their input. It’s essential to get technical insights from people in the industry who were largely ignored in the political process.” And now we get to the part most near and dear to our hearts.

Is now the time for all good Doctors to come to the aid of their country, or is the U.S. still ignoring physicians?

Jay Angoff’s work history is as a lobbyist and political activist. It’s sure he’s going to be tough on the insurance companies and brook no legalese doublespeak (since he’s an attorney himself.) Some may claim that he’s going to be too tough, confrontational and prone to litigation. Most of those are insurance company representatives, though. Nevertheless, that still doesn’t make him a physician.

Jeane Lambrew is nothing, if not persistent. She worked all through the Clinton administration, never wavering from the goal of ensuring that children have insurance coverage. Now she’s been tapped by President Obama and Kathleen Sebelius, to deliver on a very short deadline. Within 90 days, she is expected to obtain compliance across the Union on the required high-risk insurance pool. Here we have a bit more promising influence, as Ms. Lambrew’s parents are in the industry. Her father and grandfather were both physicians, and her mother is a nurse. She worked with officials in Maine in 2003 to overhaul the health care system there in her home state. Ms. Lambrew comes with qualifications and a demonstrated dedication to the cause.

Ms. Borzi is also an attorney, and an Assistant Secretary of Labor. She has 35 years of work history dealing with employee benefits issues. From 1979 to 1995, she worked under House Democrats who were on the pensions and employee health benefits subcommittee. A former research professor at George Washington University with extensive practical experience advising multi-employer health benefit plans, her job is now to pen regulations which will provide employers with clear guidance while avoiding heavy-handedness. Of herself, she says she is “committed to preserving the employment-based system and encouraging employers to keep their health plans in place.” She is a longstanding Democrat but has earned the respect of Republicans for her expertise on related subjects including the ERISA (Employee Retirement Income Security Act of 1974.) Opposing views suggest that a heavy hand may discourage employers from actively striving to provide employees with quality health care benefits, but it’s hard to take such concerns seriously, as benefits packages are part of how companies recruit the best possible candidates.

Tally: 1 person with health care history experience, and two attorneys. Let us hope that the sum is greater than the parts, at least when summarized in that fashion. Where is the place for physicians to be involved? It would seem that the medical profession’s place at the table will be found in leading by example, uninvited. Just as is the case with tort reform (or the lack thereof) it is left to doctors to protect themselves and their patients. When it comes down to it, the doctors may be the only ones without a political voice in it all.