Hotel and Towers
Sunday, June 11,
R. Reardon, MD
Thank you, Mr. Speaker. And thank you, ladies and
The few steps I just took to get up here mark the end of a
year-long, continent-spanning, soul-enriching journey.
And I end this journey the same way I began it by, thanking
each of you from the bottom of my heart for the privilege, the
honor, the trust, the confidence you placed in me one year
Being President of the American Medical Association, being
your representative in Washington, in literally every state of
the Union even in Europe at the World Medical Association
meeting, being an eye-witness to history on your behalf -- all
of that is extremely satisfying and humbling.
So, I must say “thank you” and “thank you” again.
And I can report to you that we have achieved many
successes. Too many to list. But each is a hard-won,
And, as a result, the net effect today is that the image of
medicine in America is the highest it has been in decades. For
we are advocating for those things that resonate well with the
At a recent conference, I addressed a meeting of top
executives from Corporate America. I pointed out to them what
a respected futurist from Denmark said about health care.That
scholar, Rolf Jensen, predicted that in the next two decades
health care would come full circle, from its present
institutional and bureaucratic approach back to home-like care
and concern, where effective treatment would place the main
emphasis on caring.
And, in a very real sense, we have been working to put care
back into healthcare with our advocacy.
And, that leads me to tell you this morning about some of
the major contributions the AMA has made in the last 12
First was a new venture for the AMA, a foray into
presidential politics called the American Medical Association
National House Call.
It began last December with a letter that might be
considered a bit audacious, a letter we sent to all
That letter said, “No candidate can or should be elected
unless they support the health care issues important to the
All the polls put health care issues at the top as we in
this room well know.
An NBC News/Wall Street Journal Poll in November showed 82
percent of Americans, four out of every five, call HMO
excesses a serious problem 85 percent said health coverage for
all Americans was a key issue. In the spring, other surveys
showed one-third of Americans felt health care issues were
urgent and another third said “very urgent.”
So, we launched the National House Call campaign a
grassroots effort to ask six questions wrapped around three
First , the Patients’ Bill of Rights.
Second, Health care coverage for all Americans.
And third, Medicare Reform.
Our goals were simple and direct.
First, to bring the issues to the candidates so they would
have to address them.
Second, to bring the issues to the media to keep them
high-profile and visible.
Third, to bring the issues to the public to educate and to
create an informed electorate.
We talked about a Patients’ Bill of Rights that really was
- That determination of medical necessity should be made
by their physicians not by bureaucrats.
- That everyone in managed care should be covered by the
bill of rights.
- That an appeals process be established that is
independent, external, binding.
- And that health plans be held legally accountable when
they make decisions that are negligent and result in harm to
We pointed out as the campaign evolved that the House of
Representatives had passed the Norwood-Dingell Bill which is a
strong Patients’ Bill of Rights.
But the Senate passed a weak, water-down bill which
protected managed care and put profits before patients.
Now the issue still is in Conference Committee still not
enacted into law.
To move things along we sent a message to several members
of the Senate who sit on that Conference Committee. We ran
advertisements and we repeated our basic theme, suggesting
that the voters ask their Senators where they stood on the
Patients’ Bill of Rights.
This is not a Democratic issue.
It is not a Republican issue.
This is a patient issue.
I have delivered and continue to deliver a strong message.
If the Congress of the United States does not do the right
thing and pass a strong Patients’ Bill of Rights, we will make
this an election issue in the fall.
We will take this to the voters.
We will continue our efforts this year, next year, the year
after that, until they get it right.
In a similar vein, we have worked and will continue to work
on the issue of health care coverage for all Americans. The
40-45 million uninsured who lack coverage. In the past, you
and I could provide care through the cost-shift or with
However, the pressures of cost and managed care are
limiting our ability to provide care through the cost-shift
and charity care.
So, the AMA took the initiative last year and called a
major Health Sector Assembly. More than 60 representatives
from every part of the healthcare spectrum came together. Not
to solve problems but to identify the problems, to agree on
the problems and determine whether we had the will the
commitment to solve them.
And indeed we found the will and the commitment.
We established several principles of which four deserve
- We should look at health care coverage is an investment
in the infrastructure of the nation, its people;
- We should identify a basic benefits package that all
Americans should have access to;
- We should do nothing to disturb the 85 percent of
Americans now covered;
- And we should not expect that there is a single, simple
Our third issue in the National House Call campaign was
Medicare. We consistently and repeatedly hammered home the
need for significant Medicare reform. We have called for a
stable program that will be there for our children and
grandchildren. And we called for pharmaceutical benefits for
our elderly as Medicare is reformed.
Now lest you think all our efforts have been just on behalf
of patients let me tell you about some of our many activities
on behalf of physicians:
- We contacted the Justice Department to express concern
over the mergers and consolidation of the insurance
- We sued HCFA to recover payments to physicians who had
been under-paid in the past.
- We worked with Congressman Bill Thomas to correct errors
in HCFA payment systems.
