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President's Message

 


It is a vivid memory. The vast gloom of Cologne Cathedral arched above my head. Footsteps echoed, candles sputtered, elderly women whispered prayers – and my high school Latin teacher quietly reduced the enormity of the edifice to human terms.

She told us that it took more than 600 years to complete the cathedral. Its progress was spurred on in times of vision, fervor and resources, but frequently impeded by the constraints of redirected priorities, war and economic downturns. She described the clumsy, rudimentary construction methods of the time and, most memorably, the role of the individual worker.

The typical worker specialized in a craft, perhaps constructing foundations, laying floors, or carving wood or stone. The time required for the simplest project could be enormous, given the tools and methods. The workman shared his skill and commitment with his sons or apprentices, ensuring the work continued past his time. He knew the cathedral would not be completed in his lifetime or the lifetime of his children or their children. He would never view the completed structure from one of its dreamed about spires. He knew, however, his job was to build a foundation, a column base, or window casement that would support the structure to come – a structure from whose spires untold generations would view the magnificent cathedral.

This experience comes to mind when I consider our nation’s critical need for and periodic attempts at healthcare reform. As association executives, we know the facts and figures on the uninsured, infant mortality rates, access to preventive care, health plan costs and abuses, and government bureaucracy. Last year, the AMA and nine medical societies released a vision for healthcare reform to serve as a roadmap to achievable solutions (see box below).

The presidential candidates propose their own healthcare reform initiatives – which include aspects of those principles – and promise focus on that initiative in 2009. However, at AAMSE’s 2008 Annual Conference, we again heard the discouraging prognosis that entrenched special interests, lack of political will, limited resources and the intricacy of the undertaking make the chances of meaningful reform dim.

Like the Cologne Cathedral, the enormity and complexity of healthcare reform is a daunting and likely long-term project – a difficult concept for us “want it now” Americans. Like the cathedral workman, medical society executives must steadfastly keep our focus on the ultimate goal of healthcare reform – creating the solid foundation and sharing our expertise and commitment with our physician members, staff and colleagues.

We can catch a glimpse of the design elements and impact of healthcare reform by standing on the inspiring “flying buttresses” of state initiatives. What a glorious thing it will be when we, or those who come after us, stand with AAMSE colleagues, physicians and patients on a “spire” of a reformed, sensible healthcare system and view the magnificent results.

 

Cal Chaney, JD, CAE
AAMSE President

General Counsel/Associate Executive Director, Policy
American College of Emergency Physicians

Principles for Reform of the U.S. Healthcare System

  1. Healthcare coverage for all is needed to ensure quality of care and to improve the health status of Americans.
  2. The healthcare system in the U.S. must provide appropriate health care to all people within the U.S. borders, without unreasonable financial barriers to care.
  3. Individuals and families must have catastrophic health coverage to provide protection from financial ruin.
  4. Improvement of healthcare quality and safety must be the goal of all health interventions, so that we can assure optimal outcomes for the resources expended.
  5. In reforming the healthcare system, we as a society must respect the ethical imperative of providing health care to individuals, responsible stewardship of community resources, and the importance of personal health responsibility.
  6. Access to and financing for appropriate health services must be a shared public/private cooperative effort, and a system which will allow individuals/employers to purchase additional services or insurance.
  7. Cost management by all stakeholders, consistent with achieving quality health care, is critical to attaining a workable, affordable and sustainable healthcare system.
  8. Less complicated administrative systems are essential to reduce costs, create a more efficient healthcare system, and maximize funding for healthcare services.
  9. Sufficient funds must be available for research (basic, clinical, translational and health services), medical education, and comprehensive health information technology infrastructure and implementation.
  10. Sufficient funds must be available for public health and other essential medical services to include, but not be limited to, preventive services, trauma care and mental health services.
  11. Comprehensive medical liability reform is essential to ensure access to quality health care.

Released January 2007.

American Academy of Family Physicians
American Academy of Orthopaedic Surgeons
American College of Cardiology
American College of Emergency Physicians
American College of Obstetricians and Gynecologists
American College of Osteopathic Family Physicians
American College of Physicians
American College of Surgeons
American Medical Association
American Osteopathic Association