This column was originally published in AMA eVoice on August 2, 2007. Dr. Davis is president of the American Medical Association.
The U.S. House of Representatives passed an important piece of legislation yesterday that—if it becomes law—would have a significant impact on access to care for millions of America's children and seniors.
This bipartisan bill—the Children's Health and Medicare Protection (CHAMP) Act—would reauthorize the State Children's Health Insurance Program (SCHIP) and provide increased funding for health insurance coverage for children of lowincome families. It also would replace two years of cuts in Medicare physician payments, including a 10 percent cut scheduled for 2008, with two years of positive updates. I'd like to thank all those who contacted their U.S. representatives urging them to vote for this bill.
The funding mechanism attached to this legislation is one the AMA has been advocating for the past few months—an increase in federal tobacco taxes, which would have the additional benefit of decreasing smoking. The bill also calls for reducing excess payments to insurance companies, thereby establishing a level playing field between the traditional (feeforservice) Medicare program and private Medicare Advantage plans. In support of this legislation, the AMA launched a major advertising campaign that included Internet ads, emails, letters, phone calls and direct mail brochures in an effort to reach tens of thousands of physicians and patients across the country.
Prominent among those efforts was this TV ad—jointly sponsored by the AMA and AARP—that spells out the facts about the CHAMP Act. And this print ad (PDF, 90KB) appeared in Capitol Hill publications during the past few weeks, showing how an increase in federal tobacco taxes can serve as a key funding source for children's health care and help deter current and future Americans from using tobacco.
I can't stress enough how vital this legislation is for our children and seniors. SCHIP is a valuable safety net of care that allows millions of kids to see the doctor when they're sick and get routine checkups, hearing and vision screenings, and prescription drugs. And I probably don’t have to remind you about the Medicare physician payment cuts looming on the horizon. According to an AMA Member Connect® Survey, 60 percent of physicians indicated they plan to limit the number of new Medicare patients they see if the 10 percent cut scheduled for 2008 takes effect.
This bill is a step in the right direction in addressing both issues. It's a winwin scenario that would preserve access to doctors for Medicare patients, limit older Americans' outofpocket costs, strengthen Medicare for lowerincome people and extend health care coverage to millions of uninsured kids. Thanks again for all your efforts.
The lighter side
And frame your mind to mirth and merriment, which bars a thousand harms and lengthens life.
— Shakespeare, The Taming of the Shrew
In May I gave a talk to the Minnesota Academy of Medicine, entitled "Coping With Crises in Health Care: Is Laughter the Best Medicine?" After discussing the major crises in health care, and the AMA's responses to them, I asked the question, how should physicians cope with these crises (during those times when we're not working on solutions)?
Should we do what Howard Beale urged in that 1976 movie Network, and stick our heads out of the window and yell, "I'm as mad as hell and I'm not going to take this any more"? Should we go on antidepressants? Should we retire early? Or—as Michael Moore's Sicko would suggest—should we move to the United Kingdom, where all doctors are happy, live in nice homes or apartments, and drive fancy cars? Well, my suggestion—again, as we're pursuing remedies to the problems in medicine—is to look for humor to lighten our emotional load.
In my talk, I reviewed evidence (admittedly rather thin) that laughter improves health status and prevents disease. I also presented examples of humor in medical research and health education. The BMJ, for instance, publishes a Christmas issue every year that features humor, parody, and lighthearted science. The 2006 Christmas issue includes articles on the side effects of sword swallowing, the height and attractiveness of male surgeons versus internists versus film stars who play them on screen, the portrayal of physicians in children's books, and the utility of disposable laryngoscope blades in opening paint cans.
Cardiologists at the University of Maryland Medical Center conducted research showing that people with heart disease were 40 percent less likely to laugh in a variety of situations compared to people of the same age without heart disease. This study doesn't answer the key (chickenandtheegg) question: did laughter protect the study participants from heart disease or did heart disease depress their mood and sense of humor? Nevertheless, it used interesting questions to measure people's sense of humor. How is your sense of humor?
Please send comments, questions, and replies to amaprez@ama-assn.org
Content provided by: Ronald M. Davis, MD