Philadelphia Country Club
Gladwyne, Penn.
Thursday, June 29, 2000
7:00 p.m.

D. Ted Lewers, MD
Chair
American Medical Association

Thank you, ladies and gentlemen.

And let me add my congratulations to Dr. (Paul) Siegel on becoming the 139th president of this prestigious group.

I want to briefly discuss with you this evening how much progress is being made these days by the AMA and by you; some of the issues our wonderful profession is facing right now.

And some of the news is quite good.

PATIENTS’ BILL OF RIGHTS

One example has been the broad, national, bipartisan support for our continuing battle for meaningful protections of the rights of patients in this country.

It’s the best news in the six years that the AMA has worked to pass a patients’ bill of rights.

Our goal has been to both protect patients and hold insurance firms accountable.

The House of Representatives gave overwhelming support to our approach last year, passing the bipartisan Norwood-Dingell bill.

Unfortunately the Senate caved in to the $100-million-dollar propaganda campaign by the insurance industry.

And, the Senate passed what I would call the insurance industry protection bill.

Now, a joint Senate-House conference committee is working to resolve the wide differences between these bills.

To bring pressure on some of those members, the AMA is running ads in their home states calling for real patient protection:

• Like protecting all 168 million Americans covered by managed health care plans;

• Like holding health plans accountable when they make decisions that harm patients;

• Like providing independent, timely appeals process if patient care is delayed or denied

Today, I’m hopeful that the conference committee will do what it should do protect the patients of America not the insurance companies of America.

AMA’s NATIONAL HOUSE CALL

We’re keeping the full-court press on for more than patients’ bill of rights.

It is one of the themes of the new AMA National House Call a grassroots, state-by-state, city-by-city effort to make sure each presidential candidate takes a strong, positive stand on health care issues.

Most recently, we barnstormed through Missouri, Michigan and Washington to pressure Republican senators to approve a patients' rights bill using pinpoint advertising and media interviews to bring pressure to bear.

But, House Call is not just about patients’ bill of rights.

But also meaningful Medicare reform adequate coverage for the 44 million Americans not insured today proper use of the tobacco settlement funds

And, other issues that poll after poll show are the number one or two or three top issues in the minds of all Americans.

This grassroots approach is paying off. A few weeks ago, The Wall Street Journal reported the words of a GOP strategist who said and this is her quote “You cannot be a majority party unless you talk about issues that the majority of people care about.”

And she was talking about health care issues.

CAMPBELL BILL

One of the issues strategists and the presidential candidates and all Americans should be talking about is the Quality Health Care Coalition Act of 1999 the Campbell bill.

It would allow self-employed physicians the right to negotiate collectively with health plans.

It would offset the enormous advantage insurance companies have in dictating what the underwriters think is appropriate patient care and appropriate levels of quality.

The bill overwhelmingly passed the House Judiciary Committee in March and soon will be voted on by the House of Representatives.

Now is a good time to contact your representative and remind them of how essential it is to level the playing field for physicians.

There isn’t much time left the Summer Recess is approaching.

So I would act now, if you already haven’t. Working together we can have an enormous impact.

PHYSICIANS FOR RESPONSIBLE NEGOTIATION

One issue that is no longer in doubt is the new vehicle for physician advocacy named Physicians for Responsible Negotiation or PRN.

It is up and running independently of the AMA.

It is working on its first contracts to represent physicians who until now had little or no voice in dealing with their big, managed care firm employers.

PRN has its first bargaining assignment representing physicians working for the Medicaid HMO in Detroit named Wellness Plan.

Those physicians had feared they would have no say in the plan’s future.

And, we physicians are men and women who have very critical stakes in the futures of any plans, especially where patient care and quality of care issues are concerned. It’s our job. And PRN will help us do it.

And, PRN will do it without strikes, without shutdowns or slowdowns, without any of the abuses its critics screamed at the time PRN was formed criticism that tried to scare a public that is more fearful of HMO abuse than physician organization.

PRN is a simple, direct, American way to settle disputes and fight back again unjust abuse of power.

IOM REPORT

We are fighting back also against a potentially unjust abuse of power, in the wake of the Institute of Medicine’s report on medical error.

