First, do no harm. With the U.S. House of Representatives likely to take a historic vote on health system reform this weekend, your Texas Medical Association is engaged on multiple fronts to make sure the end result doesn't violate the Hippocratic Oath.
Our position on health reform remains steadfast: Keep what's good in the health care system and fix only what's broken.
House Speaker Nancy Pelosi this morning released the Congressional Budget Office evaluation of the $940 billion House package. It reduces annual growth in Medicare expenditures by 1.4 percentage points, and expands health insurance coverage to 32 million Americans.
The vote is expected to be extremely close, as the Obama Administration pressures all Democrats to vote for it. Already, though, Rep. Chet Edwards (D-Waco) has announced he cannot support it. Representative Edwards voted against it in the House Budget Committee earlier this week.
Bad for Patients
TMA's deep concerns with the bill haven't changed since the Senate passed the original version on Christmas Eve. "This bill is still bad medicine for our patients, and TMA cannot support it," TMA President William H. Fleming III, MD, said in December. The legislation:
- Does nothing to correct the flawed Medicare payment formula that Congress created in 1997. That formula is directly responsible for the slow erosion of access to care for seniors and the poor;
- Would increase the cost of health insurance for our patients and deliver even less in return;
- Would dramatically enhance federal government interference, bureaucracy, and red tape for patients and physicians;
- Would create incentives for patients to pay a fine for not having insurance rather than pay an unrealistic amount for insurance coverage;
- Would not protect Texas' liability reforms and does even less to expand those protections to patients and physicians in other states; and
- Would impose untested and arbitrary treatment standards that do not improve the quality of patient care.
In addition, it could be a budget buster for Texas and all state governments. According to the Texas Health and Human Services Commission, the current proposal could cost the State of Texas up to an additional $24 billion in increased Medicaid spending over the first 10 years of its implementation.
Fix Medicare First
TMA's No. 1 priority is to win a permanent fix to the Medicare payment formula before Congress moves on to more extensive health system reform. Despite their professed support for a new Medicare payment system for physicians, senators and representatives from both parties have done nothing to fix the formula that threatens to bankrupt physicians and leave Medicare patients without a doctor. For 10 years, they've done nothing to fix the single largest government health program. How can they build a new system on a broken foundation?
"You and your colleagues have recognized this glaring problem - this gaping wound in our health care system - but have been willing to address it only with Band-Aids," Dr. Fleming wrote in TMA's open letter to Congress ( PDF ). "We need more than Band-Aids. We need more than sutures. We need a complete transplant. You created this disease, and only you can cure it."
To educate patients on Medicare's problems and to engage all Texans in the drive to fix them, TMA is embarking on a campaign to gather 1 million signatures to stop the Medicare Meltdown. We will deliver the open letter to Congress ( PDF ) to members of the Texas congressional delegation the first week of April at news conferences across the state. The petition drive includes online petitions posted on the TMA ( PDF ) and MeAndMyDoctor Web sites, another online petition for patients and the general public, social media petitions for Facebook and Twitter, and other tactics. We are using our communication vehicles and our county medical society partners to send campaign materials and the petitions to physicians and patients. We are working with community partners such as senior citizen groups, disability rights organizations, and others.
Given the highly partisan arm twisting that's going on in Washington, TMA is teaming up with Gov. Rick Perry tonight to engage voters in four key South Texas congressional districts whose Democratic representatives are considered potential "no" votes. Dr. Fleming and TMA President-Elect Susan Rudd Bailey, MD, will join the governor in a telephone "town hall meeting" with constituents in those districts.
As part of the call, Governor Perry is expected to announce his support for TMA's petition to stop the Medicare Meltdown and encourage his followers to sign it as well.
TMA leaders are planning tele-town hall meetings of their own with voters in those and several other swing districts.