- We went to court with medical societies in Georgia, in
New York and in Pennsylvania, and other states over HMO
And we’ll keep fighting on behalf of physicians all of this
For as long as it takes to make certain that Congress, the
Courts, the insurance companies do the right thing.
When I spoke to the City Club in Portland, Oregon, last
month I reminded them of two speeches they had heard in
January when their mayor and the governor of the state
presented their State of the City and State of Oregon
Both spoke of their visions their plans to make Portland
and Oregon even better places to be and the programs they
thought were needed to do so.
What struck me in particular was an unspoken assumption
that all Oregonians would be healthy and active and have a
good quality of life. Good health, longevity, a long and
active life, a good quality of life don’t just happen.
Ladies and gentlemen, I think that we have a marvelous
story to tell about our health care system. But we have not
done a good job of telling this story. And I need your help in
We have been on the defensive over health care costs,
quality, errors, for too long.
In the last 100 years, we have almost doubled the life
expectancy of Americans.
Since the 1960s alone we’ve added 10 years to that number.
And a year ago in my inaugural address I told you about the
many scientific breakthroughs in the 20th century.
Insulin being the first major discovery in the 1920s.
Immunization in the ‘20s and ‘30s allowed us to prevent some
diseases. Antibiotics in the ‘40s and ‘50s allowed physicians
to finally begin to cure certain diseases.
Now, with the human genome project, we are at the dawn of
the era of genetic engineering We are on the verge of
literally predicting and preventing disease before it occurs.
But all of this does have a cost; it doesn’t just happen.
In the years since I earned my license technology has made
dramatic improvements in the quality of life. MRIs and CAT
scans; Endoscopy. Cardiac surgery angioplasty. Joint
These are not just terms these are miracles in the lives of
people who benefit from them.
In my own practice, patients with angina in the 1960s were
homebound, now with angioplasty or CAB, they’re restored to
full, productive lives.
My patient with worn-out joints used to live out their days
on crutches or in wheel chairs. Now joint replacement
technology puts them out on the golf course or jetting around
Asthma was an acute disease in 1900 and patients died in
days or weeks. In the 1960s, I could control most of the
symptoms. Today, new pharmaceuticals allow asthma patients to
live normal, happy, productive lives.
You know full well what medicine has done for the quantity
of life and you’ve seen improvements in the quality of life,
as well. But did you ever consider how that translates into
A few months ago, I had a conversation with a former Oregon
senator Mark Hatfield. He told me of a study he had
commissioned involving two economists at the University of
Chicago School of Business. They were asked to evaluate what
the impact of better health; what increased longevity a better
quality of life have had on the economy.
Their estimate, based on very conservative assumptions as
you would expect, shows that better healthcare adds more than
2 and a half trillion dollars to our Gross Domestic Product.
Each and every year.
That means that 25 to 30 percent of last year’s G.D.P. can
be directly related to better health long life more active
You might wonder how this could be. Well, let’s look at the
patients I just spoke about.
That angina patient is not homebound, he’s out on the golf
course. He’s buying gasoline to get to the course, paying
green fees, buying golf balls, losing golf balls. Then, he’s
stopping at the 19th hole and going out to dinner with his
Or the lady with arthritis who had joint replacement
surgery. She and her friends regularly fly from Portland down
to Reno. She pays for her air fare. She rents her hotel room.
I won’t say that she gambles or drinks. But, she certainly
Or the asthma patient no longer homebound is back at work
shopping and traveling and leading a full, complete life.
All of them earning money. Spending money. Fueling the
The conclusion is inescapable. Yes healthcare costs. But
those costs produce very significant benefits.
Yes technology will continue giving us more and better
tools. To do more and better things for our patients.
And yes -- healthcare costs will continue to rise. Better
health, increased longevity of life, better quality of life
are an investment in the infrastructure of this country in its
However, after a year of representing you in Washington of
participating in public sector and private sector advocacy on
your behalf, I leave the presidency with a feeling of
accomplishment, a sense of gratitude for the combined efforts
of all of us in the Federation.
I leave with a new appreciation for our profession. Yes, we
can be more efficient. Yes, we can improve the quality of
medicine. Yes, we can create a safer, better health care
But our system has extended life expectancy has improved
the quality of life and has contributed to the national
And will continue to do so in the years ahead.
So, let me end my term of office with a request.
I need your help.
The AMA needs your help.
Most of all your patients need your help.
We need to tell our story and take pride in a job well
The public, the policy-makers, the politicians, corporate
America need to hear about and understand the benefits that a
vigorous and viable health care system brings to this country.
And, yes, we need the AMA and its powerful voice in
Washington, in the state capitals, throughout the length and
breadth of this great nation.
America has rediscovered the American Medical Association.
And, I’m more excited today than when I first devoted my
life to this profession nearly 50 years ago.
I’m excited by the challenges -- the growing awareness in
America of medicine’s value throughout the fabric of society.
Most of all, I’m excited about the opportunity to help
We are adding a noble, hard-won, admirable page to the
history of the American Medical Association.
And I am proud to have been part of it.