For all of the media coverage and emotion generated by the report, the issue comes down to no disagreement

No debate or argument over whether medical error exists or whether we can’t learn from mistakes and move on.

The debate, the disagreement, the argument has to do with the extent to which mandatory report of errors will result not in learning and improvement but in blame and lawsuits.

Some of you might have seen the column I wrote in the American Medical News back in January on the IOM Report.

I noted that long before the IOM report the AMA helped launch the National Patient Safety Foundation

With the avowed purpose of adapting airline and aerospace industry practices to error detection and correction.

That approach creates a culture of cooperative learning and mutual improvement as opposed to a culture of blame and trial lawyer enrichment.

And, that’s what we’re urging on the Congress now.

The NPSF approach needs to be incorporated into whatever system evolves.

The AMA will be involved at each step as the Congress studies the problem and designs a reporting and measurement system aimed at improving not punishing.

• Aimed at reporting and disseminating lessons learned not blaming.

• Aimed at finding prevention strategies promoting them and helping implement them.

• And aimed at maintaining confidentiality and the security of the data.

All in the interest of our patients.

PRIVATE SECTOR ADVOCACY

Let me depart from legislative and labor issues at the national level and talk for a minute about direct, local actions the AMA has been taking.

We have partnered with 49 state medical societies to form the AMA Litigation Center.

It currently is pursuing 22 cases in state and federal courts on behalf of physicians and their patients.

Some samples:

• Sued Aetna/US Healthcare with the Medical Association of Georgia for money damages under Georgia law resulting from late payment of physician claims;

• Sued United HealthCare Corporation and Met Life with the Medical Society of the State of New York accusing the two firms of knowingly using flawed, invalid data to reduce their payments for medical services;

• Fostered an investigation of anti-competitive practices within two Pennsylvania Blue Cross/Blue Shield associations.

The list goes on but the message is the same:

The Litigation Center advocates in the one way our adversaries understand in the courtroom.

There’s a second private sector advocacy initiative you’ll be interested in.

It’s the AMA Model Managed Care Contract now updated and to be unveiled next month at the AMA Annual Meeting in Chicago.

The revised model contract speaks to such emerging contract issues as “all products” policies, reimbursement issues and plan bankruptcies as well as strategies you can use to challenge health plans.

HCFA’s SUSTAINABLE GROWTH RATES

And speaking of challenges that’s just what the AMA did in forcing HHS to update payment systems in last fall’s Balanced budget Refinement Act.

We went after HCFA to increase Medicare physician payments to catch up with reality and HCFA announced a 5.8 percent target growth rate for this year’s Medicare physician payments a record level for them.

The original Sustainable Growth Rate would have been 2.1 percent. Now it’s 5.8.

The next step AMA is taking is pressure to force HCFA to update the methodology that produced the imbalance in the first place.

Last December we sued them and we’ll keep advocating to replace fuzzy thinking with real-world data and inclusion of new technologies in the backward-looking SGR process.

INTERNET

One very vital tool and a last area I’ll touch today is the Internet and its potential for impacting health care reform.

You may already be a customer of the AMA Grassroots Action Center.

All you have to do is log on through the AMA Web site and you can communicate directly with your senators and representative.

You can also access our new CITS system the Compliance Interactive Tutorial System.

CITS offers you a wealth of practice information on current fraud and abuse regulations how to respond when the Medicare carrier storm troopers claim billing errors or seek repayment for alleged over-payment.

CLOSE

The AMA just completed its Year 2000 Annual Meeting in Chicago.

I was struck by the tone of the meeting a tone of real optimism a feeling that we’ve turned the corner in the public estimation.

That the AMA and American medicine are once again held in the highest regard.

I believe that is because we have kept the issues focused and kept ourselves focused on the issues.

At heart, they are all issues of concern for our patients.

And we will continue to fight for our patients.

We will fight because our patients have no voice like ours.

We will do it because when our patients benefit, we benefit.

We will do it because our patients have for 153 years learned that the AMA and the county associations and the state medical groups and the specialty societies all are caring, committed, resourceful and persistent advocates.

We will do it for the same reason that young student will be attending medical school this fall.

We’re doing because we care deeply.

For those Americans for your patients I congratulate you for what you have done.

And I thank you for what you will do working with your colleagues all over America in the days to come.

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