DJP 3-18-2010 Update: State Medical Associations speak out regarding health bill in Congress; Meanwhile AMA still studying; By the way, health bill train pulling out of station
Lots of states medical associations and specialty societies are speaking up about the health system reform debate. I previously sent you the list of the Coalition of State Medical and National Specialty Societies who have written Congress and also have written AMA requesting AMA oppose the bill before the House at present. Here are some new letters urging action and encouraging everyone to get involved.
Texas Medical Association (TMA) See full statement below and the Weblink to it.
EXCERPT:
Bad for Patients
TMA’s deep concerns with the bill haven’t changed since the Senate passed the original version on Christmas Eve. “This bill is still bad medicine for our patients, and TMA cannot support it,” TMA President William H. Fleming III, MD, said in December. The legislation…
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Louisiana State Medical Society (LSMS)
http://www.lsms.org/cms/component/content/article/526
Health Care System Reform Hangs in the Balance
LSMS Call to Action – March 18, 2010
A message from LSMS President Dr. Patrick Breaux and LSMS AMA Delegation Chair Dr. Keith Desonier
The Democratic leadership in the US House of Representatives is pushing franticly to secure the necessary votes to bring a bill to the floor for a vote. It will be the Senate passed HSR bill or a reconciliation bill now being worked on by the House Budget committee (which may contain the embedded “deemed past” language regarding the Senate passed bill). To this point the AMA has remained silent on the impending vote preferring to wait and see the provisions of the reconciliation bill. This, however, is not the time for the AMA to be on the sidelines. It is the time to be in the fray, taking a stand and having the courage and leadership to speak out on behalf of the physicians it represents. If ever there is a time for the AMA to hear from every member it is now making your feelings on these two bills known to the AMA Board of Trustees. We urge you to contact the AMA and lend your voice to the critical debate that will decide the future of health care in America.
Contact the AMA
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Texas Medical Association (TMA)
http://www.texmed.org/Template.aspx?id=8470
TMA Fights for Patients and Physicians as House Prepares to Vote
Keywords: Liability_Reform Medicare Quality_of_Care
First, do no harm. With the U.S. House of Representatives likely to take a historic vote on health system reform this weekend, your Texas Medical Association is engaged on multiple fronts to make sure the end result doesn’t violate the Hippocratic Oath. (See “Five Things You Can Do Right Now,” below.)
Our position on health reform remains steadfast: Keep what’s good in the health care system and fix only what’s broken.
House Speaker Nancy Pelosi this morning released the Congressional Budget Office evaluation of the $940 billion House package. It reduces annual growth in Medicare expenditures by 1.4 percentage points, and expands health insurance coverage to 32 million Americans.
The vote is expected to be extremely close, as the Obama Administration pressures all Democrats to vote for it. Already, though, Rep. Chet Edwards (D-Waco) has announced he cannot support it. Representative Edwards voted against it in the House Budget Committee earlier this week.
Bad for Patients
TMA’s deep concerns with the bill haven’t changed since the Senate passed the original version on Christmas Eve. “This bill is still bad medicine for our patients, and TMA cannot support it,” TMA President William H. Fleming III, MD, said in December. The legislation:
Does nothing to correct the flawed Medicare payment formula that Congress created in 1997. That formula is directly responsible for the slow erosion of access to care for seniors and the poor;
Would increase the cost of health insurance for our patients and deliver even less in return;
Would dramatically enhance federal government interference, bureaucracy, and red tape for patients and physicians;
Would create incentives for patients to pay a fine for not having insurance rather than pay an unrealistic amount for insurance coverage;
Would not protect Texas’ liability reforms and does even less to expand those protections to patients and physicians in other states; and
Would impose untested and arbitrary treatment standards that do not improve the quality of patient care.
In addition, it could be a budget buster for Texas and all state governments. According to the Texas Health and Human Services Commission, the current proposal could cost the State of Texas up to an additional $24 billion in increased Medicaid spending over the first 10 years of its implementation.
Fix Medicare First
TMA’s No. 1 priority is to win a permanent fix to the Medicare payment formula before Congress moves on to more extensive health system reform. Despite their professed support for a new Medicare payment system for physicians, senators and representatives from both parties have done nothing to fix the formula that threatens to bankrupt physicians and leave Medicare patients without a doctor. For 10 years, they’ve done nothing to fix the single largest government health program. How can they build a new system on a broken foundation?
“You and your colleagues have recognized this glaring problem — this gaping wound in our health care system — but have been willing to address it only with Band-Aids,” Dr. Fleming wrote in TMA’s open letter to Congress (PDF). “We need more than Band-Aids. We need more than sutures. We need a complete transplant. You created this disease, and only you can cure it.”
To educate patients on Medicare’s problems and to engage all Texans in the drive to fix them, TMA is embarking on a campaign to gather 1 million signatures to stop the Medicare Meltdown. We will deliver the open letter to Congress (PDF) to members of the Texas congressional delegation the first week of April at news conferences across the state. The petition drive includes online petitions posted on the TMA(PDF) and MeAndMyDoctor Web sites, another online petition for patients and the general public, social media petitions for Facebook and Twitter, and other tactics. We are using our communication vehicles and our county medical society partners to send campaign materials and the petitions to physicians and patients. We are working with community partners such as senior citizen groups, disability rights organizations, and others.
Voter Outreach
Given the highly partisan arm twisting that’s going on in Washington, TMA is teaming up with Gov. Rick Perry tonight to engage voters in four key South Texas congressional districts whose Democratic representatives are considered potential “no” votes. Dr. Fleming and TMA President-Elect Susan Rudd Bailey, MD, will join the governor in a telephone “town hall meeting” with constituents in those districts.
