National Advocacy Conference - Wednesday's Sessions

Congressmen to physicians: We need your input

Two members of Congress told physicians Wednesday morning that lawmakers need to hear from physicians on important health care topics.

Rep. Fred Upton, R-Mich., who chairs the U.S. House Energy and Commerce Committee, announced that the committee is on track to submit a plan to fix the broken Medicare payment system before Congress’ summer recess.

"Our goal is to get it done this year, to actually have it on the House floor before the end of the summer—July or the first week of August," Upton said.

The proposal would eliminate the sustainable growth rate formula and transition over a period of time to fees based on quality and clinical improvement. Upton said such measures “must come from the medical profession” and should be flexible for all specialties.

“It’s essential that we have input from you,” Upton said. “That is the only way it will work.”

The AMA and 100 other medical associations have given Congress core principles and elements for a new, high-performing Medicare system that uses an array of delivery and payment models that help lower costs and improve quality.

Sen. Sherrod Brown, D-Ohio, said it is by speaking out that physicians really make a difference for public health. He encouraged physicians to meet with their lawmakers, whether at home or in Washington, D.C., and tell them how they can better help patients.

“What I’ve been able to do in health care is because physicians have come to me and explained things,” he said.

Brown noted that members of Congress need to be educated about such pressing health care issues as graduate medical education and mental health.

“What you do as individual doctors is so important,” he said, “and what you do as a group—as an organization—is equally as important.”

Combating prescription drug abuse: A long way to go, but making progress

While prescription drug abuse continues to plague the country, a number of national initiatives are beginning to make an impact, said Gil Kerlikowske, director of the U.S. Office of National Drug Control Policy, during a Wednesday session.

In 2011 Kerlikowske’s office released the Prescription Drug Abuse Prevention Plan, leading nationwide initiatives to reduce abuse of medications. Prescription drugs are the second most abused category of drugs after marijuana, and more people die each year from prescription drug abuse than gunshot wounds, Kerlikowske said.

Kerlikowske noted that the public debate on this issue is highly polarized, with people either holding to the decades-old “war on drugs” or claiming that legalization of illegal drugs will help solve the problem.

“But right in the middle are solutions that work,” Kerlikowske said.

He pointed to such public health efforts as education programs, especially for young people who often believe that drugs coming from prescription bottles are somehow safe, and treatment programs for those struggling with addiction.

“We’ve already made a huge difference in this,” he said, “and it’s because of your knowledge and support.”

Another initiative that has proven effective is state prescription drug monitoring programs, he said. These databases are intended to empower physicians to identify potential abusers while still helping patients who need pain management. Kerlikowske said that his office is trying to make these databases interoperable and available across state lines.

The AMA is doing its part as well, offering on-demand webinars covering safe opioid prescribing and the epidemiology of overdoses.

Kerlikowske applauded physicians’ efforts in helping to address the prescription drug abuse epidemic and thanked them for their continued input on the Office of National Drug Control Policy’s work.

“We stand by to support you on this issue,” he said. “We value and appreciate the relationship, dialogue and conversation. Our door is always open to you.”

U.S. economy needs balanced national budget, former comptroller general says

If the U.S. economy is to survive, the government needs to change course, and do it soon. That’s the message David Walker, a former comptroller general of the United States, delivered Wednesday during the AMA’s National Advocacy Conference.

The federal government has had a $1 trillion deficit for four years in a row, Walker said. The national debt now stands at $16.5 trillion, up from $5.6 trillion in 2000.

When the statutory budget control expired in the mid-1990s, Congress dramatically increased spending, Walker said.

“They burned a whole in their pocket, through the floor and almost all the way through the planet,” he said.

As the March 1 federal budget sequester approaches, it is becoming more evident that things must change.

“Math is the new four-letter word in Washington,” Walker said. But dramatic reforms will be necessary to get the country back on course for a healthy economy.

Not focusing on costs “ignores reality,” he said. “We do not have a blank check. We have to allocate resources.”

Walker noted that changes will have to be made in health care as well. Next to interest on the national debt, health care is the fastest growing expense in the country.

Walker suggested that an option for the future is centering the health care system more on evidence-based medicine. Payments would be made for evidence-based practices, not volume of services, and safe harbors protecting physicians from unnecessary lawsuits could be created as a result of those practices.

Across all areas of spending, Walker said, the country must do “what is appropriate, what is affordable and what is sustainable.”