Help the Heart Rhythm Society have an advisory seat at the House of Delegates by becoming a member of the AMA      The Society is currently part of the Specialty Service Society (SSS), the entity allowing admittance to the HOD for national medical specialty societies. (We need to serve three years in SSS to be able to apply for a seat at the House of Delegates.) An advisory status in the HOD will allow us to vote on important AMA policy in the House of Delegates, and will also enable us to directly participate in the Medicare reimbursement code change review and valuation processes. It will also give us voting rights in the AMA Physician Consortium for Performance Improvement (PCPI)., which review and approved quality performance measures. We need to show that 25 percent of the Society's U.S.-based physician members are also members of the AMA to quality for a seat at the AMA House of Delegates. Help us ensure that electrophysiology is appropriately represented among the medical specialties in AMA policy by become a member of the AMA. Learn more »

President Barack Obama spoke at the 2009 Annual Meeting of the American Medical Association (AMA) House of Delegates in Chicago on June 15, 2009, giving a comprehensive explanation of his health care reform proposal. Visit the AMA website to watch video of his speech, listen to the audio file, or read a transcript.

President Obama, the first U.S. president to address the House since Ronald Reagan in 1983, said "I need your help, doctors. To most Americans, you are the health care system," and also told physicians that he "will listen to you and work with you to pursue reform that works for you."

Outline of the President’s Health Care Reform

President Obama reinforced that in order to secure the financial stability of the country, health care reform must happen, and that it needs to be deficit-neutral over 10 years. Among other provisions, the President said that health care reform must include:

• The adoption of Health IT by all physicians to reduce medical errors, administrative cost, and increase coordination of care
• Investments in preventive care to avoid costly chronic diseases;
• Creation of a system that rewards quality of care rather than quantity of care. This will include bundled payments (one payment for all care delivered in relation to one chronic condition), payment system linked to outcomes, better coordination of care through medical home model or accountable care organizations
• Restructuration of medical educations to reward students who choose to become primary care physicians or nurse practitioner
• Investment in comparative effectiveness research to provide doctors and patients with the best information available allowing them to make the best medical decisions
• Medical liability reform
• Expansion of the role of Medicare Payment Advisory Commission (MedPAC) to evaluate how to eliminate waste, reduce cost and improve quality. MedPAC is currently an independent congressional agency advising Congress on issues affecting Medicare. Senator John Rockefeller (D-WV) introduced the Medicare Payment Advisory Commission (MedPAC) Reform Act of 2009 (S. 1110) in early June; this legislation would transform MedPAC into an executive branch agency with the power to make determination of updated payment rate for physician and hospitals

Policy makers are increasingly concerned when contemplating the question of how to fund health care reform. During his speech, the President presented the funding of healthcare reforms emphasizing that it needs to be deficit neutral over 10 years. As part of his FY 2010 budget specific to health care, the President’s budget proposal includes $635 billion over 10 years as a “reserve fund” to give Congress necessary resources for health reform efforts. The health care reserve fund will be paid for in part by various cuts to Medicare and Medicaid. The following is a partial list of funding cuts included in the FY 2010 budget proposal, and the estimated 10-year savings for each:

• Increase the tax on wealthy at the same level than during the Reagan’s Administration: approximately $326 billion will come from limiting the value of itemized deductions for families making over a quarter-million dollars a year to the rates they were during the Reagan years
• Improving care after hospitalizations and reducing readmission rates: a combination of incentive payments and penalties should lead to better care and result in fewer readmissions — saving roughly $25 billion over 10 years.
• Reducing Medicare overpayments to private insurers: the establishment of a competitive system where payments are based upon an average of plans’ bids submitted to Medicare would save taxpayers close to $177 billion over 10 years
• Improving Medicare and Medicaid payment accuracy: by strengthening program integrity efforts, the Centers for Medicare and Medicaid Services (CMS) will address vulnerabilities that have led to billions of dollars in overpayments and fraud each year
• Expanding the Hospital Quality Improvement Program: by linking a portion of Medicare payments for acute in-patient hospital services to hospitals’ performance on specific quality measures, quality of care for beneficiaries will improve, and Medicare will save approximately $12 billion over 10 years
• Removing barriers to creating generic versions of biologic drugs: doing so will save approximately $30 billion

On Saturday, June 13, 2009, as part of his weekly addresses to the nation, the President presented "Health Care Reform as the Key to Our Fiscal Future" and outlined saving an additional $313 billion dollars over the next decade by implementing the following:

• Incorporate productivity adjustments into Medicare payment updates: adjusting permanently most annual Medicare payment updates by half of the economy-wide productivity factor estimated by the Bureau of Labor Statistics; this will save approximately $109 billion
• Reduce subsidies to hospitals for treating the uninsured as coverage increases: as health reform phases in, the number of uninsured will go down, which will allow the reduction of payments to hospitals for treating those previously uncovered, allowing the government to save more than $106 billion
• Pay better prices for Medicare Part D drugs: the pharmaceutical industry has committed itself to helping to control the rate of growth in health care spending and there are a variety of ways to achieve this goal; for example, drug reimbursement could be reduced for beneficiaries dually eligible for Medicare and Medicaid. The Administration is working with the Congress to develop the most appropriate policy to achieve these savings
• Adjust payment rates for physician imaging services to better reflect actual usage: the Department of Health and Human Services would increase the equipment utilization factor for advanced imaging (such as magnetic resonance imaging (MRI) and computed tomography (CT) machines) from 50 percent to 95 percent, providing amore accurate payment for physician imaging services
• Adopt MedPAC’s recommendations for 2010 payments to skilled nursing facilities, inpatient rehabilitation facilities, and long-term care hospitals
• Cut waste, fraud, and abuse: scrutiny will be increased on physicians in high-risk areas or those that order a high volume of high-risk services (such as home health, durable medical equipment, and home infusion therapy) through additional pre-payment review, To discouraging physicians from ordering unnecessary or excessive treatment and saving $1 billion.

Within the next two weeks, the Senate Finance Committee and the Senate HELP committee will begin the mark-up process, which means that each committee will review the legislation line by line and will either approve, change or amend the text. The U.S. House of Representatives will not formally markup their legislation until after the July 4th recess, but all three core committees — Education and Labor, Ways and Means and Energy and Commerce — are drafting their proposal for release shortly.