AMA backs cuts in Medicare, wins pledge on fees House GOP also promises to limit doctors' liability


WASHINGTON -- The American Medical Association gave a vigorous and unexpected boost to prospects for Medicare reform yesterday, endorsing the House Republican plan after GOP leaders promised to reduce the financial impact on doctors by billions of dollars.

The AMA will "work very hard to make sure" the nation's doctors are aware of the GOP plan and will "encourage them to inform their patients," AMA President Lonnie Bristow said at a news conference in House Speaker Newt Gingrich's office last night.

The AMA's support greatly strengthened the hand of Mr. Gingrich in battling with the Democrats over Republican plans to trim $270 billion from Medicare outlays over the next seven years.

Under the agreement with House leaders, AMA general counsel Kirk Johnson said doctors will get billions of dollars in relief.

AMA officials expect the final savings in doctors' reimbursements will be closer to the Senate figure of $22 billion.

The plan already had other elements the AMA embraced, including limits on medical malpractice suits, and permission for doctors to form health care networks and charge unrestricted fees.

Mr. Gingrich refused to discuss specific figures, saying only that the doctors received a commitment that the reimbursement schedule -- the system of payments by Medicare to health care providers -- would be "equitable."

The AMA's support is thought to be crucial to public acceptance of the reforms. For Medicare's 37 million beneficiaries, there is no better source of information on health issues than their doctors, Mr. Gingrich said.

The House legislation called for changes in the antitrust laws to permit doctors and hospitals to work together to create health care networks. They could fashion health maintenance organizations and other networks, bypassing the insurance companies and other managed care systems.

And the House GOP leaders bill also includes a cap of $250,000 for pain and suffering awards -- noneconomic damages -- in medical malpractice cases.

But the clinching factor for the AMA was a promise of smaller reductions in reimbursement levels for doctors.

AMA leaders emphasized that the GOP bill would be good for patients by expanding access to a broader range of health care systems. Senior citizens will get "a wider array of choices," Dr. Daniel Johnson, the AMA president-elect, said at the news conference.

The AMA's announcement came as a solid Republican majority brushed aside Democratic amendments to the legislation on the House Ways and Means Committee, which continued working late into the night heading toward a deadline of midnight today for passage of the full bill.

One amendment would have given consumers expanded rights to drop out of HMOs or to receive protection against higher rates. It would "give consumers peace of mind," argued its author, Rep. Pete Stark, the California Democrat.

But arguing against the amendment, Republican Rep. Sam Johnson of Texas said, "This is America, for goodness sakes; we're not government-driven, we're not bureaucracy-driven." The proposal was defeated 22-13 on a straight party-line vote.

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