AMA chief on doctor pay, Congress and ‘backseat drivers’

Delivered daily by 10 a.m., Pulse examines the latest news in health care politics and policy.
Jul 06, 2023 View in browser
 
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By Daniel Payne

Driving the day

American Medical Association President Dr. Jesse M. Ehrenfeld is pictured.

Jesse Ehrenfeld is the new president of the American Medical Association. | Morry Gash/AP Photo

Q&A WITH THE AMA Jesse Ehrenfeld, recently inaugurated as the American Medical Association’s president, takes his post amid increasing political pressures on doctors and discord around the policies that determine their pay.

He spoke to Pulse about what’s on his mind and his goals for leading one of the most powerful provider groups in Washington.

This interview has been edited for length and clarity.

What do you make of what seems to be increasing political influence on health care?

We've got a whole lot of backseat drivers trying to tell doctors how to practice medicine.

For a while, we just had insurance companies through prior authorization practices that get in the way of medical decision-making. Now, increasingly, we're seeing legislators through their activities interfere with our ability to practice evidence-based medicine.

We have longstanding policy … to push back against intrusion on the doctor-patient relationship.

Is there a concern that speaking out on polarizing issues will further divide who trusts medical professionals?

I don’t think so. We've obviously got a lot of challenges ahead of us in terms of the messages that people are able and willing to receive, but people still trust their doctors. That’s been a consistent theme for decades, and we continue to see that be true today.

Ultimately, I remain optimistic. We can get this right. We can maintain that trust.

We have seen threats from some Republican lawmakers to tie funding for some providers to political issues like gender-affirming care. Are you concerned about funding and politics becoming increasingly linked?

I’m not particularly concerned about that issue. I think that, ultimately, we will have an ability to separate some of these socially charged challenges from doing what’s right for all patients — and to maintain access for children on Medicaid and CHIP and for seniors through Medicare.

Have you gotten nods from lawmakers that those are separate issues?

I don’t know if I’ve gotten nods, but I haven’t seen them really connected the way that you’re describing in a meaningful way.

There are certainly elected officials who like to make talking points and generate news coverage for politically motivated things that just don’t make sense.

But we’ll ultimately, I think, prevail in trying to get rational payment policy through Congress.

What are your goals for your tenure leading the AMA?

I’ll be leading the AMA’s Recovery Plan for America’s Physicians — that’s among my main priorities.

I know firsthand — the AMA knows firsthand — how physicians have put everything into our response to Covid over the last three years. And now, it’s time for the nation to renew its commitment to physicians and shore up our health care system.

We’ve got a health care system in crisis. And as president, I’m going to continue to help the AMA lead our charge to prioritize our recovery plan, which includes reforming Medicare payments to physicians, improving telehealth and reducing the stigma around mental health care and burnout.

Personally, issues of LGBTQ health and health equity are close to my heart and have long been a focus of my work in medicine — and will certainly be an important part of my work in the year ahead.

WELCOME TO THURSDAY PULSE. Are you also leading a major health care organization or in discussions with policymakers about what’s happening on the Hill?

We want to hear from you. Drop me a line at dpayne@politico.com.

TODAY ON OUR PULSE CHECK PODCAST, host Carmen Paun talks with Robert King, who reports on congressional Republicans' criticism of CMS for ignoring the advice of an appointed board of doctors on how to transition Medicare payment policies using new payment models.

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At the White House

Exterior of the U.S. Department of Justice is pictured with American flag.

The White House is appealing a Tuesday ruling that limits its interaction with social media companies. | Kevin Dietsch/Getty Images

APPEAL AND CARRY ON — The Biden administration is appealing a court ruling sharply limiting the ability of federal officials to interact with social media companies about the content on their platforms, POLITICO’s Josh Gerstein reports.

A Justice Department official said Wednesday night that DOJ attorneys also plan to act “expeditiously” to seek a stay of the sweeping preliminary injunction that bars administration officials from contacting social media firms to persuade them to change their content policies.

The suit claims that President Joe Biden’s White House, the Department of Health and Human Services and officials at other agencies committed censorship in violation of the First Amendment by pressuring social media companies to remove or limit access to anti-vaccine posts and take down certain users’ accounts.

The DOJ’s appeal will send the Tuesday ruling and accompanying injunction to the New Orleans-based 5th Circuit Court of Appeals for review.

In the meantime, the White House continues its efforts to beat back Covid-19 misinformation.

“We’re going to continue to promote responsible actions,” White House press secretary Karine Jean-Pierre told reporters earlier Wednesday. “Our view remains that social media platforms have a critical responsibility to take action.”

 

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Abortion

EYE ON OHIO — With advocates submitting more than enough signatures Wednesday to get an abortion rights initiative on the ballot this fall, Ohio is set to be the latest battleground over abortion rights, POLITICO’s Madison Fernandez reports.

More than 700,000 signatures were submitted for a ballot initiative that would codify the right to abortion in the state’s constitution.

The initiative results could be an early indication of the potency of abortion as a political issue for the 2024 election.

Even before the issue goes to the ballot, the effort to bring the initiative to voters represents the force of Democrats in a state that voted twice for former President Donald Trump and where the state legislature has chipped away at abortion rights since the fall of Roe v. Wade.

Global Health

MALARIA VACCINE ROLLOUT — A dozen African countries are set to receive 18 million doses of the malaria vaccine Mosquirix over the next two years, POLITICO’s Carmen Paun reports.

This is the first time the vaccine — which the World Health Organization endorsed in 2021 — will be rolled out massively in countries where many children continue to die from malaria.

Besides Ghana, Kenya and Malawi, where the vaccine was piloted in the last few years, nine other countries — including Benin, Cameroon and the Democratic Republic of the Congo — are set to introduce the four-dose vaccine, the WHO, UNICEF and Gavi, the Vaccine Alliance, said today.

Why it matters: Malaria remains one of Africa’s deadliest diseases, killing nearly half a million children under age 5. The supply isn’t enough to meet the demand of the 28 African countries interested in introducing the vaccine, the organizations said.

WHO officials hope a positive assessment of a second malaria vaccine candidate, the so-called R21 vaccine, could increase the supply substantially.

At the Agencies

CDC’S STARTUP — About six months after launching, the CDC’s Center for Forecasting and Outbreak Analytics is building out its organization focused on creating disease-monitoring systems, our colleagues at Future Pulse report.

Looking to the immediate future of the center, its leaders said they’re focused on getting data to move faster — part of a larger effort across the agency to get better intel on the country’s health.

One tool that might help in that effort? Artificial intelligence. Leaders at the center said that, though it might be too soon to tell, AI could make their work faster and more efficient.

Names in the News

Perham Gorji is now a partner with DLA Piper’s litigation practice. He previously was deputy chief counsel of litigation at the FDA.

What We're Reading

The Washington Post reports on the financiers who bought anesthesia practices and raised their prices.

STAT reports on the 450,000 meals and snacks Novo Nordisk bought for prescribers to promote drugs like Ozempic.

CNBC reports on influential investor Bill Ackman’s reasoning for backing RFK Jr.’s skepticism of Covid vaccines.

 

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