“Status quo is unsustainable; reform is a necessity,” he says
More than 1,000 of the nation’s top physicians, including several AAOS members, attended the American Medical Association (AMA) Annual Meeting in Chicago, June 13-17, 2009. The hot-topic issue—healthcare reform—included consideration of various reports and resolutions by the House of Delegates (HOD), which heard testimonies from several physicians as well as a plea from U.S. President Barack Obama.
A call for health reform
President Obama, the first U.S. president to address the HOD since Ronald Reagan in 1983, outlines several priorities that were consistent with the principles of health system reform endorsed by both the AAOS and the AMA. His remarks focused on the following areas:
- extending coverage and access for both the uninsured and the underinsured
- making healthcare coverage more affordable
- increasing the value physicians receive from health care spending
- improving the quality of care
- enhancing prevention and wellness for all patients
In his speech, President Obama commended the AMA for joining with other healthcare stakeholders to help reduce the rate of growth in health care spending by 1.5 percent over the next decade. “That would have been unthinkable just a few years ago,” he said.
The president went on to address specific concerns of physicians, noting that the current system requires doctors to spend “20 percent of each day supervising a staff, explaining insurance problems to patients, completing authorization forms, and writing appeal letters; a routine that [is] disruptive and distracting, giving [you] less time to do what you became a doctor to do and actually care for patients.”
The president noted that physician involvement in the ongoing debate is crucial. “Building a health care system that promotes prevention rather than just managing diseases will require all of us to do our part. It will take doctors telling us what risk factors we should avoid and what preventive measures we should pursue.”
The president urged a switch to electronic medical records and an investment in prevention programs. He called for compensation reform that should shift payments “so you aren’t getting paid for every single treatment you offer a patient…but instead are paid for how you treat the overall disease.” He noted that incentives for coordinated care and for good outcomes are necessary, and that changes in medical education and the dissemination of medical information are needed.
The president recognized the need for tort reform, saying, “it will be hard to make some of these changes if doctors feel like they are constantly looking over their shoulder for fear of lawsuits.” He stopped short, however, of endorsing caps on awards.
He outlined various methods of paying for his program, including the following:
- establishing a “health reserve fund”
- using Medicare reimbursements to reduce preventable hospital readmissions
- creating an approval pathway for general biologic drugs
Reports and resolutions
The following reports and resolutions considered by the HOD are of significance to orthopaedic surgeons and the AAOS:
Council on Ethical and Judicial Affairs (CEJA) Report 1: Financial relationships with industry in Continuing Medical Education (CME)—This report proposed an ethical framework to guide professional practice with respect to financial relationships in the context of providing CME. After much discussion by members of the AMA Orthopaedic Section Council and other delegates, the HOD voted to refer the report back to CEJA. Although many delegates praised the CEJA for its work, they expressed the sentiment that the language within the report needed significant improvement.
Resolution 110: “Public Option” Health Insurance—In alignment with current efforts to provide all Americans with affordable, high-quality health coverage, the House voted for a new policy stating that the AMA “supports health system reform alternatives that are consistent with AMA principles of pluralism, freedom of choice, freedom of practice, and universal access for patients.”
The Speakers’ Special Advisory Committee on the HOD—The 18 recommendations in the Speakers’ report were approved. The AMA will appoint a task force to look into the structure and function of a meeting that could replace the current Interim Meeting of the HOD, including the role and function of members, the timing and location of the meeting, the timing of the AMA Annual Meeting, transition plans, and efforts to maximize value, minimize cost, and address the concerns of the various AMA councils, sections and special groups.
AMA election results
Andrew W. Gurman, MD, a hand surgeon and AAOS fellow, was re-elected to a third term as vice speaker of the House. Stephen L. Brotherton, MD, was appointed to the CEJA. William A. Dolan, MD, and William A. Hazel Jr., MD, will continue to serve as members of the AMA Board of Trustees for 2009-2010.
Toya M. Sledd, MPH, MBA, is the clinical quality improvement coordinator in the AAOS medical affairs department. She can be reached at firstname.lastname@example.org