Wedged between the war on terrorism, possible war in Iraq, and the economy, President Bush had a word or two to say during his State of the Union address about American health care that caught physician leaders’ attention.
In particular, the president emphasized his concern about the spreading crisis in malpractice premiums.
"To improve our health care system, we must address one of the prime causes of higher cost, the constant threat that physicians and hospitals will be unfairly sued," the president said. "Because of excessive litigation, everybody pays more for health care, and many parts of America are losing fine doctors. No one has ever been healed by a frivolous lawsuit. I urge the Congress to pass medical liability reform."
That met with an approving nod from APA Medical Director James H. Scully, M.D. "Liability reform is a priority for APA," Scully said. "As the president indicated, the legal system threatens medical practices nationwide, and all Americans are paying the price of our nation’s outrageous liability system. Due to increasing costs of liability insurance, physicians have been forced to limit their services and in some cases close their practices completely."
AMA President Yank D. Coble Jr., M.D., echoed the sentiment. "[W]e are all threatened by a legal system that is out of control," he said. "Because of the sky-high cost of liability insurance, physicians throughout the country have been forced to limit their practices, stop delivering babies, and some are even leaving the practice of medicine completely. Liability reform is the AMA’s top legislative priority. The vast majority of Americans support liability reform as well. . . .All Americans pay the price for our nation’s dysfunctional liability system."
Coble said the country needs a fair system that puts an end to what he called "lawsuit lottery."
"An ob-gyn in California, where reforms are in place, pays about $57,000 a year for liability insurance," Coble said. "The same ob-gyn in Florida, where there are no reforms, pays about $210,000 for the same coverage."
Bush also garnered some applause from physicians for remarks about strengthening the Medicare program and his pledge to commit $400 billion to the program over the next four years.
"Health care reform must begin with Medicare," Bush said. "Medicare is the binding commitment of a caring society. We must renew that commitment by giving seniors access to preventive medicine and new drugs that are transforming health care in America. Seniors happy with the current Medicare system should be able to keep their coverage just the way it is."
The president reminded his congressional audience that they enjoyed a benefit most American seniors do not. "Just like you, the members of Congress, and your staffs and other federal employees, all seniors should have the choice of a health care plan that provides prescription drugs."
Scully said the commitment to Medicare and to a prescription drug benefit was reassuring, but emphasized that it should include medications for psychiatric conditions. "Psychotropic medications should be included in every prescription plan, and we urge that all such medications will receive equal coverage and access," he said.
The president said that the American health care system is a "model of skill and innovation, with a pace of discovery that is adding good years to our lives." He acknowledged the high cost of care and the lack of access to care for many, but suggested no inclination toward broad-based reform.
"These problems will not be solved with a nationalized health care system that dictates coverage and rations care," he said. "Instead, we must work toward a system in which all Americans have a good insurance policy and choose their own doctors, and seniors and low-income Americans receive the help they need. Instead of bureaucrats and trial lawyers and HMOs, we must put doctors and nurses and patients back in charge of American medicine."
Scully said that APA would "look forward to working with the president and members of Congress toward bipartisan, meaningful solutions to the difficult health issues facing Americans today." ▪
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