10+ Year Member
Aug 30, 2006
Attending Physician
Via email:

We are writing to update you concerning the current situation in Washington, DC, and our actions regarding the health care reform debate.

As you are aware, the elements of the health care reform package are changing by the hour. The Health Policy Advisory Group (HPAG), under the leadership of Dr. Andrew Warshaw, has been very active in keeping up with the volatility related to the health care reform bill. Our staff in Washington, headed by Christian Shalgian with the able assistance of Kristen Hedstrom and our other DC staffers, keep us briefed on a regular---and recently, on a daily---basis. They are providing us with new information as details emerge.

In keeping with our core principles, the American College of Surgeons remains dedicated to the passage of meaningful health care reform that encourages and promotes quality and safety, access to surgical care, medical liability reform, and the reduction of health care costs. After a year and a-half of debate surrounding a comprehensive health care reform package, the College feels that the Patient Protection and Affordable Care Act of 2009 (H.R. 3590), which the House will likley vote on within the next few days, falls short of meeting our principles.

Throughout this process, the College has worked extensively with key Congressional leaders to shape and improve the provisions in both the House and Senate health reform bills.
The College was successful in making improvements to H.R. 3590 that include:
• Exclusion of a tax on cosmetic surgery.
• Bonus payments to rural general surgeons, without the use of budget neutrality (cutting payments to other physicians).
• Removal of the Medicare application fee, which would have required physicians to pay an application fee to cover a background check for participation in Medicare. Trauma provisions that reauthorize the Trauma-EMS program, authorize pilot projects on regionalized emergency care systems, stabilize and support existing trauma centers, create service availability grants for trauma care, and provide for research on emergency and pediatric emergency care.
It was because of the commitment to our core principles that the College opposed the Patient Protection and Affordable Care Act of 2009 (H.R. 3590) when it was considered in the United States Senate in December 2009. The College was deeply disappointed with the Senate's decision not to address several provisions that we believe will have a negative effect on surgical patients and the surgeon's ability to provide quality, efficient health care including the:
• Creation of an independent Medicare commission, which would undermine efforts to provide transparency, fairness, and stability in the health care delivery system by leaving Medicare payment policy decisions in the hands of an unelected, unaccountable governmental body, thereby threatening the availability of quality, efficient health care to Americans.
• Failure to permanently repeal the flawed sustainable growth rate (SGR) formula, which threatens patient access to surgical care and does nothing to address the pending 21.2% cut to Medicare physician payments scheduled to go into effect on April 1.
• Lack of meaningful medical liability reforms, including protections for physicians who follow established evidence-based practice guidelines or who are volunteering services in a disaster or emergency situation.
Without addressing these fundamental concerns, the College believes H.R. 3590 will undermine quality and threaten patient access to surgical care. As a result we have officially opposed the Patient Protection and Affordable Care Act of 2009 (H.R. 3590) and have communicated our position to every member of the U.S. House of Representatives. To read the College's letter, please go to:


A. Brent Eastman, MD, FACS, Chair, ACS Board of Regents
LaMar S. McGinnis, MD, FACS, ACS President
Andrew L. Warshaw, MD, FACS, Chair, ACS Health Policy and Advocacy Group
Michael J. Zinner, MD, FACS, Chair, ACS Board of Governors
David B. Hoyt, MD, FACS, ACS Executive Director
Christian Shalgian, Director, Division of Advocacy and Health Policy

Interesting to note that the AMA supports 3590.

All that lobbying and all we get are:
• Exclusion of a tax on cosmetic surgery.
• Bonus payments to rural general surgeons
• Removal of the Medicare application fee

pretty sad.