Now is the time to build on our health policy victories

From the AMA board chair. By J. Edward Hill, MD. April 7, 2003.

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A message to all physicians from J. Edward Hill, MD, chair of the AMA Board of Trustees.

March came in like a lion for the AMA and all of organized medicine -- and we roared the rest of the month.

We started off with the first National Advocacy Conference in Washington, D.C., during the first week in March. Those in attendance gave us rave reviews, and organizations, inside and outside the health care community, were impressed by our line-up of speakers -- led by President George W. Bush.

We heard from Senate Majority Leader Bill Frist, MD, (R, Tenn.), who urged physicians to take the fight for tort reform to their Senators.

We heard from the House Ways and Means Committee chair, Rep. Bill Thomas (R, Calif.), who was crucial in passing the fix to the Medicare payment mistake -- as was Rep. Billy Tauzin, (R, La.), House Energy and Commerce Committee chair, who also spoke at the NAC. And we heard from Sen. Max Baucus, (D, Mont.), who helped achieve bipartisan consensus on fixing the Medicare update mistake on the Senate side.

Our speakers also included Centers for Medicare & Medicaid Services Director Tom Scully, who urged organized medicine to bring the same focus to battling the medical liability crisis that it applied to the Medicare mistake; and U.S. Surgeon General Richard Carmona, MD, who stressed the importance of diet and exercise, and not smoking.

Many who spoke had one thing in common -- praise of the AMA and the Federation of Medicine for our leadership and influence on national health policy issues such as the Medicare payment update issue and medical liability reform. This vote of confidence makes us want to work that much harder to reach our goals for American medicine and for our patients.

A real highlight of the conference was the speech March 4 by President Bush, which addressed, among other vital issues, the liability crisis.

"We have a problem in America. There are too many frivolous lawsuits against good doctors, and the patients are paying the price. ... And the problem doesn't start in the waiting room or the operating room, it starts in the court room," the president told us.

President Bush went on to present the case for reform -- a goal the AMA shares:

"If harm is caused by serious misconduct, patients should also be able to seek reasonable punitive damages. [But] without fair and reasonable limits, the legal system looks more and more like a lottery. ... American courts should not be serving the self-interest of personal injury lawyers; they should be serving the cause of justice and the needs of American patients," he said.

Judging by the warm response the president received -- he was interrupted almost 40 times by applause -- representatives of organized medicine who were on hand are unified by this crisis and the urgent need to fight it.

One weapon available nationally is the HEALTH Act, which was introduced by Reps. Jim Greenwood (R, Pa.) and Chris Cox (R, Calif.), both of whom also spoke at the Advocacy Conference. The legislation was passed by the House of Representatives March 13. Similar legislation is pending in the Senate.

So it is imperative that we contact our senators -- and both President Bush and Dr. Frist encouraged physicians to do just that.

Do it. Call your senators. Write them. E-mail them. Explain the danger our out-of-control system poses to patient access. Ask them to support medical liability reform.

Take two minutes to go to the AMA grassroots Web site (www.ama-assn.org/go/grassroots). Type in your ZIP code, and you will be given contact information for your senators.

This may be the most opportune moment for the fortunes of liability reform in my memory -- it has the support of the president and a majority in both chambers of Congress.

The nation's biggest newspapers, network and cable news shows have done major stories on medical liability reform. And the AMA -- and all physicians and patients -- are coming off policy victories that gives us some additional momentum.

In late February, President Bush signed the Omnibus Appropriations bill, authorizing the U.S. Dept. of Health and Human Services to correct the 1998 and 1999 Medicare physician payment projection errors.

The AMA worked together with specialty, state and county medical societies as well as group and academic medical practices toward this victory. With your support, we averted a 4.4% cut in Medicare physician payment and instead, physicians will get a 1.6% increase in 2003.

The calls to lawmakers, the participation in rallies, and the active grassroots efforts paid off. And 40 million Americans now in the Medicare program got the good news that their access to care won't be jeopardized by an accounting error -- at least not this year. This particular fight was won, but we cannot relent -- the struggle for Medicare reimbursement fairness is an ongoing one.

The AMA also helped lead the charge toward another victory in Congress when the House in mid-March passed the bipartisan Patient Safety and Quality Improvement Act, which establishes a system where health care errors can be reported and analyzed to improve patient safety and health care quality.

This legislation strikes the proper balance between accountability and confidentiality by creating a voluntary database to track errors.

We are building on this success.

We are continuing to seek solutions to the disgraceful problem of Americans living -- and dying -- without health insurance. And to work toward Medicare reform as proposals are made to include prescription drug benefits, and to find ways to cope with the baby boomers as they reach retirement age.

And of course, there is the immediate threat posed by an out-of-control legal system -- one that has precipitated a medical liability crisis and that is forcing physicians to stop doing high-risk procedures or to flee from states without commonsense reforms in place.

America's physicians and our patients have powerful allies on this issue in Congress and the White House.

But nothing is more powerful than the unified voice of organized medicine, crying out for relief from, and reform of, a medical liability system that decreases access for millions of patients while increasing costs for everyone. More than ever, now is the time to make our unified voice heard.

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Dr. Hill is a board-certified family physician residing in Tupelo, Miss. You can contact him by e-mail (boardchair@ama-assn.org).

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Copyright 2003 American Medical Association. All rights reserved.