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TO: Metropolitan Medical Community

FR: Congressman Lee Terry

RE: Important Legislative Update


      Although I know there has been a level of controversy over a recent letter from my campaign to the legal community, I truly believe that there are far more areas of public policy that unite us than there are that divide us. I wanted to put in writing my thoughts about several aspects of health care policy, outline a number of areas where I am working hard on the medical community’s behalf and address the controversy that arose.

Open Communication

      But first let me say that I have always valued my working relationship and open communication with Metro area physicians. It is something that is very important to me, and I want that to continue in the years ahead. I meet frequently with physicians and, incidentally, I like to do so at the physician’s office so I can see the application of Federal rules and regulations with my own eyes. The recent controversy might prompt some to think I am “anti-physician”. Nothing could be further from the truth.

      In fact, the American Medical Association’s “Federal Advocacy Agenda” specifically lists me as voting on the side of physicians four out of five key measures. That’s one reason why I have continued to receive support from the AMA in my congressional race. Also, I believe it is relevant to point out two things: 1) I serve on the House Energy and Commerce Committee, which has primary jurisdiction over many aspects of the nation’s health care system; and 2) I am a member of the majority party. Quite simply, this puts me in a position to help construct a legislative agenda that will prevail in the U.S. House of Representatives.

     When physicians from Douglas and Sarpy County give me information, I pay attention to it. This open communication is a major reason I supported a doubling of the budget for NIH as well as cosponsored numerous bills of importance to the medical community, including H.R. 1068, the Pancreatic Islet Cell Act, and H.R. 1622, which changes the payment mechanism for chemotherapy.

Medicare and Physician Payments

      I am a very strong proponent of the Medicare improvements sought by the AMA and enacted by Congress last year. The law includes substantial changes in the way physicians are treated under the program. For instance, prior law was going to reduce the Medicare reimbursement rate by nine percent over the next two years. We scrapped that cut, and actually provide an increase in each of calendar year 2004 and 2005. In doing so, we “swung” the rate issue 18 percent in favor of physicians! We also wrote into law new protections for physicians in dealing with overpayments, and took action to reduce paperwork requirements and unnecessary rules.

     One area of the new law that I take a great deal of pride is the development of upfront preventive care. We authorized, beginning in 2005, Medicare coverage of many new preventive services, including a diabetes screening test, an initial preventive physical exam, adult immunizations, an electrocardiogram, pelvic exam, mammograms, pap smears, and other screens.

Tort Reform

      Finally, I would like to address an issue that arose recently—my position on federally imposed caps on damages. The issue before the U.S. House in H.R. 5 was whether Congress should unilaterally mandate a nationwide cap. The primary reason I opposed the bill was that I believe this is an issue that should be left to the states to decide. I don’t have to tell you the damages that can be done to states rights when the federal camel gets its nose under the tent. It is not an overstatement to warn that federal law has the potential for overreach that would erase all state laws governing jury awards.

      I do believe there is a crisis in malpractice insurance rates. To this end, I drafted an amendment that would ban punitive damage awards in medical error cases. I’ve also discussed ways that we might create a national reinsurance pool for specialties that have the highest insurance costs. The overall issue is extremely complicated and is driven by many factors in addition to jury awards. We need a comprehensive solution that includes incentives for reinsurers to re-enter markets (something they haven’t done as a result of 9/11), as well as a realization that tort reform will require all parties to give a little and compromise. I assure you that I am open to looking at any reasonable solution to the issue of excessive increases in medical malpractice insurance premiums.

      Thank you for taking the time to review this material. As I mentioned previously, I value a good working relationship with local physicians, and want this open exchange of ideas to continue in the future. If you have any questions or comments, please feel free to contact my campaign headquarters in Omaha.


          Lee Terry

  Member of Congress