BY CINDY BORGMEYER
The AMA House of Delegates, during its annual meeting in Chicago, gave a hearty thumbs-up June 16 to a resolution directing AMA to advocate the position that states be permitted to develop and test new models to improve coverage for low-income patients.
Potential models include combining advanceable and refundable tax credits to purchase health coverage, as well as converting Medicaid from a "categorical eligibility program to one that allows for coverage of additional low-income persons based solely on financial need," said the resolution.
The Academy and five other organizations signed onto the measure, developed by the American College of Physicians.
The AMA will lobby federal legislators for changes to support states' ability to pursue such programs "without incurring new and costly unfunded mandates" and will work with medical specialty societies and other organizations to help develop the programs. The AMA Council on Medical Service also will study options and projects states might now be developing.
The proposal "flew through" the AMA house, said Daniel Ostergaard, M.D., AAFP vice president for international and interprofessional activities. Perhaps most telling, he added, is that the Council on Medical Service -- which historically has favored funding reform primarily through tax credits -- gave the measure its stamp of approval.
AMA delegates also considered a Council on Scientific Affairs report that responded to concerns that pharmaceutical sponsorship of clinical research was skewing study quality and the reporting of results.
In accordance with recommendations adopted as part of that report, the AMA will petition HHS to establish a registry of all U.S. clinical trials. The association also will urge institutional review boards to require all clinical trials to be included in such a registry as a condition of approval. All results of registered clinical trials are to be made readily available to the public, either through journal publication or via an electronic database.
Barely two weeks after adoption of the AMA measure, the Pharmaceutical Research and Manufacturers Association released new "PhRMA Principles on Conduct of Clinical Trials and Communication of Clinical Trial Results." The principles incorporate many of the points in the AMA measure. A June 30 PhRMA press release linking to the principles and related documents is at http://www.phrma.org/mediaroom/press/releases/30.06.2004.427.cfm.
AMA delegates also approved various measures aimed at combating obesity, such as encouraging hospitals to offer healthy food choices, calling for schools to eliminate junk food and soft drinks and to boost physical activity, and advocating development and utilization of public recreational resources. In addition, the delegates directed the AMA to study the U.S. Department of Agriculture's dietary guidelines and food pyramid and possibly suggest improvements. The USDA has since announced plans to revamp its food guidance system, asking for public comments and scheduling a public meeting for Aug. 19 in Washington to discuss the issue.
Finally, the AMA will petition the FDA to reconsider its recent refusal to grant over-the-counter status to emergency contraceptive pills. Coincidentally, the 2003 Congress of Delegates directed the AAFP to support offering progesterone-only contraceptive pills on an OTC basis.
Read highlights from the AMA annual meeting at http://www.ama-assn.org/ama/pub/article/3216-8628.html. Information about selected measures approved by AMA delegates is at http://www.ama-assn.org/ama/pub/article/1615-8642.html.
FP Report is published by the
AAFP News Department.
Copyright © 2004 by
American Academy of Family Physicians.