D. Ted Lewers, MD
Chair
American Medical Association

Thank you, Dr. (Yank) Coble and thank you, ladies and gentlemen, for that kind Florida greeting.

My task with you this morning is to provide an update on AMA activities that should be of interest to you.

And you all know the precedent for messengers:

When news is bad, kill the messenger.

For that reason, among many others, I’m relieved to have good news for you.

What’s more, the messages are good and getting better.

We’re reading news that we never could have expected to report 5 or 10 years ago.

And that good news comes in two forms good news for the profession and good news for each of us as practitioners.

Well, of course, all AMA activities don’t take place in a vacuum

• It’s the beginning of a new century;
• It’s an election year,
• It is a time of great change and greater challenge.

And all of those factors play into the news about the AMA.

And some of the news is quite good.

PATIENTS’ BILL OF RIGHTS

Two examples of good results are the enormous, broad, deep bipartisan support in Washington we found for the patients’ bill of rights and the Campbell bill.

I want to add my own thanks for the work you and your peers in this room accomplished.

Whatever progress we’ve made we’ve made in a coordinated, joint effort of time, talent and dollars.

I can report that lawmakers heard us.

And that progress is continuing.

Last week we were in Tennessee and Oklahoma putting pressure on senators in those states to help us get a meaningful Patients’ Bill of Rights through the Congress.

And this week, we’re in Pennsylvania and Michigan doing the same.

We’re asking the Senate to do what the House already did.

The bill many of you joined with us in supporting the Norwood-Dingell bill earned sweeping bipartisan support in the House.

It includes real protections of the rights of patients in this country.

Overwhelming passage of that bill is the best news in the 6 years –

That you and the AMA have worked to pass a real bill of rights.

It both protects patients and holds insurance firms accountable.

Meanwhile, the Senate passed what I would call the HMO protection bill.

The resulting Senate-House conference committee produced a stalemate.

But we again are determined to work for real patient protection:

No matter what happens in the remaining days of the 106th Congress the AMA will remain focused disciplined and aggressive.

And, I hope you will stay the course with us.

Call upon your Senators to move the House bill onto the President’s desk for signature before the October close.

Tell them it’s not a Republican issue or a Democratic issue but a patient issue with enormous bipartisan support in the House.

There is still time for this Senate for this Congress to give patients the protections they deserve.

CAMPBELL BILL

We’re playing political hard-ball –

And we’re going to remain committed to our new-found aggressiveness –

And not just for the patients’ bill of rights.

We’re after Congress to approve the Campbell bill.

The House by a wide margin voted to allow collective bargaining by self-employed physicians

Off-setting the enormous advantage insurance companies have in dictating terms dictating what the underwriters think is appropriate patient care and appropriate levels of quality.

The House acted. The Senate slept. The Summer Recess is about over and Congress adjourns for good in October.

So, again, I would act now in urging your Senators to support Campbell.

PRESCRIPTION DRUGS

Your AMA is also urging Congress to do what’s right for our older patients advocating on behalf of a prescription drug benefit for Medicare recipients.

It’s simple economics and it’s inexcusable that some senior citizens have to choose between groceries and medicine.

What good is the best diagnosis if the cost of medicine is beyond the patient’s reach?

I’m sure I’m preaching to the choir on this one, but you and I need to inform our patients, inform the media and inform our lawmakers about the need to serve our seniors.

Whether it’s the patients’ bill of rights or the Campbell bill or providing prescription drugs the AMA is in the thick of the fight.

We will persevere until the Congress does the right thing if not this year, then next or the year after.

We won’t stop working on behalf of your patients.

PHYSICIANS FOR RESPONSIBLE NEGOTIATION

Now -- 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 assignments in Detroit and Chicago.

And organizing efforts are under way with other groups all over the United States and you’ll be reading more about that as time goes by.

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

More to the point, our patients will profit from PRN with their chief and sometime only advocate their own physician better able to speak out against injustices and unfair practices.

TOBACCO

A second example of advocacy at the local level with your help and the help of others in the Federation of Medicine has to do with the tobacco settlement.

The big news and it is good news is the success the AMA SmokeLess States program has had in tobacco prevention efforts especially among children and teens.

Florida was one of the initial states involved and now thanks to a $52 million grant from the Robert Wood Johnson Foundation the program is being expanded to all 50 states.

The program has proven conclusively that education and preventive programs really work.

It’s part of a one-two punch against big tobacco the second being wise use of tobacco settlement funds.

Now, I’m aware of the leadership Florida took nationally in a very strong education program two years ago.

Now, however, I understand funds are being constrained in a state with strong, positive results.

I would encourage you to push for settlement dollars to follow the CDC guidelines for spending those funds to concentrate on educating the young and then look at other ways of spending the funds.

The message is a simple one: Use the settlement monies to educate and prevent smoking in the first place.

In all too many states, the legislature wants to pave roads and roll out the pork barrel with all those billions of dollars. We think the right use is to prevent smoking especially among kids who are the prime targets for industry advertising.

Preventive medicine not windfall spending that’s our message.

And I urge you to speak on talk to your state lawmakers and your patients and help us channel to funds to the right use.

PRIVATE SECTOR ADVOCACY

Let me talk for a minute about direct, local actions the AMA has been taking in addition to those national activities.

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 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 being used across the country.

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.

INTERNET

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

Internet represents a building block for the future based on AMA’s traditional information role.

One example is Medem dot com which stands for Medical Empowerment.

Right now 11 professional societies are pooling their most precious resources accurate, professional information for patients.

And, they’ll be bringing that information directly to anyone anywhere any time over the Internet.

The implications for improved physician-patient communication are enormous.

Indeed the unfortunate flood of bad information clogging the Internet arteries today only increases the appetite of concerned people for reliable, authentic, understandable information.

The kind of information only a disciplined, focused effort like Medem dot com can provide.

Medem is the answer to one of the industry’s needs.

A second Internet activity might be of interest, as well.

A growing number of AMA members are using our Grassroots Action Center on the worldwide web.

It lets members communicate directly with senators and representatives.

And I can tell you from first-hand conversations with lawmakers, they pay attention to the E-mail.

And beyond advocacy the AMA home page offers our new CITS system the Compliance Interactive Tutorial System –

A wealth of practice information on current fraud and abuse regulations how to respond when the Medicare carrier bureaucrats claim billing errors or seek repayment for alleged over-payment.

There are other e-commerce projects in the works all geared to strengthening your practice and the AMA’s ability to advocate on your behalf.

CLOSE

Let me close with a little analogy from the history books.

On this Labor Day weekend, it is fitting to look back to that first observation in 1882 of a day to recognize the contribution of working people to society.

Clearly, no working people contribute more to society than the physicians of America.

Increased longevity the quality as well as the quantity of life for all Americans

But especially older Americans, which each of us is becoming.

All of that personal and society benefit is due to better medicine, better treatment, research and the application of new knowledge.

No profession has served America better than ours.

Every now and then, America forgets its physicians.

It then becomes our job to remind people of the bargain they are getting and the vital importance of our profession to their individual lives.

When we do that as we have been doing very well in the last few years America responds.

That is why the news is good and getting better.

And that is just what we’re going to continue to do.

Together as in the past in countless cases telling the world what we’ve done and what needs to be done in the interest

Not of ourselves, not even of our organizations, but of the men and women who pay the bills.

They are our patients / the taxpayers / the voters.

And we owe it to them to tell them what we’re doing and why.

That is our challenge and that is the key to the 21st century.

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