D. Ted Lewers, MD
Chair
American Medical Association

Thank you, and good morning ladies and gentlemen.

I’ve been asked to talk about the increasing impact specialty societies have had on the AMA.

It’s more appropriate, however, to speak in terms of the collective impact we’ve had together on behalf of our colleagues and our patients.

This year, as you know, there are double the amount of specialty society delegates to the AMA House.

Your increased presence means better representation for the entire physician population, members and non-members alike.

The issues we introduce, debate and resolve together help shape the course of medicine for all of us.

We’re not always going to agree on every issue.

It’s important we have a healthy debate.

It’s important we know where we all stand.

Because when we do act together, it is no surprise we act stronger.

And this year, our collective actions were very strong.

We succeeded this year by working together to reduce the regulatory burdens HCFA places on physicians.

We succeeded this year in blocking misguided attempts to open the National Practitioner Data Bank.

And we succeeded this year in building strong bipartisan support in both houses of Congress for a real patients’ bill of rights.

PBR

Last year, the House of Representatives voted overwhelmingly to pass the Norwood-Dingell patients’ bill of rights. The nation’s media hailed the passage as a milestone, but we knew the insurance industry would fight back.

After all, this is an industry that has executives pulling down as much as $10 million a year.

An industry that has spent more than $100 million to fight us.

But we were ready.

When the HMO big guns tried to water down the Norwood-Dingell bill, we responded swiftly – using our grassroots physician network rather than million dollar advertising blitzes.

Our physician network worked the phones, sent letters and e-mails.

We did what was necessary to ensure that patients and physicians weren’t forced to accept a weak bill that only helped maintain the status quo.

You raised your voices and you were heard.

And your AMA was right there with you, supporting the patient protections favored by almost 90 percent of America, including:

The right for a patient to sue his or her health plan when the plan’s decisions result in harm to the patient.

The right for all Americans to receive health insurance coverage.

The right for a physician to decide what is medically necessary.

And the right for an appeals process that is independent, external and binding.

I want to thank you and your peers for the efforts we’ve made to get this far.

Along the way, there were difficult moments trying to keep everyone satisfied.

Along the way, we sometimes disagreed.

But when it mattered most, we came together and supported a bill that would give patients the rights they deserved.

When it mattered most, we put aside our differences and stood outside the halls of Congress asking our elected officials to support our actions.

And support our patients.

But as you know, despite having a majority of supporters in both houses of Congress, the Republican leadership did not let the Norwood-Dingell bill come to the floor for a vote.

We need to stay vigilant.

We need to continue to reach out to our colleagues and our elected leaders and tell them enough is enough.

Patients’ rights is not a Democratic or Republican issue, but the stalemate in the 106th Congress was unacceptable.

I think you’ll agree it’s high time the Republican leadership steps forward and shows the courage necessary to ensure patients – and we’re all patients – receive the rights we deserve.

That’s why in the 107th Congress, we’ll continue our call for a patients’ bill of rights that reaches out to all patients.

And we’ll continue to advocate for patients to have the right to hold their HMO accountable if the HMO denies necessary medical care.

When the 107th Congress convenes next month, we’ll be there together fighting for our patients.

SGR

This morning I also want to take a few minutes to talk about physicians’ rights.

I’m very pleased to report several examples where your AMA helped our profession.

We succeeded once again in securing an increase in the Medicare Sustainable Growth Rate.

Effective January 1st, you’ll see a 4.5 percent increase in Medicare physician payments for 2001. This follows a 5.4 percent increase for this year.

I know that many specialties feel the refinements to the Balanced Budget Act could have gone further.

We’re working in that direction.

But I want to emphasize, however, that the increase we did win is critical for the Medicare program.

We’re not going to solve the problem overnight.

But the steps we’re taking are steps in the right direction to fix a system that desperately needs fixing.

For years, we have provided needed care to America's elderly despite Medicare's insufficient reimbursements.

This increase will begin to provide long overdue relief.

Our argument to HCFA was simple.

In 1999, we advocated strongly for provisions in the Balanced Budget Refinement Act of 1999.

That directed HCFA to correct the ways in which it estimated the Sustainable Growth Rate (SGR) – a target which had not based on actual data.

We backed provisions in the BBRA that required HCFA to correct its estimates when actual data became available.

If the AMA and the physician community had not successfully argued for the actual data, physicians would not have seen this year's SGR raise to its highest level since the SGR began in 1998.

But that’s not all we accomplished with HCFA.

We convinced HCFA to eliminate its “black box” coding edits and to install toll-free lines to answer your questions about Medicare claims processing requirements.

And our CPT-5 project continues to streamline CPT and prepare for an increasingly electronic world.

In fact, HCFA just a few months ago named CPT as a national standard, which means the days of varied, confusing and contradictory local coding systems will soon be left in the past.

IOM/PATIENT SAFETY

Let me talk for a minute about another important effort we are taking together.

Patient safety.

This past year, we have worked together to encourage the Institute of Medicine to support constructive learning and shared experience in the development of a properly constructed health system error reporting system.

We came together and developed a framework that emphasizes the need to create a non-punitive reporting culture.

Information provided must be comprehensively analyzed.

Confidentiality for patients, physicians and other providers must be maintained.

And we need to share patient safety information between health care organizations and collaboration between health care reporting systems.

Finally, we have to ensure clear legal protections are in place.

We want to enhance patient safety, not create a culture of fear.

We came together because we believe health system errors can be reduced.

Our collective experience and expertise enables us to provide the best solutions.

CLOSE

Let me close by sharing with you what I’ve been especially thankful for this year.

I’m thankful that we’ve worked together in so many ways to pave the way for patients’ rights.

I’m thankful that we’ve worked together to win major improvements in the ways HCFA treats physicians.

And I’m especially thankful that we’ll continue to work together.

Last year there were 100 specialty society delegates to the AMA House.

This year there are 200.

I think you’ll agree that this increase not only signals your increased impact.

But it signals an incredible opportunity to work together more closely.

We know our work is not yet finished.

And while we know that we may not agree 100 percent of the time on 100 percent of the issues we face.

I do know that we’re moving in the right direction.

And I invite each of you to join me in the coming year on behalf of America’s patients and physicians.

Thank you.

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