Medical Society of Virginia

Virginia’s AMA delegation responds to presidential address

17 June 2009

Monday, members of the Medical Society of Virginia’s (MSV) delegation to the American Medical Association (AMA) were present as President Barack Obama addressed the AMA House of Delegates for over 50 minutes. According to Thomas Eppes Jr., M.D., MSV president, “President Obama was warmly greeted with eight standing ovations as well as numerous interruptions with applause as the majority of his points were well received.”

The delegates are participating in the AMA’s annual meeting in Chicago and are accompanied by Dr. Eppes, Rufus Phillips, MSV executive vice president, and Keith Hare, MSV director of government affairs.

During his speech, President Obama outlined his reasoning for health care reform, his vision of what that would look like and what must be done to make it work. Calling the current system “unsustainable,” President Obama said the AMA must be involved in working to control the rising cost of health care. He was most enthusiastically received when speaking about coverage for all, the need to end defensive medicine via tort reform, prevention of disease and minimizing the need for physicians to be mired in business issues.

“Physicians don’t need to spend time filling out insurance forms. They need to spend their time doing what they became doctors to do, taking care of patients,” he said. “You entered this profession not to be bean counters, but to be healers.”

The president outlined several steps toward health care reform including the upgrade of medical records from paper to computerized systems and investment in preventive care.

His desire to expand primary care services was warmly applauded; however, his inclusion of nurse practitioners as a cornerstone of meeting this need was not embraced by the audience.

The president said that he did not support malpractice caps, which was also not well received by the audience, but he did express a willingness to consider other types of tort reforms.

"There is no doubt that this president was well informed,” said Dr. Eppes. “His delivery was inspirational and eloquent. His engagement of physicians in the process is greatly appreciated. Both the AMA and the Virginia delegation will stay engaged in this process as it rapidly progresses in Congress during the next few weeks. The devil will be in the details. Stay tuned, stay involved, be prepared to act when the time comes. Together we are stronger," he continued.

AMA perspective
Members of the Virginia Delegation to the AMA have been at the table and have been involved in discussions with the Obama Administration and the Senate Finance and Health, Education, Labor and Pensions (HELP) Committees. The Senate committees will plan the markup of their health reform bills this summer and President Obama hopes to have a bill to sign by the end of the year. Financing will be a key driver of health system reform. This is a very fluid process and there are still opportunities to promote AMA’s definition of success, which includes:
  • Expand affordable coverage for all Americans.
  • Permanent repeal of the the Sustainable Growth Rate (SGR).
  • Focus on quality improvement over profiling and penalties.
  • Adequate physician payment.
  • Administrative simplification.
  • Medical liability reforms.
  • Empower physician practices with antitrust relief and breaking down silos.
As stated by Randy Gould, M.D., vice chairman of the Virginia delegation and member of the AMA Council on Legislation, “there has been a lot of confusion about the AMA’s position on a public plan.” According to Dr. Gould, the overriding principles include:
  • A single payer proposal is an absolute non-starter.
  • We are strongly opposed to expanding Medicare for all patients at current reimbursement levels.
  • We are opposed to mandating physician participation in public plans.
  • Private insurance market reforms (e.g.. reduce medical-loss ratio, eliminate pre-existing conditions, portability) combined with a possible health exchange for private plans (Federal Employee Health Benefits Plan Model) will achieve affordability and choice.
  • We will consider co-op or level playing field option.
Dr. Gould also added, “The AMA is working diligently with Federation partners on Medicare physician payment reform. The AMA and 59 specialty societies have reached consensus on repeal of the SGR, positive updates during transition, additional increases for primary care services, and piloting new payment models that reward physicians for system-wide savings.”

Also at the AMA annual meeting
While attending the AMA annual meeting, members of the Virginia delegation, along with Phillips and Hare attended meetings with representatives of other state delegations on issues ranging from scope of practice to health information technology initiatives. Monday night, they attended a reception for newly initiated president of the AMA Alliance, Virginian Nancy Kyler.

Dr. Eppes, Phillips and Hare also met with representatives from Colorado including their CEO, Alfred Gilchrist and president-elect, Mark Laitos, M.D. to discuss their state’s experience with medical malpractice caps.

A full report from the Virginia delegation to the MSV membership will be included in a future edition of Virginia Medical News.


Official transcript of President Obama's remarks at the annual conference of the American Medical Association (

Watch the video or listen to the audio of President Obama's speech (

AMA offers its take on health care reform (

Obama's reform plan to start with EHRs (

In pitch to AMA, Obama paints mixed picture (

President Obama receives warm welcome from AMA physicians (

AMA principles for health system reform (