AAMC Reporter, December 1999: 1999 Annual Meeting Highlights

VOLUME 9, NUMBER 3

JORDAN J. COHEN, M.D., PRESIDENT

DECEMBER 1999

1999 Annual Meeting Highlights
Health Policy Leaders Pledge Support for Academic Medicine

From top: Dr. Satcher, Secretary Shalala, Sen. Frist, Rep. Gephardt.

They came from both sides of the aisle, bringing different points of view to the troubles surrounding health care in this country and, in particular, to those confronting medical schools and teaching hospitals. But on one point, HHS Secretary Donna Shalala, Surgeon General David Satcher, M.D., Ph.D., Sen. William Frist (R-Tenn.), and House Democratic Leader Richard Gephardt (D-Mo.) all agreed: the role of academic medical centers in enhancing the nation's health must be preserved.

During her keynote remarks at the 110th AAMC Annual Meeting, Secretary Shalala referred to the AAMC as the "most important voice in American health care," and challenged academic medical centers to continue their commitment to the underserved and their focus on extramural research. "In terms of serving the uninsured and securing medical advancements," she said, "you have no peer. Our commitment to you must be unwavering."

While acknowledging that some relief from the Medicare cuts resulting from the Balanced Budget Act of 1997 (BBA) is on the way, Secretary Shalala stressed that this would be only a stopgap measure. She said that HHS and academic medical centers must continue to work together to find a stable funding system independent of the Medicare program.

Both Secretary Shalala and Dr. Satcher, Surgeon General and HHS Assistant Secretary for Public Health and Science, spoke to the ongoing disparities in health care on the basis of race, ethnicity, and, in many cases, wealth. Dr. Satcher outlined the upcoming launch of Healthy People 2010, the national strategy for health promotion and disease prevention, which he believes will go far in addressing those disparities. "We invest more than any other nation in health care, in terms of percentage of gross national product," Dr. Satcher said. "Yet, 90 percent of that spending is in treating diseases, rather than in disease prevention."

On a related note, Dr. Satcher cited the fact that minority physicians are more likely to practice medicine in underserved communities, and called on medical schools and teaching hospitals to continue their efforts to educate a diverse health workforce. He also challenged the AAMC to address the underlying reasons that so many Americans have no health insurance, including a lack of minority doctors, a paucity of health information, and consumers' mistrust of the health system.

Sen. Frist, a prominent transplant surgeon at Vanderbilt University prior to his Senate career, decried Congress' attempts to micromanage the U.S. health care system through certain provisions of the Balanced Budget Act of 1997. Consequently, he said, Congress made "a potentially destructive mistake."

Sen. Frist served on the National Bipartisan Commission on the Future of Medicare, and reiterated his position that graduate medical education is a public good that must have sustained, guaranteed funding. He also lamented the "deteriorating safety net" for the more than 44 million uninsured. "It's not due to a lack of a government program," he said, pointing out that Medicaid and the Children's Health Insurance Program cover many who lack traditional health insurance. "We have to look at ways to build the public health infrastructure and modify the tax structure to address the issue of the uninsured," he concluded.

In his remarks, Rep. Gephardt acknowledged that Congress erred in passing the BBA, noting that his was one of the opposition votes. "We overdid it. Changes must be made, and must be made this year," he declared. He also called to task "over-the-top" govern-ment investigators, overzealous in their pursuit of fraud and abuse at academic medical centers, "categorizing our researchers wrongly and doing harm to reputable institutions."

Rep. Gephardt ended his remarks with a moving anecdote about his son, Matt, who developed a tumor on his prostate as a young boy. An experimental therapy, he said, saved Matt's life. Gephardt, clearly emotional, expressed gratitude to academic medicine and its commitment to biomedical research: "He would not be here if it weren't for you."

Revised: 07 December 1999