Posts Tagged Politics
Today’s health care reform vote on Capitol Hill, while high drama, really only signals the beginning of the work that needs to be done by emergency physicians to improve access to emergency care for our patients and future patients. As I write this, I am watching the floor deliberations via the miracle of technology, and I know that the outcome will disappoint 48% of ACEP members, 48% of all physicians, and 48% of the American public, if polls are to be believed … and that will occur regardless of the outcome.
The greatness of our democracy lies in the ability of our people to freely elect their government representatives and to express themselves fully in the debate over crucial issues. Never in my lifetime has this been more apparent than during the health care reform debate. I believe that almost everyone has an opinion on health care, including many non-Americans, and almost everyone has expressed that opinion at some point.
The real challenge to our democracy, to our specialty, and to our organization is to move forward once today’s vote has been taken. We must have great care not to fall victim to Jefferson’s “tyranny of the minority.” We must move forward to create the greatest health care system in the world, befitting the greatest nation in the world, no matter the outcome of today’s vote.
There is no “win” today for emergency medicine. There is only new illumination on the path to achieving better emergency care. The real work comes as we identify areas that need our skills in innovation and problem-solving and get to work shoring up the nation’s emergency care system. My fervent wish is that emergency physicians will find a common bond in the needs of our patients, and put the rancor and division of the path to health care reform behind us in the interest of better emergency care for everyone.
Thank you for your leadership and partnership in this endeavor,
Angela F. Gardner, MD, FACEP
American College of Emergency Physicians
A clip from Hardball (can’t seem to get the video to embed on the site, but clicking on the image above will show you the ~5 minute clip.
The gist is this: some seniors are now being told that part of the health care bill includes asking seniors “how they want to die,” and taken to such extremes as “euthanizing seniors because the government won’t pay for their expensive care anymore in the new health care legislation.”
The actual part in question of the House bill (warning, gigantic PDF), “SEC. 1233. ADVANCE CARE PLANNING CONSULTATION,” simply pays doctors for having DNR/DNI and advance directive conversations with patients. Something we’ve already been doing for years without compensation, yet several of the talking heads in the bill claim this is some new, awful thing.
If the politicians and talking heads can turn “payment for advance directive discussions” into “euthanizing seniors,” we’re in for a dirty, dirty mud-slinging contest, folks.
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
Are you a political animal? If not, you may wonder why anyone would want to go inside the beltway. You may not even have any idea what the beltway is. It’s a piece of interstate highway – I-495, known as the Capital Beltway – that loops around DC and provides a metaphorical dividing line between the thinking of those inside and outside. If you live, work, eat, sleep and breathe the Federal Government, you are a Washington Insider, an inside-the-beltway type. If not, well then, you’re normal, like everyone else.
I’ve been coming here every spring since 1994, trying to get my elected representatives – and, sometimes even more important, their senior staff who are health policy wonks – to understand that emergency medicine isn’t just the center of my universe, but the center of THE universe – and that what matters most in life is that everyone in these United States has access to an adequately (dare I say generously?) funded, high quality system of emergency medical care.
If you do what I do for a living, and especially if you see it (as I do) as not so much a living but a calling, then you understand what I mean. But people inside the beltway often don’t. They require much education – and re-education, which means not sending them off to a camp in the Chinese countryside but coming back here every year to reinforce the old messages and add important new ones. Once you get used to this ongoing need they have to be indoctrinated … I mean informed … then you realize that trips to DC at other times of the year and the occasional visit to the office in the home district can also be useful. After a while they recognize you and know your name, and you’re on your way to building relationships with your elected representatives. In politics, as in so many other facets of life, getting what you want is all about building relationships.
The immutable foundation of our message is that what we want is what is best for our patients and the nation’s healthcare system. We’re the guys and gals with the white hats, the ones who take care of the least fortunate among us – and the most fortunate in their worst moments. We’re there 24/7/365, and all we ask is that we be provided adequate resources to enable us to do our job the way it should be done.
Think you might be interested? Call the Washington office (202-728-0610) and ask how you can get involved. And then put on your white hat and saddle up!