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America’s Medical Society, Inc. 03 NOV 2011 Position Paper on the U.S. Deficit Reduction Super Committee (The Intersection of Economic Limitations, Fiscal Choices, and Patient Care) The Budget Control Act of 2011 established a bipartisan Super Committee of 12 members of Congresswho are tasked with identifying $1.5 trillion in deficit reduction for the next decade; the deadline for identifying areas to ‘reduce’ was set as“November 2011.” December 23rd, 2011 is the date that Congress is poised to pass legislation incorporating these recommendations. The time for making hard choices is fast approaching. If the committee fails to implement such a plan, as much as 1.2 trillion in across-the-board cuts, evenly divided between defense and non-defense sectors, will be imposed. The Joint Select Committee could propose cuts that would reduce spending in Medicare and/or restrict Medicare benefits; these changes will likely have a significant impact on patient care services, co-pays, prescription drugs, and physician/provider reimbursement. There is much ongoing debate about the ‘Affordable Care Act’ (PPACA), but by any estimation our nation is facing the imperative to provide increased medical services to millions of more Americans in the next decade alone. The Board of America’s Medical Society (AMS) believes it stands with the majority of laypersons and healthcare professionals alike when it asks ‘canMedicare truly afford to cut benefits and pay to doctors and other medical providers and expect the access to that care to remain unchanged?’We believe the answer to that question is unequivocally ‘no’. Medicare is a national healthcare safety net for America’s elderly and disabled; Medicare Part D, also known as the Medicare Prescription Drug Plan, was created under the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (2003 Medicare Act) to help cover the costs of prescription drugs for patients and seniors. Thanks to competition among plans and strong cost controls, Medicare Part D works. Free market competition in Part D drives drug costs down; likewise, potential reforms that would act to stifle that competition will inflate seniors’ premiums, quash R&D and cut tens of thousands of skilled, high-paying American jobs. Since its creation, nearly 900,000 patients have used Part D discounts to save $461 million. Part D plans are also negotiating medicine rebates for millions of patients. According to the Medicare Trustees, rebates are 20-30 percent on many brand name drugs, with biopharmaceutical companies providing a 50 percent discount on brand name drugs in the Part D coverage ‘gap’. The AMS Position on Cuts to Healthcare and Medicare Part D: America’s Medical Society strongly urges Congress and the new ‘Joint Select Committee’ to preserve Medicare Part D, and to resist the urge to curtail the robust American free-market health care system. Any spending cuts that artificially restrict one of our unique national strengths—free-market competition and innovation—will negatively affect our national value, our competitive edge worldwide, and the long-term benefits of private sector research and development. Medicare Part D is a good example of a government safety net which also preserves the positive input of private markets. Like the Independent Payment Advisory Board (IPAB), put in place by the PPACA legislation, the Congressional budgetary super committee could apply ill-advised payment cuts to doctors providing care to seniors. Some in positions of power are advocating for this very thing—a move that would jeopardize patient care and limit seniors’ choice on necessary treatments and medications. The super committee and the IPAB will have little-to-no accountability – with no oversight by the Federal courts, the Department of Health and Human Services or even Congress at large – and patients will not be able to question, challenge, or seek redress from their changes or recommendations once made. America’s Medical Society strongly urges the Joint Select Committee to resist the temptation to implement short term cuts to doctors and patients at a time when our nation is looking for viable ways to effect long-term improvements to an expanding health care delivery system. AMS, Inc.The Independent Physician©

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