AMA's advocacy agenda: Driven by physicians

The 2006 AMA Health Care Advocacy Agenda is the road map for how the organization will help doctors help patients in the coming year. Most important, it's drawn in large part by AMA member physicians through surveys and physician roundtables.

Here are the six issues on this year's AMA agenda, along with notes on some of last year's progress.

Medical liability reform. The AMA will continue to press for reforms patterned after California's landmark MICRA legislation, including a $250,000 cap on noneconomic damages, as a means to solve the liability crisis. This will be done on both a federal level, where in 2005 the AMA successfully urged U.S. House passage of a $250,000 cap and limits on attorneys' contingency fees, and on a state level, where last year the AMA supported medical societies who got caps or other reforms in eight states.

Medicare physician payment reform and regulatory relief. The AMA "will be relentless" in fighting to replace the flawed Medicare payment formula that would result in deep reimbursement cuts, threatening care for seniors. Last year the AMA secured House and Senate passage of a bill that halted a 4.4% hike in favor of a one-year freeze, allowing time to work for a long-term solution. Building on the success last year of urging the Centers for Medicare & Medicaid Services to reverse eliminating coverage of more than 100 procedures at ambulatory surgery centers, the AMA also plans to push Congress and federal agencies to reduce costly and counterproductive administrative burdens and unfunded mandates.

Expanding coverage for the uninsured and increasing access to care. In the short term, the AMA plans to push for incremental measures to expand coverage for children and lower-income individuals and families, while also building political pressure for action on coverage and access to care. Meanwhile, as the momentum for health savings accounts continues to build, the AMA will continue to press for the adoption of a consumer-driven, market-based plan using tax credits and insurance market reforms as a means to cut the number of uninsured.

Improving the health of the public. The AMA will continue its work through programs and tools to help promote healthy lifestyles, reduce racial and ethnic disparities in health care, and develop training programs for disaster preparedness. Last year, for example, the AMA launched a series of radio advertisements focusing on such topics as obesity, alcohol abuse and vaccines. The AMA last year also co-founded, with the National Medical Assn., the Commission to End Health Care Disparities.

Patient safety and quality improvement in health care. The AMA, along with 129 other health care and patient groups, worked to achieve a huge victory in the passage of the Patient Safety and Quality Improvement Act, which set up a confidential system allowing physicians and other health professionals to report mistakes -- without fear of retribution -- so that others may learn from them. In 2006, the AMA will work to ensure the law's implementation, as well as push for other voluntary error-reporting systems with strong confidentiality protections. The AMA will continue convening the Physician Consortium for Performance Improvement to help develop evidence-based performance measures.

Managed care reform. The AMA will continue its efforts to ensure that third parties do not interfere with the patient-physician relationship, particularly in making decisions based on economics rather than on optimal patient care. The AMA also intends to advance antitrust reform to allow for fair negotiations between physicians and ever-larger health plans.

Beginning in March, the AMA will travel to 30 cities around the country to talk to doctors in roundtable discussions about the agenda items and about anything else member physicians would like to discuss. Meanwhile, the Member Connect Web site gives AMA physicians another opportunity to make their voices heard.

Whether in person or through online or paper surveys, the creation of each year's advocacy agenda demonstrates the AMA's commitment to take its direction from where it gets its strength -- the physicians of America.