Congressional and Bush administration support for the education of and equitable payment to primary care physicians will go far in saving money while providing health care coverage for the uninsured.
That was the message taken to lawmakers and administration officials May 16 and 17 when AAFP President Mary Frank, M.D., of Mill Valley, Calif., visited Capitol Hill in a whirlwind of meetings.
In what she dubbed "very productive meetings," Frank and AAFP staff members met with Jennifer Young, HHS assistant secretary for legislation; Cybelle Bjorklund, minority staff director of the House Ways and Means Health Subcommittee; and several senators' legislative aides.
With background documents in hand, Frank explained to HHS Young and legislative aides for Sens. Susan Collins, R-Maine; Thad Cochran, R-Miss.; and Richard Durbin, D-Ill., that the greatest threat to community-based residencies came from CMS demands for repayment of graduate medical education funds from programs that use volunteer preceptors. Moreover, the agency's policy impedes implementation of the Balanced Budget Act of 1997, in which Congress encouraged community-based residency training.
Sens. Collins and Durbin have asked their colleagues to sign their letter urging CMS to reinstate a moratorium on audits of the residencies.
Frank emphasized the medical community's position that CMS has the authority to reinstate the moratorium. Authorized by the Medicare Prescription Drug, Improvement and Modernization Act of 2003, the moratorium expired Dec. 31, 2004.
"It was very heartening because she understood the negative impact this has on residency training and she understood it will have a negative impact on patient care," said Frank of her discussions with Young. "She made the connection. We didn't have to make it for her. We plan to continue our dialogue with her on this issue and, through her, with other members of the Department of Health and Human Services."
Meeting with Ways and Means Health Subcommittee's Bjorklund, Frank targeted congressional perceptions that physicians focus too much on their own financial security.
"This (meeting) was in response to Rep. Pete Stark (D-Calif. and senior Democrat on the House Ways and Means Health Subcommittee), who had challenged physician involvement in the issue of health care coverage," said Frank. "We took our proposal for health care coverage for all and discussed how we're working with different coalitions. I think it gave her (Bjorklund) a heightened awareness of the Academy's ongoing activities in this arena."
That involvement with coalitions continued during Hispanic Health Leadership Development, a congressional briefing sponsored by the Hispanic Health Caucus. In addition to the credit given to the Academy for its work in minority health, the briefing "offered a very good networking opportunity," said Frank. "The Academy was mentioned three times in the panel discussion because of the work we're doing in minority and Hispanic health care."
Rep. Hilda Solis, D-Calif., chairs the Hispanic Health Caucus. Other attendees included Mirtha Beadle, deputy director of the Office of Minority Health at HHS, and Delegate Donna Christian-Christensen, D-Virgin Islands, a family physician.
