Public Policy & Advocacy
Health & Public Policy Committee Report-Summer 2006
Submitted by Robert McLean, M.D., FACP
The end of 2005 once again saw a panic over Medicare physician pay cuts which were automatically scheduled to occur. With great effort from organized medicine (the ACP, AMA, and other specialty organizations), legislators and the President in 2006 budget negotiations finalized in late January settled on a freeze of the Medicare fee schedule to 2005 levels.
Despite efforts by Rep. Nancy Johnson (with ACP support) to pass legislation which would truly fix the Medicare physician fee schedule update problems by eliminating the SGR (sustained growth rate) formula, nothing has changed for the future. We can anticipate Medicare fee cuts of over 20% over the next 5 years unless a legislative fix is implemented.
While occasional bills surface in Congressional committees, the Congress has not been interested in passing significant legislative initiatives in other areas of interest: malpractice reform, physician collective bargaining anti-trust exemptions, or reform of the dysfunctional Medicare payment system. However, the ACP continues to aggressively advocate for crucial reforms, and Dr. Mazur notes in his Governor's column that we are making an impact. There have been several important new policy papers see ACP's Legislative Action Center on the Advanced Medical Home concept, national healthcare workforce, and reforming the dysfunctional payment system - all of which address crucial aspects of the health care system which need change to ensure improved access to health care for our patients and ensure that internists play an appropriate central role in delivery of care to those patients. Dr. Mazur's column explains more of these details well.
Our Chapter's Health & Public Policy Committee met with Rep. Nancy Johnson in February to present her with our 2005 Legislator of the Year Award in recognition of her efforts to fix Medicare's dysfunctional payment system. We introduced her to the ACP's just-announced "Advanced Medical Home" policy paper, and she subsequently became quite interested in the concept.
As of early May, the state legislature had concluded its short session with no major health policy addressed after some very minor "reforms" passed in 2005 regarding medical liability. In Congress, the House of Representatives has passed medical liability reform (largely along party lines) over the past several years, but that legislation has stalled in the Senate. Finally, that appears to be changing. In mid-May, the Senate is scheduled to take up S.22, a bill based upon liability reforms which proved effective at stabilizing the liability insurance market in Texas. ACP members signed up as key contacts should have received e-mail alerts to contact our Senators about this bill.
Clearly, change is upon us, whether we like it or not. Technology has appropriately spurred a movement to improve patient safety by decreasing medical errors and has also pushed the movement to ensure that certain evidence-based measures of care are actually being delivered in quantifiable ways. It is in the best interest of our patients and of our profession to embrace and help to mold the changes which our health care system needs through our relentless advocacy work. I must quote a "fortune" I recently received in a fortune cookie: "Turbulence is a life force. It is opportunity. Let's love turbulence and use it for change."
We are the experts in health care, and legislators and policy makers still recognize that. Therefore, we must ensure that our voices are appropriately heard and invited to the policy-making table. If any ACP members in Connecticut are interested in more formally joining our Health & Public Policy advocacy efforts or in signing up as a key contact, then please contact me at firstname.lastname@example.org