Surgical groups oppose Senate’s health care reform bill

American College of SurgeonsNov 5 2009

Twenty surgical organizations, led by the American College of Surgeons, sent a letter to the U.S. Senate today stating they are prepared to oppose the Senate's health care reform bill because it will threaten patient access and harm quality. Surgeons state that as the legislation currently stands, it fails to address some of the fundamental problems that plague the health care system.

"We strongly support health care reform that will expand access to quality surgical and medical care to as many Americans as possible, but we cannot support legislation that puts at risk both quality of care and patient access," said A. Brent Eastman, MD, FACS, chair of the American College of Surgeons' (ACS) Board of Regents and chief medical officer, Scripps Health. "Our system is badly in need of reform but if the legislation does not address these concerns, it will do little to fix its underlying problems and may make it worse."

The surgical groups said they plan to oppose the Senate health care reform bill if a number of provisions that were included in the Senate Finance bill are retained. In addition to failing to permanently fix Medicare's broken physician payment system and to include any meaningful proven medical liability reforms, the surgical community opposes a number of the bill's provisions including:

• The legislation establishes a Medicare Commission that would shift the responsibility for making difficult Medicare payment and coverage decisions to an unelected Executive branch agency without appropriate checks and balances.
• The legislation includes mandatory participation in the seriously flawed Physician Quality Reporting Initiative (PQRI) - a program through which CMS is still attempting to address systemic problems dating back to 2007.
• The legislation attempts to improve patient access to certain physician services through reimbursement changes, but funds these changes through payment cuts to all other physicians - thereby exacerbating workforce shortages, including general surgeons.

"The result of these serious deficiencies will make it more difficult for the American people to receive the surgical care they will need in the future. We will work with the Senate to improve the legislation, but if these shortcomings remain in the final Senate bill, we will have no choice but to urge Senators to vote no," Dr. Eastman added.

The American College of Surgeons met with policymakers over the past year to educate them about programs that would improve quality, reduce costs and increase patient access. One such program, the ACS National Surgical Quality Improvement Program (ACS NSQIP), is helping to prevent thousands of surgical complications each year. Each hospital in the program, on average, is seeing 250 to 500 fewer complications and thus an annual reduction of $3 million in costs. Nine of the top 10 private hospitals in the nation, along with more than 240 additional hospitals, use ACS NSQIP. The ACS believes that these types of quality programs, if supported by Congress, could save the health care system a minimum of tens of billions of dollars over the next decade.

"There are ways to improve quality, cut costs and increase patient access - but the Senate isn't hearing those of us who are closest to the patient and work in the system every day," Dr. Eastman said.

The surgical groups that signed the letter include: American College of Surgeons American Academy of Facial Plastic and Reconstructive Surgery American Academy of Ophthalmology American Academy of Otolaryngology-Head and Neck Surgery American Association of Neurological Surgeons American Association of Orthopaedic Surgeons American College of Obstetricians and Gynecologists American College of Osteopathic Surgeons American Osteopathic Academy of Orthopedics American Society of Anesthesiologists American Society of Breast Surgeons American Society of Cataract and Refractive Surgery American Society of Colon and Rectal Surgeons American Society for Metabolic & Bariatric Surgery American Society of Plastic Surgeons American Urological Association Congress of Neurological Surgeons Society for Vascular Surgery Society of American Gastrointestinal and Endoscopic Surgeons Society of Gynecologic Oncologists