The Good of the Many—An AMA House of Delegates Report

The Good of the Many—An AMA House of Delegates Report

Edward P. Balaban, FACP, DO, FASCO

Nov 26, 2013

I just returned from participating in the American Medical Association (AMA) House of Delegates (HOD) as a representative of ASCO. I, along with Drs. Chris Nunnink and Barb McAneny and ASCO staff Ms. Jennifer Brunelle and Ms. Monica Tan, attended the interim session. This session has a similar format to the larger more expanded session usually held in June. Practice issues are discussed, resolutions are debated, and decisions are made that will shape AMA policy. This particular meeting was held in Washington, DC, in an attempt to also link AMA delegate visits with members of Congress.

As always, issues, reports, and resolutions were discussed covering a vast array of topics. That is always the case. The topics invariably have to do with legislation (regional or national), education (medical and public), organizational policy, and/or specialty specific concerns. This session tends to be a more abridged version of the annual HOD, but the problems faced are far from abridged.

In addition, we (ASCO) coordinate a Cancer Caucus. This is a forum that provides a time to address ongoing oncology centric concerns that are or should be discussed. All interested parties including surgery, palliative medicine, radiation therapy, and gyn oncology, among others, attend the forum, which has quickly developed its own momentum.

The highlight and major concern of this meeting was really in what was in many ways left unsaid. The AMA, along with its many specialty organizations such as ASCO, is deeply involved in the ongoing legislative proposal to finally eliminate the sustainable growth rate (SGR). We were told that there seems to be—now more than ever—a bipartisan and bicameral attitude to finally get this done.

I was impressed to hear that members of Congress were using this gathering as a barometer to judge as to whether to move forward with what has been proposed. In short (and far from finalized), the potential bill would repeal the SGR and replace it with a freeze in Medicare payments from 2014-2023. The draft also includes payment incentives based on a performance program and bonuses tied to participation in alternative payment models. The HOD unanimously approved the current legislative proposal in resolution form. The AMA-HOD added language that would continue to advocate for future positive updates in the Medicare Physician Fee Schedule.

In summary, there was real sense of urgency to get this done now. The window is closing, particularly with the election year fast approaching. This meeting, like so many before, brought out many (and sometimes very vocal) varying opinions. Ultimately, and although far from perfect, the HOD realizes the “good of the many”—it is a good feeling.


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