Lawmakers Share Their Health Care Reform Ideas With Docs


WASHINGTON — Wouldn't reform be nice? That seemed to be the message from politicians speaking at a national advocacy conference sponsored by the American Medical Association.

Democrats and Republicans told the audience of politically active physicians about their ideas for addressing problems with Medicare reimbursement, the medical liability system, and, more generally, a health care system that is failing both physicians and patients.

“If our health care system doesn't work for doctors, it doesn't work,” said Sen. Hillary Clinton (D-N.Y.).

“It's fair to say that the AMA and I did not see to eye to eye,” said Sen. Clinton, referring to her failed health care reform proposal when she was First Lady. “But it is 12 years later, and we have many of the same problems.”

Sen. Clinton may not have been speaking to the friendliest audience, but she drew resounding applause from the physicians when she proposed that Congress stop legislating Medicare reimbursement freezes and replace the sustainable growth rate formula with something better.

Physicians at the meeting heard similar rhetoric from other lawmakers.

“Most of us don't want to go through this annual ritual,” said Rep. Nathan Deal (R-Ga.). However, he also said that fixes are expensive and doctors should not expect them to happen this year.

Rep. Edward Markey (D-Mass.) proposed that Congress form a task force to review the sustainable growth rate over a 2-year period and increase physician reimbursement 5% a year in the interim.

Lawmakers from both parties also noted that physicians need relief from skyrocketing medical liability premiums in many states.

Republicans continue to push for caps on noneconomic damages in medical malpractice lawsuits, an approach supported by states in which similar caps have been linked to slower increases in liability premiums. Democrats oppose caps because caps put limits on legitimate lawsuits.

“Caps don't get to the heart of the problem,” said Sen. Clinton. Instead, Congress needs to bridge the gap between medical liability reform and error-reporting legislation.

She cited the University of Michigan's “Sorry Works!” initiative—a program that encourages doctors and their insurers to be honest when mistakes happen, offer apologies, and provide compensation up front to patients and their attorneys—which has cut liability costs, freeing up new money to improve systems that can reduce errors.

Democrats and Republicans showed a similar divide on the uninsured.

Rep. Markey said that the government should expand Medicare, Medicaid, and the Federal Employees Health Benefits program to include more of the uninsured.

Rep. Tom Price (R-Ga.) said the last thing government should do is take over the responsibility for providing health care from private entities.

The Democrats said that the government should spend more money on prevention and research, which has the potential to lower costs over the long run. Republicans said that what is needed is a marketplace that allows individuals to “own” their coverage while making them more aware of the cost of health care.

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