Chicago Hilton Hotel and Towers
Chicago, Illinois
Saturday, June 10, 2000

D. Ted Lewers, MD
Chair
American Medical Association

Thank you, ladies and gentlemen.

It is a privilege to meet with this outstanding group of leaders from New England.

Someone reminded me that New Englanders cherish two things above all else –

First, the honored memory of the Minutemen.

Second, speakers who don’t take much more than that.

So, to honor that tradition, I’ll get right to the point and answer the question put to so many politicians this election year – What have you done for me lately?

Well, the American Medical Association has done quite a bit for you lately – as most of you already know.

PATIENTS’ BILL OF RIGHTS

We should all take heart in seeing the broad, national, bipartisan support for the our continuing battle for meaningful protections of the rights of patients in this country.

Specifically, we’ve had the best news in the more than 6 years that the AMA has worked to pass a Patients’ Bill of Rights.

Our aim is simple – both to protect patients – and to hold insurance firms accountable.

The overwhelming support we found in the House of Representatives -- the Norwood-Dingell bill – was never matched by the Senate.

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

And they 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 has been running ads in their home states – calling for real patient protection.

Meanwhile, the American Association of Health Plans began its own campaign -- a scare campaign that blames medical errors on physicians and calls them the real problem with health care today.

The AMA yelled “foul.” We wrote an open letter to the AAHP saying, “Your recent ad campaign sets a new low.”

“The AAHP is only interested in patient safety as a tool to block enactment of meaningful patients’ rights legislation.”

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.

But – make no mistake about it – should Congress fail this session, we’ll be right back there after bringing that failure to the attention of every voter we can between now and November.

Congress may go away, but the issue will not.

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.

Not just Patients’ Bill of Rights.

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

And other healthcare issues that poll after poll show are the number one or two or three top issues in the minds – not of the politicians – but of the American people.

And the grassroots approach is paying off.

Health care issues are front-and-center in this year’s campaigning.

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.

It was all set for a floor vote in May – and the House leadership got cold feet, postponing a vote until later this month.

Now is a good time to contact your representatives – regardless of party -- and remind them of how essential it is to level the playing field for physicians.

There is no doubt that the Campbell Bill is not a Republican measure or a Democratic measure – it’s a patient’s measure. And we need all the help we can muster to get that point across in Washington – and around the country, for that matter.

PHYSICIANS FOR RESPONSIBLE NEGOTIATION

One positive 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 – like many of our colleagues across the country -- feared they would have no say in the plan’s future.

And we physicians have a very critical stake in the future 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.

Of course, PRN will negotiate without strikes, without shutdowns or slowdowns, without any of the abuses its critics claimed.

Like so much of the criticism aimed at AMA issues – PRN criticism tries to scare a public that really 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 –

Not alone – by a long shot – but with your help – with the cooperation and teamwork of specialty societies from across the whole spectrum of medicine.

And we did so 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.

I urge you to read the column I’ve written in the current AMNews on this subject. I think you’ll find it interesting.

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 and Blue Shield associations.

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 being unveiled this week.

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 influencing healthcare reform.

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

It’s fast, easy and effective – and available around the clock through the AMA web site where 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 snoops claim billing errors or seek repayment for alleged over-payment.

If you haven’t visited the Internet displays in the lobby, I urge you to do so before you leave town.

CLOSE

Well – I took more than a minute.

But there are many, many issues to discuss – many successes to note – many signs of progress.

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

And we will continue to fight for our patients.

Because they have no voice like the unified voice of organized medicine.

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 partners in organized medicine –

All are caring, committed, resourceful and persistent advocates.

In the days ahead – I urge you to complete what we’ve begun together.

We are heirs to a rich tradition – participants in a worthwhile cause – and the best hope our patients have.

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