Health & Public Policy Committee Winter 2005 Report
By Robert McLean, M.D., FACP
Chairman, Health & Public Policy Committee
The re-election of President Bush and the strengthening of the Republican majority in both Houses of congress would seem to increase chances for federal legislation to reform our medical liability system with limits on non-economic damage awards. As well, it would seem more likely that the Medicare Modernization Act will be allowed to become fully implemented over the next few years without alteration. This may prove problematic.
The Medicare Reform bill involved some crucial and necessary financial fixes to Medicare in the first few years but then included complex provisions to be enacted over the next few years which encourage (some may say "force") greater involvement of managed care insurance companies in Medicare delivery and which provide an incredibly complex prescription drug "benefit" (see excellent explanation of the bill in "Assessing the New Medicare Prescription Drug Law", by Robert Doherty in the Sept 7, 2004 Annals of Internal Medicine).
Several members of our Health & Public Policy Committee met with Representative Nancy Johnson in early December to discuss many of these issues. Rep. Johnson is a knowledgeable and effective advocate in Congress on health issues, especially as Chairman of the Health Sub-Committee of the House Ways & Means Committee. We clearly need to continue to help our legislators understand the crucial role which internists play in the health care system, frequently managing multiple and complex patients with great need for time and coordination of care. The reimbursement system continues to undervalue "evaluation & management" services in comparison to procedures and diagnostic tests, and we continue to try to help Rep. Johnson understand the scope of those inequities.
In mid-November, we also met with State Senator Chris Murphy, currently co-chairman of the Public Health Committee. Senator Murphy took the opportunity to learn the internists' perspectives on topics which included the crisis in health care access for the uninsured and underinsured, the crucial need for liability insurance reform, improving patient safety and medical error reporting regulation of pharmaceutical industry marketing and influence, and even the recent flu vaccine shortage. Many health care public policy issues are more affected by state than federal legislation, and so we must maintain an effective voice in Hartford.
But whether it is contacting legislators on important issues in Hartford or in Washington, D.C., we continue to need more ACP physicians to help us. I made a request for sign-ups for the "Key Contact" program at the State Chapter meeting in late October. I am happy to report that we have added 19 new "Key Contacts" to the 52 already listed! As Key Contacts, these physicians receive email or fax alerts from the D.C. office when specific votes or issues come up which the College has determined warrant significant input from our members. It is really not more than several times per year (maybe it should be more frequent to help our legislators feel our presence more!), and I urge more our state membership to sign up. To become a Key Contact or get involved with our H& PP Committee, please contact me at email@example.com
The Connecticut State Medical Society (CSMS) remains the strongest advocacy force for medicine in Hartford. Some may feel CSMS is too specialty-oriented, but one must realize that the major health policy issues facing legislators in Connecticut impact on all medical specialties. I urge all physicians who are not currently members of CSMS to join in 2005. It is frightening to consider all the special interests and lobbyists in Hartford who are working directly against the interests of physicians, and we crucially need an effective voice.
I frequently hear concerns among physicians that the ACP is not trying hard enough to improve our dysfunctional physician payment system, our disastrous liability system, or even the recent flu vaccine shortage. How untrue! One can get a brief summary of recent Congressional testimonies and letters submitted by ACP leadership on all these issues by going to www.acponline.org/advocacy. You will be impressed at the quality and volume of correspondence to various policy makers on a diverse array of health policy issues. You can also sign up to be a Key Contact at this web site!