This week, hundreds of our fellow physicians and medical students gathered in Washington, D.C., for the AMA’s National Advocacy Conference, which is held in the capital city each February. Attendees heard from members of Congress, top administration officials including HHS Secretary Kathleen Sebelius, journalists and other experts about the health policy issues affecting our profession. Protecting federal funding for graduate medical education (GME) and replacing the failed Medicare physician payment formula, known as SGR, with a system that rewards quality and achieves cost savings were two topics receiving significant attention.
The AMA has repeatedly called on Congress to repeal the SGR and replace it with policies that promote efficiency, quality and value in Medicare. We were bolstered in this effort with recent news from the Congressional Budget Office (CBO) that the cost of repealing the SGR has dramatically decreased. According to the CBO, the cost is now $138 billion, more than $100 billion less than the previous projection. To put this in perspective, Congress has already spent $146 billion on short-term, destabilizing patches to the SGR. Now is the time to act decisively – repeal this failed formula once and for all and put in place a system that works for Medicare patients and the physicians who care for them.
The AMA and 110 other physician and medical groups are working to implement a proposal to move toward an array of Medicare delivery and payment models that would give physicians the flexibility to choose options they can use to help lower costs and improve the quality of care for their patients. These could include accountable care organizations, bundled payments and other initiatives already being pilot tested, some with great success.
Another timely topic is the need to retain Medicare funding for graduate medical education (GME) programs and to lift the cap on Medicare-supported residency slots. The number of GME slots has been frozen by the federal government since 1997. As a result, U.S. medical school graduates will exceed the number of available residency slots as soon as 2015.
We are dealing with a physician shortage, and limiting the residencies available to train physicians as they leave medical school prevents the physician workforce from growing to meet the needs of our nation. The demand for physicians will continue to grow as the U.S. population ages, life expectancies increase and 30 million newly-insured Americans have increased access to health care services from the Affordable Care Act.
During the AMA’s National Advocacy Conference, hundreds of physicians and medical students visited Capitol Hill to tell lawmakers first-hand how these and other issues affect their patients and practices every day. Now it is your turn. The AMA has launched a new website, www.SaveGME.org, where medical students, patients and physicians who are concerned about protecting GME slots to reduce the physician shortage can learn more and communicate with elected leaders. This is also a key time to urge your member of Congress to repeal the SGR, while the cost to do so is significantly lower than it has been, and move to put in place a Medicare system that works. Resources to contact Congress are available on the AMA website or by calling (800) 833-6354.
Jeremy Lazarus is President, American Medical Association.
