President Bush this morning told the AMA just what it wanted to hear about medical liability insurance reform.
"The problem doesn't start in the waiting room or the operating room, it starts in the court room," Bush said.
Bush brought the AMA members, meeting this week in Washington, D.C., for their national advocacy conference, to their feet numerous times during his 45-minute address.
He praised physicians' commitment to healing and called for a $250,000 cap on noneconomic damages in medical malpractice lawsuits, which is the AMA's top legislative priority for 2003. He also outlined a sparse framework for a three-tiered Medicare reform proposal, backing away from a previous plan that had been much maligned by Democrats as well as members of his own party.
Dunbar Hoskins, M.D., executive vice president of the American Academy of Ophthalmology, said the president's remarks on liability reform were right on target.
"It's really pleasing to see the president of the country rectify the wrongs of the legal system," said Hoskins, who practices in San Francisco. "Not just for physicians, but for everyone."
Bush told several stories of physicians driven out of practice by the high cost of insurance premiums and of patients unable to find doctors in some regions for the same reason. He said "defensive medicine," whereby doctors order more tests and procedures than needed in order to stave off potential lawsuits, costs the federal government and taxpayers more than $28 billion a year.
"No good doctor should be forced to leave a community they know and serve simply because of the cost of insurance," he said. "I want to sign good medical liability reform this year."
Bush also said patient safety would be improved only when doctors and nurses could share information about medical errors and solutions without fear of getting sued.
"Doctors don't want to put anything down on paper about improving quality because it might be used by a lawyer who is fishing for a lawsuit," he said.
Pointing out that the House last year passed liability reform introduced by Rep. Jim Greenwood (R-Pa.), Bush called on physicians to contact their senators and explain the problem in clear terms.
Addressing the group just prior to the president, Rep. W.J. "Billy" Tauzin, (R-La.), chairman of the House Energy and Commerce Committee, said he expects an identical liability bill introduced this year, HR 5, to hit the House floor next week. He, too, urged physicians to lobby the Senate, where liability reform has not passed.
"Tell 'em to get ready because we're sending them medical liability reform," Tauzin said.
Seniors to get three Medicare choices
Bush's new Medicare plan would offer seniors three choices instead of forcing all seniors into private health plans to receive prescription drug coverage.
The first choice would allow seniors to continue under traditional fee-for-service Medicare with a drug card that would provide discounts between 10% and 25%.
The second choice would be an "enhanced" form of Medicare that would provide coverage of preventive services and give beneficiaries their choice of hospitals, specialists and primary care physicians while paying most of the cost.
The third choice would place seniors in a network of providers through a choice of private health plans, much like the current Medicare+Choice program.
All seniors would get the drug discount card right away, Bush said, and low-income beneficiaries would be eligible immediately for $600 in drug subsidies.
"We're pleased that President Bush's plan recognizes the importance of patient choice, and believe such an approach is needed to ensure that the trusted relationships seniors have with their doctors are protected," said AMA President Yank Coble Jr., M.D., in a written statement. "Health care is not a 'one-size-fits-all' proposition."
Ron Pollack, executive director of Families USA, a not-for-profit consumer advocacy group, criticized Bush's Medicare proposal and said it still would force seniors into private plans.
"Under the new plan, seniors in traditional Medicare would receive coverage only after they spend thousands, and perhaps many thousands of dollars, out of their own pockets on drugs--a cost the vast majority of seniors cannot afford," said Pollack in a release. "This proposal is a clear effort to privatize the Medicare program. Seniors in this new privatized Medicare will no longer have a guarantee of specific benefits and defined coverage."