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