Jeremy Lazarus, president of the American Medical Association, was in Wichita to speak with members of the Medical Society of Sedgwick County at its annual membership meeting Tuesday night at the Hyatt Regency hotel.
His address comes at a time when the medical community faces change and uncertainty, as the Affordable Care Act is implemented and provisions in the “fiscal cliff” legislation could mean significant funding cuts.
Lazarus, a psychiatrist, has a private practice in Denver and was first elected to the AMA board of trustees in 2003. An AMA president has not spoken to the local association since 2004.
In an interview before the meeting, Lazarus said he would address how federal health policy issues will affect physicians across the country.
Most of the Affordable Care Act was upheld by the Supreme Court in June.
“We initially gave it our support because we thought it provided especially tremendous benefits for the American population,” Lazarus said of the controversial health care overhaul.
Those benefits, Lazarus said, included insuring an estimated 30 million more Americans, about half on Medicaid and half on private insurance, as well as letting young adults up to age 26 stay on their parents’ insurance, and increased coverage of Medicare recipients.
Lazarus said the hope is that the Affordable Care Act would reduce health care costs over time through improved access to care and illness prevention.
However, there are parts of the Affordable Care Act the American Medical Association is lobbying to change, including medical liability reform and the role of the Independent Payment Advisory Board.
Lazarus said the new law does not do enough to rein in the costs doctors face in medical liability insurance.
“Ideally we’d like to see a federal bill that would have caps on noneconomic damages similar to those in California, Texas, Louisiana, Colorado, where you’ve got a cap around $250,000, which serves to stabilize premiums, medical liability premiums for states and has reduced basically the stress of going through lawsuits by physicians,” Lazarus said.
A few months ago, the Kansas Supreme Court upheld the state’s medical liability laws at $250,000 for noneconomic damages.
The AMA also wants to eliminate the Independent Payment Advisory Board, which Lazarus said is in charge of making cuts to Medicare payments to health care providers if Congress doesn’t do its job to keep costs down.
“We think that, on top of the sustainable growth rate, it’s bad for physicians in particular, and that can transfer to being bad for patients in terms of physicians’ willingness to accept Medicare patients,” he said.
Lazarus acknowledged that the Affordable Care Act has been controversial even within the medical community.
“(Our support) also generated a lot of conflict, not only in the public but also with our physicians, including here in Kansas, I’m sure,” Lazarus said.
“We are aware there are strong opinions. Some physicians feel like we went too far in supporting the law and some who felt we didn’t go far enough, actually. And of course we have many in the country who think we should have a single payer system like in Canada or the U.K. So we welcome all views. …
“We have debates, we have controversies and we have a vote, and we make decisions about things like any other governing body. We welcome all points of view, we debate them and then we take a vote,” he said.
“The AMA represents a broad variety of perspectives, and I think the typical physician in this community has sometimes been at odds in terms of philosophical and political perspective, and now we’re seeing the pendulum swing back to the center with more physicians joining the AMA again,” said Jon Rosell, executive director of the Medical Society of Sedgwick County, in a recent phone interview.
Other issues that Lazarus said were important for physicians include the potential sequestration of up to 2 percent cuts in Medicare funding for health care providers and the potential for 27 percent cuts in Medicare payments to physicians if Congress does not act by Jan. 1.
The AMA is working to have the formulas for physician reimbursement under Medicare repealed and replaced, he said.