As part of the call, Governor Perry is expected to announce his support for TMA’s petition to stop the Medicare Meltdown and encourage his followers to sign it as well.
TMA leaders are planning tele-town hall meetings of their own with voters in those and several other swing districts.
Five Things You Can Do Right Now
Use the TMA Grassroots Action Center today to send a strong message to Sens. John Cornyn and Kay Bailey Hutchison and your U.S. representative. Tell them to oppose the health system reform bill in the House and begin work immediately on a permanent replacement of the Medicare payment formula.
Sign TMA’s online Stop the Medicare Meltdown petition and encourage your colleagues, friends, family, and neighbors to do the same.
Sign TMA’s open letter to Congress (PDF) and fax it to the TMA Public Affairs Division at (512) 370-1633.
Post the Stop the Medicare Meltdown petition (PDF) in your waiting areas and exam rooms for your patients to sign. Fax completed petitions to the TMA Public Affairs Division at (512) 370-1633.
Write a letter to the editor of your local paper.
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DJP Comment: Imagine if AMA entered the battlefield like Texas! In a war the timid lose!
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Meanwhile AMA still studies the latest amendments to the bill. The notice sent out today (see below) by AMA points out what AMA considers positive about the bill. WHAT ABOUT WHAT IS WRONG WITH THIS BILL!
The train is pulling out of the station. There is no SGR elimination in the bill. There is no right of private contracting without penalty. There is no medical liability reform. Medicaid is a disaster and yet this bill expands Medicaid. What about using AMA policy for vouchers! I won’t even go into the funny math and the financial disaster this bill will bring upon the USA.
And don’t forget that AMA wrote a letter to the Senate stating opposition to the IMAB. Is that out of the bill? If not, is AMA going to accept that?
EXCERPT from AMA letter December 1, 2009 at: http://www.ama-assn.org/ama1/pub/upload/mm/399/hsr-ama-reid-hr3590.pdf
Independent Medicare Advisory Board
AMA policy specifically opposes any provision that would empower an independent commission to mandate payment cuts for physicians, who are already subject to an expenditure target and other potential payment reductions under the Medicare physician payment system. Therefore, we oppose the Independent Medicare Advisory Board as currently designed in H.R. 3590, and we look forward to working with you on significant changes to the proposal.
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Here is what AMA said today by email and you also can find it on AMA Website at: http://www.ama-assn.org/ama/pub/health-system-reform/language-reconciliation-bill.shtml
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hod.advocacy.update@enews.ama-assn.org
Subject: HSR Update
Date: March 18, 2010 4:39:40 PM CDT
This afternoon, the House released legislative language for the reconciliation bill that makes refinements to H.R. 3590, the health system reform bill to be considered soon on the floor. AMA staff are still in the process of analyzing the language, but key provisions for physicians that we have identified include:
Improved Medicaid payment rates for primary care physicians to equal 100 percent of Medicare payment rates, including payments for office visits and immunizations, in 2013 and 2014. Provides 100 percent federal funding for the increased costs to states. (Sec 1202)
Extended health insurance market reforms (dependent coverage up to age 26, prohibition of lifetime limits and rescissions, limitations on excessive waiting periods) to grandfathered plans six months after enactment. For group health plans, prohibits pre-existing condition exclusions in 2014, restricts annual limits six months after enactment, and prohibits them in 2014. (Sec 2301)
Closes the Medicare prescription drug donut hole through a process beginning in 2010 and completed by 2020. (Section 1101)
Increased federal medical assistance percentage (FMAP) paid to states for individuals newly enrolled in Medicaid as a result of the expansion of eligibility to 133% FPL (100 percent for 2014-2016, 95 percent in 2017, 94 percent in 2018, 93 percent in 2019, and 90 percent for 2020 and later years), repeal of the special FMAP for Nebraska, and changes in the formula used to calculate the amount of increased FMAP that will be paid to states that had expanded Medicaid eligibility to adults with incomes up to 100 percent FPL prior to enactment of the Act. (Sec 1201)
Sets a 75% assumed utilization rate for expensive diagnostic imaging equipment (priced at more than $1 million/MRI, CT). (Sec 1107)
House Majority Leader Steny Hoyer (D-MD) announced on the floor today that debate will not begin until after members have had 72 hours to review the new provisions, which sets the time for the first potential floor votes at Sunday afternoon.
We will post a detailed summary of the legislation on the AMA web site once it is completed.
(This ends AMA message of today)
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There should be a protest of all of America for such a large bill being presented with hundreds of pages of amendments written in such a way that the average citizen could not possibly read and research the wording in 72 hours. The Congress has demonstrated they are not to be trusted with what they try to slip into these bills. Here is some wording selected at random from the amendments. This excerpt is from page 53 of the reconciliation version released today:
Act, is amended—
6 (1) in clause (i)—
7 (A) by placing the subclause (II) (inserted
8 by section 10319(g)(3) of the Patient Protec9
tion and Affordable Care Act) immediately after
10 subclause (I) and, in such subclause (II), by
11 striking ‘‘and’’ at the end; and
12 (B) by striking subclause (III) and insert13
ing the following:
14 ‘‘(III) for 2014, 0.3 percentage
15 point;
16 ‘‘(IV) for each of 2015 and 2016,
17 0.2 percentage point; and
18 ‘‘(V) for each of 2017, 2018, and
19 2019, 0.75 percentage point.’’;
20 (2) by striking clause (ii); and…
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Clock is ticking. AMA needs to oppose this bill without delay!
Stay well.
Donald
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