A PAC Is Born
The American Academy of Family Physicians has launched FamMedPAC, its political action committee, with the goal of raising $1 million in this election cycle. The idea for the PAC was approved at last year's Congress of Delegates meeting and it got underway in June. At press time, the PAC had raised more than $100,000. All of the contributions will go toward contributions to federal campaigns. Already, the PAC has contributed on a bipartisan basis to five sitting House members, including Rep. Patrick Kennedy (D-R.I.) and Rep. Tim Murphy (R-Pa.), who have cosponsored legislation encouraging the use of health information technology. Issues on the top of the PAC's agenda this year include medical liability reform and a fix to the physician pay formula, according to PAC board member Jim King, M.D., a family physician in Selmer, Tenn. He said that before the PAC was established, the AAFP had hit the limit on what it could accomplish politically. “The PAC takes us to a different level in the political game,” Dr. King said. The establishment of PACs within medicine seems to be a growing trend: In 2004, the internal medicine community formed the ACP Services PAC, which was very active during the 2004 election season.
No Free Lunch
Among the many exhibits showcasing pharmaceuticals and technology products at this year's AAFP meeting was one exhibit devoted to urging physicians not to accept free gifts from pharmaceutical reps. No Free Lunch is a group of physicians and other health care providers who say that the promotional efforts of drug companies are unduly influencing physicians. The issue is “much bigger than pens and gifts,” said Paul Bergeron, M.D., an internist based in Portsmouth, N.H., who participated in an ethics panel discussion at the American College of Physicians meeting earlier this year. If the pharmaceutical company offers something that benefits patients, such as compliance programs free of charge, that's okay, he said. “What we should not be taking are things that personally benefit the physician. If they pay me $1,000 to talk about a drug at a conference, that's not appropriate.”
Health Care Rankings
Health care quality improved markedly in many key areas in 2004, but only about 21.5% of the industry now reports publicly on its performance, according to the National Committee for Quality Assurance (NCQA) annual State of Health Care Quality report. Among the 289 commercial health plans that reported their data, average performance improved on 18 of 22 clinical measures although Medicare and Medicaid plans reported smaller gains. Improvements in measures related to high blood pressure control were made in 2004, (up 4.6 points to 66.8%) along with cholesterol control for people with diabetes (up 4.4 points to 64.8%). Fewer patients are enrolled in plans that publicly report their data, due largely to shifting enrollment patterns, the NCQA reported. Enrollment in preferred provider organizations and consumer-directed health plans is up sharply. With few exceptions, these plans tend not to measure or report on their performance. “Today we see a lot of health plans that aren't measuring anything. The right response as a consumer to these plans is simply, don't buy them,” said NCQA President Margaret E. O'Kane. “The new mantra for health care purchasers needs to be, 'show us your data.' Why trust your family's health to an organization that operates behind closed doors?” As many as 67,000 deaths have been prevented to date as a result of improvements recorded over the past 6 years.
von Eschenbach to FDA
Andrew C. von Eschenbach, M.D., has been named acting commissioner of the Food and Drug Administration, following the resignation of Lester Crawford, D.V.M., Ph.D. Dr. von Eschenbach served as head of the National Cancer Institute prior to his appointment. “As a practicing physician and research scientist, I share in the critical mission of this agency in protecting and promoting the health of the American people,” he said in a statement. Dr. Crawford had a 30-year career with the agency, serving as its deputy commissioner and director of the Center for Veterinary Medicine, among other posts. “It is time at the age of 67, to step aside,” he said. In a statement, Michael Jacobson, executive director of the Center for Science in the Public Interest said CSPI would “miss Dr. Crawford for his openness, despite various policy disagreements. He was one of the only FDA commissioners who had substantive experience with food safety.”
Public Health Unpreparedness
Many local public health agencies are ill-prepared to learn about and respond to naturally occurring outbreaks of deadly infectious diseases or acts of bioterrorism, a test by the RAND Corporation has found. To conduct the test, researchers posed as local physicians who were reporting fictitious cases of botulism, anthrax, smallpox, bubonic plague, and other diseases to 19 public health agencies in 18 states nationwide. (Agency directors agreed in advance to participate in the test, but did not tell their staff members.) In one case, after listening to a description of the classic symptoms of bubonic plague, a public health worker advised the caller not to worry because no similar cases had been reported. Another caller who reported a botulism case was told: “You're right; it does sound like botulism. I wouldn't worry too much if I were you.” The article appears in the Aug. 30 online edition of Health Affairs.