Shoot out at the RBRVS corral

1. If one understands and believes what has been noted above, then the conclusion is that some new system must be devised for payment of medical services. 2. While the Board of Trustees report in evaluation and recommendations of the RBRVS study was ultimately acceptable to the delegates, the Hsiao study was not. (It is incomplete and flawed in many ways and is to be reviewed further and ruled upon.) 3. The problems of rural v urban differential will be addressed. 4. A gradual phasing in of this entire program to avoid disruptions is mandatory. 5. The acceptance of a "balance billing concept" will be necessary and only fair to allow full access to medical care. There seems to be some "inherent reasonableness" to the fact that the well-to-do senior citizen would expect to be balance billed, and on the other hand, the indigent elderly person would receive excellent medical care, as proposed by our present "courtesy card program." 6. Ongoing surveillance by medical authorities will be needed to avoid the subversion that so often happens to well-intentioned programs. Dr. Russell Roth (past president of the AMA) has helped lighten the atmosphere among many of our stormy debates over the years. He has done this by well designed and appropriate limerics. The one that he concocted for this particular problem goes as follows: "It is true that our health depends, On our congressional friends, To grant this convention, this brief intervention, Remember Jesus saves and Congress spends." It can thus be seen from all of the above, that this "shoot out" wound up not being a deadly and divisive affair. A note of harmony allowed all of the factions to "spike their guns." Great credit for this belongs to not only the excellent report AA of our Board of Trustees but also to the long range perceptiveness of our membership who realized the necessity for this approach.