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Am Fam Physician. 1998;57(7):1471-1472

President Clinton Addresses American Medical Association Conference

President Clinton spoke to the American Medical Association Leadership Conference in March in Washington, D.C. Before addressing several health issues, the President emphasized, “We found the right family doctor for America, Dr. David Snatcher.” Dr. Snatcher, an AAFP member, was recently confirmed to the post of Surgeon General. The President noted that much needs to be done in the days remaining in the current legislative session to enact key health legislation. “I want it to go down in history as a Congress that saved lives by passing the Patient's Bill of Rights, by passing tough and sweeping tobacco legislation, by passing the Research Fund for the 21st Century with its big increase in medical research, and by extending health care coverage to those who presently are uninsured,” he stated.

NRHA Releases Issue Paper on HIV and AIDS in Rural America

The most recent issue paper of the National Rural Health Association (NRHA) focuses on the increasing incidence of human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome in rural America. Included in the issue paper are the recommendations of the NRHA for education, data collection, funding distribution and access to health care services as a means of combating HIV/AIDS in rural areas. The NRHA is also holding a conference on HIV/AIDS in rural areas in September 1998 in Albuquerque, N.M. The full text of the HIV/AIDS issue paper and other NRHA policy issue papers are available on the NRHA Web site at Copies may also be obtained by writing to the NRHA, Communications Department, One West Armour Blvd., Suite 301, Kansas City, MO 64111.

AAFP Testifies on Medicare Payment Issues

Deborah G. Haynes, M.D., Wichita, Kan., a member of the Board of Directors of the American Academy of Family Physicians (AAFP), testified before the House Ways and Means Subcommittee on Health at a March 3 hearing to examine various Medicare payment policies. Dr. Haynes' remarks focused on the method being developed by the Health Care Financing Administration (HCFA) for implementing resource-based practice expenses as part of the Medicare physician fee schedule. The AAFP, American Medical Association and other medical specialty societies have participated in several meetings with HCFA to help develop resource-based practice expenses, and preliminary results of the HCFA effort were released in 1997. Congress, in the Balanced Budget Act, asked that HCFA do additional work and directed that the General Accounting Office (GAO) report to Congress on the proposal. The GAO report, released to coincide with the Health Subcommittee hearing, certifies that the HCFA proposal meets the balanced budget law's requirements for consulting physicians and other experts and gathering actual cost data to the “maximum extent practicable.” Dr. Haynes encouraged HCFA to proceed with the data development and the rulemaking process so that implementation of resource-based practice expenses can be achieved, with full implementation scheduled for January 1, 2002.

On March 10, AAFP President Neil H. Brooks, M.D., Rockville, Conn., discussed the practice expense issue before a hearing of the Senate Appropriations Subcommittee on Labor, Health and Human Services, Education. He continued to emphasize the importance of implementing the payment changes and reiterated the AAFP's support of the work that HCFA is doing to accomplish this. The AAFP believes that the law is clear and that no further congressional action is warranted or necessary to achieve implementation of resource-based practice expenses.

Americans Cautiously Support A National Consumer Bill of Rights

Results of a survey conducted by the Kaiser Family Foundation and Harvard University show that significant numbers of Americans favor the key measures intended to protect consumers in President Clinton's “Consumer Bill of Rights” and in legislative proposals before Congress. Close to one half of Americans (48 percent) report that they, or someone they know, have experienced at least one of the problems addressed by the proposed regulations, including needing more information about health plans (29 percent), getting permission to see a medical consultant (24 percent), getting a plan to pay an emergency department bill (19 percent) and being unable to file an appeal to an independent agency for a denied claim (17 percent). However, Americans worry that the establishment of a consumer bill of rights will result in higher insurance premiums, too much government involvement in health care and will cause employers to drop medical insurance coverage. Copies of the “Kaiser/Harvard National Survey of Americans' Views on Consumer Protections in Managed Care” are available from Kaiser by calling 800-656-4533 (publication no. 1356). Also available is the report titled “1997 National Survey of Americans on Managed Care” (publication no. 1328). These documents can also be found on the Kaiser Web site at

AHCPR and Kaiser Permanente Join in Mental Health Project

The Agency for Health Care Policy and Research (AHCPR) has announced a joint research project with Kaiser Permanente Medical Care Program of Northern California that should help managed care organizations provide appropriate health services for enrollees and family members who have depression or other mental health symptoms. The research effort, led by Kaiser's Enid Hunkeler, M.A., and AHCPR's William D. Spector, Ph.D., will focus on mild depression and its interaction with chronic diseases, such as heart disease. Efforts will also focus on alcohol, drug and cigarette use, nonpsychiatric health services utilization and costs. Findings are expected to contribute to a more complete understanding of the actual health care costs of depression and other mental health symptoms in both persons who have the illnesses and those who do not. More information about the AHCPR and its research findings and publications can be obtained on the Internet at

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Copyright © 1998 by the American Academy of Family Physicians.

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