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Health & Public Policy Committee Report


By Robert McLean, M.D., FACP
Chairman, Health & Public Policy Committee

The healthcare landscape has been politically volatile for over a decade since President Clinton's efforts to pass comprehensive health system reform. Change is clearly not easy to implement. This has become ever more evident each year that several physicians from our ACP Chapter travel to Washington, D.C. to personally advocate for important health care issues and specific legislation. On May 19, five physicians (Governor David Podell, Governor-Elect Eric Mazur, David Miner, Jane Hunter, and Robert McLean) joined 220 other physicians from other ACP Chapters across the country for the ACP's "Leadership Day on Capitol Hill".

We felt compelled to warn our legislators about developments in the U.S. health care system that threaten patient access to quality care. We physicians see the problems in our daily practices, but the legislators still do not really understand the urgency of many of the problems. Key issues on our agenda included reductions in physician payment under Medicare and the need to expand health insurance coverage.

We tried to explain that projected drastic cuts to physician payments under Medicare truly threaten access to health care for Connecticut's half million Medicare beneficiaries.

We asked for support of The Health Coverage, Affordability, Responsibility and Equity Act of 2003 (H.R. 2402/S.1030), which lays out a plan to significantly decrease the number of uninsured in our country by expanding several facets of health care delivery already in place. While not a perfect solution, the ACP feels it is politically viable due to its incremental approach.

We expressed great concern to all legislators' aides that primary care physicians will soon not be available for our citizens due to several factors scaring medical school graduates from entering specialties like internal medicine: market forces and Medicare fee schedule problems lead to lower reimbursement rates for "cognitive"-oriented primary care specialties, a dysfunctional malpractice system leads to great liability concerns for all physicians, and large student loan debt burdens discourage entry into lower-paying medical fields. These problems are not news to our physician membership. However, efforts must be ongoing to inform legislators at both the federal and state level that these issues will not go away and cannot be fixed with simple pieces of "band-aid" legislation which do not address the underlying problems.

The largest issue at the state level has been malpractice reform. The Legislature passed "band-aid" legislation which included several components which did improve some of the mechanisms making ease of bringing unwarranted or frivolous lawsuits more difficult, but it did not include limits on awards for non-economic damages. Appropriately, the Governor vetoed the legislation, and we hope his veto is not overridden in late June. If such inadequate legislation is passed, the Legislature will have an excuse to not address malpractice reform issues for at least several issues. Experience in other studies shows that limits on "pain and suffering " damages are necessary for exorbitant and outrageous jury awards to get under control and thereby allow the malpractice insurance industry have actuarial data to truly reduce insurance premiums.

We are clearly living in challenging times with regard to health care delivery. We feel that physicians are central to the system, and therefore we must have our perspective heard as legislation is considered which affects our ability to practice medicine and which affects the availability of affordable health care to our patients. If you are willing to help contact our Legislators as the need arises, please ask me, Robert McLean, to add you to our growing list of Key Contacts.