Doctors, nurses, seniors target reform myths

Washington -- Organizations representing physicians, nurses and seniors laid out their principles for health system reform during a national conference call that sought to ease the fears of physicians and patients as Congress tries to close in on a final comprehensive bill.

Leaders of the American Medical Association, the American Nurses Assn. and AARP said they felt the need to address a wide audience themselves -- just as President Obama did in his Sept. 9 address to Congress.

"We are concerned about the lies and the myths," said Nancy LeaMond, executive vice president of social impact at AARP, during the Sept. 9 conference call with the AMA and the ANA. "We, along with a lot of groups, have worked very hard over the August recess with town halls and open letters to try and set the record straight. There's no question that the scare tactics have made people very nervous and very concerned. But at the same time, people are listening, and they're trying to understand what the debate is about."

Fresh off a reform-themed visit to Michigan earlier this month, AMA Immediate Past President Nancy H. Nielsen, MD, PhD, agreed that too much misinformation is being bandied about as truth to sit back and remain quiet.

"It's been pretty sad, actually, to hear about the 'killing granny' death committees and to see the fear" that's been fostered in people, Dr. Nielsen said. "People fear change. We all do. And I think people who have insurance feel that they might get into a situation where they would lose something that they have now. And I think we need to thoughtfully address that and have an honest conversation, not just empty promises."

Rebecca M. Patton, RN, ANA president, said too many families and individuals are suffering for the status quo to be acceptable. "Too many are having to choose between paying for health care or other life essentials. The medical debts are contributing to personal bankruptcies and home foreclosures. This has to change."

Dr. Nielsen also used the opportunity to restate the AMA's backing of a Democratic health reform measure that is making its way to the House floor. Among other comprehensive reforms, it would address the Medicare payment system by spending an estimated $245 billion over 10 years to align physician payment more closely with the costs of providing care.

Physicians and patients alike should not have to deal with "interminable paperwork or fight with insurers to get payment for care," Dr. Nielsen said. "And coverage clearly shouldn't be denied because of preexisting conditions that could bankrupt a family. Health reform can make these improvements a reality."

Dr. Nielsen noted that the Senate health reform negotiators to date have not addressed the Medicare physician payment formula as comprehensively as the House has.

Senate Finance Committee Chair Max Baucus (D, Mont.), on Sept. 16 introduced a comprehensive health system reform measure. But the plan as currently written only addresses the scheduled 21.5% reduction in Medicare physician payment rates for 2010, proposing a replacement of the cut with a 0.5% increase.

Medical liability reform is another area in which the Finance bill does not go as far as the House -- or the AMA -- would like to go. "We haven't seen in the Senate Finance so far an understanding that defensive medicine costs need to be reduced because they don't contribute to patient care," Dr. Nielsen said.

LeaMond did not go so far as to say that AARP also supports a permanent repeal of the doctor pay formula, but she did say the organization supports an improved payment system.

"This speaks to our overriding agenda, which is to protect Medicare for seniors. There is nothing more important to seniors than their relationship with their doctor, and we have to ensure that doctors are paid fairly and are willing to treat Medicare patients," LeaMond said.

In an effort to demonstrate more specifically to physicians and the general public what the AMA seeks in health system reform, AMA President J. James Rohack, MD, sent a Sept. 8 letter to President Obama and Congress outlining seven critical tasks the Association has identified as necessary to improve access to affordable, quality care and reduce unnecessary costs in the current system. The AMA's letter said that Congress must:

• Provide health insurance coverage for all Americans.
• Enact insurance market reform that expands choice of affordable coverage and eliminates denials for preexisting conditions.
• Assure that health care decisions are made by patients and their physicians, not by insurance companies or government officials.
• Provide investments and incentives for quality improvement, prevention and wellness initiatives.
• Repeal the Medicare physician payment formula that will trigger steep cuts and threaten seniors' access to care.
• Implement medical liability reforms to reduce the cost of defensive medicine.
• Streamline and standardize insurance claims-processing requirements to eliminate unnecessary costs and administrative burdens.