Posts Tagged Obama Administration

An ACEP Report from the AMA Annual Meeting

Nick Jouriles, MD, FACEP

Nick Jouriles, MD, FACEP

ACEP President Nick Jouriles, MD, FACEP, is at the AMA Annual Meeting in Chicago and sends this report:

First, let me congratulate Jennifer Wiler, MD, MBA, the former EMRA Speaker was just elected Chair of the AMA Women Physicians Congress. Great job, Dr. Wiler, and a well deserved honor.

In addition to the work being done by Dr. Wiler, members of ACEP’s AMA Section Council continue their outstanding representation of emergency medicine at the AMA House of Delegates meeting, where final voting on a number of resolutions important to emergency medicine will occur later in the week. Congratulations to Section Council Chair John Moorhead, MD, FACEP our other Section Council Members and staff liaison Cal Chaney for their efforts.

AMA President Dr. Nancy Neilson has been very impressive. During her speech at Saturday’s Opening Session, Dr. Nielsen compared the moment at hand for America’s physicians—the nationwide debate about health care reform—to one of the greatest in the country’s history, D-Day. “We now have the best, and maybe last, chance in a generation to build [a] bridge,” Dr. Nielsen said. “This is our profession’s D-Day.”

The speech got a standing ovation from the crowd. How appropriate that Dr. Neilson compared our task to D-Day. Our nation’s Commander-in-Chief, President Barack Obama, will be speaking the House of Delegates on Monday morning and asking America’s physicians to support his plans for health care reform. ACEP member response to the speech will be posted later that day.

After his presentation, President Obama will meet privately with the AMA Board of Trustees, which includes three ACEP members. We are living in interesting times and I’m hopeful for emergency medicine.

Here are some specifics on resolutions being considered at the meeting that are of interest to emergency medicine:

CMS Report 3-A-09: Emergency Department Boarding and Crowding, and Resolution 719: Decreasing Emergency Department Overcrowding, received unanimous support from witnesses at the reference committee.

Two ACEP leaders, Linda Lawrence, MD, FACEP and Stephen Epstein, MD, FACEP were among those who testified. Dr. Epstein urged the reference committee to accept an amendment calling for House of Delegates support for enactment of the Access to Emergency Medical Services Act and for its inclusion in federal health care reform proposal.

Next Steps: The Reference Committee will issue its report/recommendations tomorrow with House of Delegates action to follow. House of Delegate adoption of the resolution (especially if amended per Dr. Epstein’s suggestion) would constitute official AMA endorsement of the Access Act. Stay tuned

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A Clear Path?

Today we have heard a variety of opinions from close observers of, and one participant in, the early phases of development of health care reform legislation.


The participant was Neera Tanden.  Ms. Tanden was a senior vice president for Academic Affairs at the Center for American Progress before being appointed Hillary Clinton’s policy director for the 2008 presidential campaign.  Then, late last June, she was recruited to become Director of Domestic Policy for the Obama campaign.  She is now the point person on health reform for the Department of Health and Human Services in the Obama Administration.  After making relatively brief remarks as the luncheon speaker at ACEP’s Leadership & Advocacy Conference, she invited questions.


Most of the questioners focused on enlarging her understanding of the emergency medicine perspective on reform of the health care system.  She did her best to assure us that our concerns were not unfamiliar to policy wonks in the Administration and among the leaders and staffers of key Congressional committees.  And she was forthright in asserting that the Administration has learned from the errors made during past, unsuccessful, efforts at comprehensive reform.  One member of the audience (can you guess who it might have been?) asked if there is reason for us to believe that the president’s “clear path” toward universal coverage does not represent more ineffective incrementalism on a “long and winding road” (apologies to Paul McCartney).  Ms. Tanden was certainly the most optimistic of the speakers who addressed us today, asserting that President Obama did not come to the White House to accomplish small things, that his approach to reform will be bold and aggressive, and that it will be weeks to months, rather than years, before we are firmly on that clear – and short – path toward the goal of covering every American.


An earlier speaker had pegged the likelihood of enacting substantial health care reform legislation this year at no better than 50-50.  Let us hope that Ms. Tanden’s optimism proves to be well founded.  As Mr. Obama has said repeatedly, the cost of inaction is unacceptable, and doing nothing is simply not an option.   

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Health Care System Reform in the Age of Obama

When Barack Obama was elected, I anticipated changes that might be coming with the unease felt by many who are naturally conservative – by which I mean opposed to change merely for the sake of change. But there are clearly some features of our society that are desperately in need of change, and the health care system is one of them.
If you ask a gathering of emergency physicians what is needed in health care system reform, you will discover a wide range of opinion. There are those who favor a single-payer system with the federal government as the payer. Others, of a libertarian bent, believe that is the worst thing we could do, and the focus should be on increasing competition and giving the public a much greater sense of individual personal responsibility for achieving and maintaining health.
The president, his Administration, and the Democratic leadership in Congress all seem to agree that health care is a right to which there should be universal access and for which there should be universal coverage – and that the time is now to move decisively toward making that view a reality. Efforts to achieve that kind of reform have been made several times over the last half century and have repeatedly failed. Many believe the forces aligned in support of such a sea change are now more formidable than ever and that the opposition is weak and scattered. But in a time of economic recession there will be resistance to new, very large, and very expensive government programs. Mustering the national social and political will to make universal access to basic health care an American reality will require inspirational leadership. Obama’s admirers and detractors alike perceive that ability in him. Let us see how he brings it to bear in addressing this pressing social problem.

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Health Care Reform Tops Agenda

The ACEP Leadership and Advocacy Conference begins on April 19 and you can bet that the 400 or so attendees, presenters and guests will be focused on the Obama administration’s efforts at reforming this country’s health care system. Of particular interest of course will be proposed changes to the way emergency care is delivered.

What will the government’s overarching goal be? Could we wind up hearing echos of the last administration’s ” Of course we have universal care. Just go to the emergency room.” Or will we begin to see real discussions on real issues such as boarding, crowding, ambulance diversion- and access to care?

In another week, hundreds of emergency physicians will be making the trek to Capitol Hill to talk to members of the house and senate. They will share stories of the real ER-the good, the bad and the ugly.  And they plan to hear the same from their elected representatives, the good, bad and ugly of the reform process and what the Congress and the president are really thinking.

The Central Line will be there every step of the way, keeping you up to date on the conference and what your elected representatives are saying.  Stay tuned.

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