Response of William Hall, MD, FACP
to President Bush's State of the Union Address
(Washington, DC): The American College of Physicians-American Society of Internal Medicine (ACP-ASIM) applauds President George Bush's plans for ensuring the nation's security as outlined in his State of the Union address. The more than 115,000 members of the ACP-ASIM were gratified to hear the president address key health care issues such as preparedness for the possibility of a bioterrorism attack, tax credits to help uninsured workers maintain health insurance coverage, a patient bill of rights, and modernizing Medicare to include a prescription drug coverage benefit.
Other critical steps need to be taken, however, to truly ensure the nation's "health security" and sufficient funding must be provided in the president's forthcoming budget to support urgent health priorities:
- Provide adequate funding, and target funds toward training primary care physicians, hospitals and public health authorities to prepare for a potentially catastrophic attack with chemical or biological weapons;
- Assure that the funds allocated to a health insurance tax credit are sufficient to make health insurance affordable to all low-income Americans and take further steps to assist the more than 39 million Americans who lack health insurance;
- Commit sufficient funding to ensure that the Medicare system continues to offer high-quality and accessible health care, including halting cuts in payments to physicians, teaching hospitals, and other "safety net" providers;
- Assure that a Medicare prescription drug benefit is adequately funded. ACP-ASIM agrees with the president that the highest priority should go toward providing drug coverage for low-income beneficiaries;
- Conserve funds in the Medicare program by eliminating unnecessary paperwork and other regulatory burdens;
- Assure that final rules are published on the administrative simplification, privacy and security requirements from the Health Insurance Affordability and Accountability Act and that such rules meet their original intent of easing paperwork and protecting patient privacy.
The ACP-ASIM has specific suggestions on how to successfully implement the programs proposed by President Bush as presented in the College's "State of the Union's Health Care" available online at www.acponline.org/advocacy.
ACP-ASIM urges Congress and the president to agree on a comprehensive funding plan for essential initiatives:
- Improving Centers for Disease Control and Prevention capacity, and enhancing communication networks for public health officials;
- Improving health care professionals' training;
- Enhancing hospitals' surge capacity
- Securing a sufficient national stockpile of vaccines;
- Protecting the nations' food supply with more frequent inspection and better surveillance.
Despite the nation's prosperity, 39 million Americans lack health insurance and that number is increasing. We agree with President Bush that refundable tax credits for health insurance coverage can help make affordable coverage available. The effectiveness of a tax credit will depend, however, on whether or not it is high enough to make insurance premiums truly affordable for people who cannot afford to contribute a substantial share out of their own pockets. ACP-ASIM has published a new monograph that explains how a tax credit should be designed to be effective in expanding health insurance coverage. In April, ACP-ASIM will release a detailed seven-year plan to provide all Americans with access to affordable health insurance.
Medicare Prescription Drug Benefit
We applaud the president's commitment to offerings prescription drug coverage through the Medicare program. Prescription drugs costs are the fastest growing segment of health care expenditures. Yet Medicare, representing 40 million Americans, is the only major insurer that does not offer any type of drug discounts or cost sharing. If funding limitations preclude offering this benefit to all Medicare enrollees, ACP-ASIM agrees with the President that the benefit should be targeted to the lowest-income seniors.
Medicare Regulatory Reform
The promise of Medicare, Medicaid and other safety net programs have been weakened by excessive cuts during a time when the costs of providing care increased. The time has come to reform the Medicare program by changing the focus from bureaucracy to quality.
As physicians, we are pleased that the President ha srecognized the need for a sound and modern Medicare program. Particular areas of reform must include reducing the bureaucracy that stands between physicians and their patients, a rational method of updating program reimbursement levels that reflects the cost of providing services, and screening tests.
Patient Bill of Rights
We applaud the president's support for a patient bill of rights. Managed care companies must be held accountable for decisions they make. A strong patient bill of rights should guarantee insured patients access to the right care at the right time without needless hurdles.
The American College of Physicians-American Society of Internal Medicine is the largest medical specialty society and the second largest medical association in the United States. Membership encompasses more than 115,000 physicians and medical students.
Page updated: 11-04-03