Action Needed to Include Emergency Care Issues in Health Care Reform

From ACEP President Nick Jouriles, MD, FACEP
June 24, 2009

Game on!

Sitting through President Obama’s speech to the American Medical Association it became readily apparent that health care reform is here. Or will be. Or not. But the discussion is here and so far there’s not enough discussion about emergency care. That doesn’t make me happy. And if you, like me, want emergency care to be part of the discussion, we need to act.

Game on!

Let’s credit the president for making health care reform a priority and having the courage to address organized medicine personally at the AMA meeting. This is a great start to the discussion. And everyone agrees that reform is needed.

The president told us that he believes in eliminating caps on malpractice verdicts. He also challenged us to eliminate variations in care. Most of us believe that there are real issues here, but there are reasons beyond physicians control to account for this. What I heard was the president blaming the nation’s physicians. But it’s really a system wide issue.

The president mentioned primary care as the answer. And while primary care needs help, that alone will not change the fact that patients with good primary care also get sick and need us. The Massachusetts universal coverage experience proved this.

There was no mention of the millions of Americans who are injured every year. This was another chance for the president to mention emergency care. Unfortunately, he did not.

Finally, the president mentioned bundled payments as a solution. That is, give all reimbursement dollars to the hospital and let them decide which physicians to pay – and how much. In emergency medicine, we’ve seen this over the last twenty years when hospitals have received funding to subsidize indigent care. Very few of those dollars filter down to the emergency physician.

Fortunately, our friends on Capitol Hill, Senators Stabenow and Specter and Representatives Gordon and Sessions and 121 Congressional co-sponsors, have shown outstanding support for emergency care by supporting our Access to Emergency Medical Services Act. But we, the nation’s emergency physicians need to act now to build more support for emergency care in the health care debate.

Game on!

No one will stand up for emergency medicine except us. No one knows about us or cares about us as much as we do. If we want to save the specialty, we need to act. And action is in our DNA.

We need money and votes to influence Congress. Every emergency physician must be involved. Today.

Game on!

If you followed me so far, here’s what I want you to do: First realize that this is a marathon and you'll have to be active over next several months and years. I will send you e-mails on what you need to do at any point in time. 

Wednesday, June 24, 2009
I need you to do TWO quick things immediately.

First, call your two U.S. Senators and your Representative. Use ACEP's online resource and follow the prompts that will give you information on how to complete those calls. The message is simple: Congress must include provisions, in their health care bills that ensures continued access to emergency care, supports new efforts to address some of the barriers to that care (boarding and crowding, ambulance diversions), and additional resources to improve the delivery of care. If your congressional offices have any questions about what specific initiatives they can support, refer them to Brad Gruehn (, 800-320-0610, ext. 3015) in ACEP’s DC office.
Second, we need to reach into our pockets and support NEMPAC. Politicians respond to money. They need a lot of it to finance their re-election campaigns. If we in emergency medicine want to make a difference, we need the largest medical PAC. So reach into your pocket today and write a check to NEMPAC. Every emergency physician can afford $250. If you are in private practice, you can afford $1,000. You absolutely can’t afford to not contribute. The time to act is now. It sounds crass, but the current winners on Wall Street, the trial bar and big pharmacy donate thousands of dollars per member. Physicians donate tens of dollars. Money talks and not enough in Congress are listening to us.


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