Neurosurgeons support new healthcare reform bill

Aug 6 2009

The American Association of Neurological Surgeons (AANS) and Congress of Neurological Surgeons (CNS) announced their support for many of the provisions contained in H.R. 3400, the “Empowering Patients First Act,” which was unveiled in Congress last week.

“America’s neurosurgeons are working to achieve meaningful healthcare reform legislation that will fix what is broken with our current healthcare system, without destroying what already works well,” stated Troy M. Tippett, MD, President of the AANS. “The Empowering Patients First Act includes a targeted set of reforms that will help individuals obtain health insurance coverage and ensure consumer choice without a lot of new government mandates.”

P. David Adelson, MD, President of the CNS agreed, stating, “We are pleased that this legislation will preserve patient access to quality healthcare provided by the doctor of his or her choice – specialists and primary care alike.” He further added, “The country is facing a looming shortage of surgeons, and this bill takes a number of important steps to ensure that we maintain and train enough surgeons, who provide vital lifesaving treatment to our nation’s citizens.”

The AANS and CNS support the legislation because the bill:

• Uses tax incentives to expand health insurance coverage and provide individuals with enhanced insurance choices and includes insurance reforms to address problems associated with preexisting conditions (although this aspect of the bill could be strengthened).
• Recognizes the looming physician workforce shortages in primary care and surgery by establishing a new program that allows medical students in all medical specialties to defer loan repayment until after their full residency and any fellowship training.
• Preserves patient-centered healthcare by ensuring that comparative effectiveness research (CER) findings are not disseminated unless the Federal Coordinating Council for CER first consults with and obtains the approval of medical specialty societies and ensures that our nation’s senior citizens will have the full panoply of treatment options by preventing the government from denying care based on CER findings.
• Includes safeguards in the process for developing performance based quality measures by requiring that these measures must be created in concert with the Physician Consortium for Performance Improvement (PIPC) and only those measures agreed upon by each physician specialty organization may be used by Medicare.
• Enhances the availability of neurosurgeons and other on-call physicians providing emergency care services by allowing these physicians to write-off as bad debt any uncompensated emergency care.
• Reduces medical costs due to defensive medicine and frivolous lawsuits by incorporating comprehensive medical liability reforms, including: reasonable limits on non-economic damages and attorney contingency fees; protections for physicians following practice guidelines that are developed by specialty societies; and a state grant program to establish administrative healthcare tribunals.
• Addresses the underlying problems of the sustainable growth rate (SGR) used to calculate Medicare physician payments by: halting the pending 21.5 percent cut in Medicare reimbursement and replacing the cut in 2010 with a modest payment increase; replacing the SGR in 2011 with a new target growth rate system; and resetting the budget baseline for the Medicare physician payment system.

“The introduction of this bill is a positive development in the debate over healthcare reform and we hope that the ideas in H.R. 3400 will find their way into a final healthcare reform bill that is voted on by the Congress,” stated Dr. Tippett.

The AANS and CNS look forward to working with Congress to ensure that we enact meaningful health system reform, without dismantling the current system, which works well for most Americans.