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Health & Public Policy Committee

The CT Chapter's Health & Public Policy Committee works to promote and protect the interests of the physicians and patients of our state on all these issues and more. We work closely with the Connecticut State Medical Society on many of these issues, and we work to maintain dialogues with legislators representing us in both Hartford and Washington.

We need grass-roots help from all interested physicians. If you want to be kept informed and would help with letter writing or phone calling when needed, then please contact our H&PP Committee chairman Robert McLean.

Health & Public Policy Committee Report By Robert McLean, MD, FACP

The Medicare Prescription Drug Bill which was passed in late November by both houses of Congress has brought the crisis in our health care system back into prominence at a level not seen since the Clinton administration effort to achieve significant reform in 1994. We must recognize that this increased attention is long overdue. Many are very dissatisfied with continually increasing costs in a health delivery system which continues to leave over 40 million Americans uninsured.

The ACP feels that the Medicare Prescription Drug Bill overall made some major improvements in Medicare which will impact on our practices almost immediately. The Medicare physician pay cut of 4.5% scheduled for January 2004 (and again in January 2005) has now been averted and replaced by a positive update. This major provision pushed by the ACP and other medical organizations will ensure that Medicare beneficiaries have access to physician services, since many physicians would likely have severely limited their availability to Medicare if the previously scheduled pay cuts had occurred. The bill also includes other measures strongly supported by the ACP, including regulatory relief provisions to reform the Medicare audit process, improve carrier performance, and require testing of alternatives to onerous Evaluation and Management paperwork requirements; and incentives--rather than mandates--for electronic prescribing.

Much of the attention given to the Medicare Prescription Drug Bill has focused on some of the longer term provisions related to expanding use of Medicare HMOs as well as details of the Prescription Drug provisions. While the Bill as passed will not benefit all seniors equally, it does provide at least some prescription drug benefit, and that is a first step in making major Medicare changes which will ultimately need to be enacted. Most of the potentially problematic provisions in the Bill have a timeline of several years, which will allow modifications to occur as Medicare beneficiaries and the rest of the electorate begin to understand the true implications, which are major! Yet, the short term positive aspects of this Bill are clear and allow Medicare to continue to serve in the short term as a fairly efficient system to deliver healthcare to millions of Americans. Without many of the reform provisions in this complicated Bill, Medicare's short term survival would have been in jeopardy.

The other major health care issue this year has been malpractice liability reform. At the state level. the Connecticut legislation was bogged down with budget issues, which led legislative leaders to successfully put off this malpractice reform issue. A working group of legislators (consisting of chairmen of most of the involved committees) was given the task of developing a comprehensive piece of legislation, but this group has yet to publicly make any announcements.

At the federal level malpractice reform did pass the House in March with the "HEALTH Act of 2003" (H.R5), but it was a mostly party line vote, likely reflective of the historical support given to Democrats by the trial lawyer lobby. The Senate did not successfully act on this legislation this year.

Several members of our Health & Public Policy Committee had the opportunity in August to meet with Senator Chris Murphy, Co-Chairman of the Public Health Committee, and Rep. Mike Lawlor, Co-Chair of the Judiciary Committee. We had productive discussions centering on the malpractice reform issue as well as the topic of reducing medical errors and the role of reporting of such errors. These issues are being actively discussed by a working group of legislators, and we will continue in our efforts for them to understand our physician perspective on these crucial issues.

Senator Murphy was the driving force behind legislation ultimately passed into law which bans smoking in public places like restaurants. In recognition of his efforts with this important legislation, we presented Senator Murphy with our Chapter's "2003 Legislator of the Year Award" at our Chapter meeting in late October.

Our D.C. ACP office works hard with lobbyists to advocate on these many issues which affect us, but we need to remain personally committed as well. Letters asking for support of legislation and telling very specific personal stories about your patients or practices do have an impact. As well, follow-up letters after specific votes to express appreciation or disappointment remind the legislators that we are truly paying attention! When such letters are particularly timely or crucial, I will notify a list of those physicians in our Chapter willing to participate. If you are not already on my list and getting such e-mail requests but would be willing to have your voice be heard, then please contact me at rmmclean@optonline.net. It is time to get involved!

Contact Information

Robert Nardino, MD, FACP
ACP Governor, Connecticut Chapter

Nancy Sullivan
30 Dwight Drive, Middlefield, CT 06455
Phone: (860) 349-8995
Fax: (860) 349-3004 or
E-mail: ctacp@comcast.net

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