AMA's National House Call is an antidote to apathy

AMA Leader Commentary. By D. Ted Lewers, MD. Feb. 7, 2000.

AMA LEADER COMMENTARY

A few words about current events in medical practice

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A message to all physicians from D. Ted Lewers, MD, chair of the AMA Board of Trustees.

The AMA National House Call, covered extensively in this and other publications, is striking a resounding chord as American voters once again consider who would best lead the nation in the four years beginning January 2001.

Presidential candidates are beginning to show concern for the issues we are raising. They are listening as we ask questions. They are starting to listen to the American public.

Voters express overwhelming concern about health care issues, the identical issues the AMA is concerned about. As the Washington Post reported on its national survey on health:

"Republicans, Democrats and Independents said that their single greatest concern -- from a list of 51 possible worries -- is that 'insurance companies are making decisions about medical care that doctors and patients should be making.'

"Three other health issues were among the dozen that one-half to two-thirds of those polled said now cause them a great deal of worry. Those other health-related fears are that elderly Americans will be unable to afford prescription drugs, medical benefits will be reduced or eliminated by employers, and the number of uninsured Americans will rise."

But, until the AMA got involved, politicians seemed uninterested. And this lack of interest turned voters off.

Harvard University's John F. Kennedy School of Government has been polling American voters about which candidates they favor. At the beginning of the year, three out of four voters said their preference was "No candidate yet."

In fact, the poll shows that, week in and week out, 80% of American voters have totally ignored the presidential campaign. Voters said they were neither thinking about it, nor talking about it, nor following it in the news.

At that point, then, presidential politics faces a seeming paradox.

On one hand, there's overwhelming concern about health care. But on the other, there's overwhelming boredom with presidential political campaigning. It was timely, then, for the AMA to step in and launch our National House Call as an antidote to apathy.

The AMA National House Call is the first such effort in the Association's history. By plying the highways and byways of America, we are injecting health care issues that are on our patients' minds into the electoral scene. State by state and city by city, the AMA is asking candidates:

Do you support a meaningful Patients' Bill of Rights?
Do you believe physicians, not insurance plans, should determine what care is medically necessary for you and your family?
Do you believe HMOs should be held accountable for treatment decisions that harm patients?
Do you support health insurance coverage for all Americans?
Do you support tax-based incentives to make it easier for American families to afford health insurance?
Do you have a plan to reform Medicare?

Those six questions distill the issues the vast majority of Americans care about. They stimulate thought and, we hope, political commitment on the part of those who would lead America in the next four years.

As the AMA House Call caravan continues rolling through the primary elections, the debates and the conventions, it does more than create awareness of the issues and a renewal of public support for our efforts: It raises the visibility of the AMA in each of the states it touches.

We're working with state and local medical associations in more than a dozen key states, providing whatever local visibility we can as the AMA representatives visit major media offices, challenge the candidates and alert the voters.

In Iowa and New Hampshire, our very first states, we found the concerns of patients and their physicians are just about the same as those in any other U.S. state or community. They are concerned about the uninsured and underinsured. They are concerned about the cost and quality of health care. They are concerned about patients' rights.

Candidates are beginning to show concern, too. They recognize us not only because of our prior visits with them and their staff members, but also because, recently, they've been seeing us and our campaign vehicles in the political venues they're visiting.

More important, they recognize questions the AMA is triggering wherever the House Call campaign goes. Now they see us, face to face, on the campaign trail. They know us. They know our questions. They know they'll be pressed for answers.

Some of the debates have included major discussions of health care reform. Some of the candidates are answering some of our six questions with clear comments. Our goal is for each candidate to address all six.

We are gaining support. The Columbus Dispatch editorialized:

"With luck and a proper dose of public pressure, perhaps at least one presidential candidate will use the questions posed by the AMA as a starting point for just such a discussion."

In a letter from the AMA president, president-elect and immediate past president, we asked for more. We let each presidential candidate know, as the letter put it, "we strongly believe that no candidate can be elected next November without a solid commitment to the issues that mean the most to patients, physicians and the health of the country."

The AMA is breaking with its traditional silence in the presidential campaign for a very good reason: It's time to speak out on behalf of patients. It's time to carry the banner on behalf of the House of Medicine. It's time to engage voters and the candidates.

And who better than the AMA? In fact, who other than the AMA could do it?

The AMA is raising the stakes. We have had face-to-face encounters with four of the major candidates already. More will follow.

As we succeed in forcing candidates to address health care issues head-on, we also will succeed in drawing more and more Americans back into the political process.

And that bodes well for the future of this great country.

I'd welcome an e-mail with your views.

Dr. Lewers of Easton, Md., a nephrologist and internist, was AMA board chair during 2000-01.