approximately one month on hearings and markups and have a bill on the floor for a vote soon.

Comments by Congresswoman Eddie Bernice Johnson related the problems that many of her constituents in South Dallas have in obtaining affordable, effective healthcare. Even those patients who are under Medicaid and S-CHIP often cannot find physicians to treat them. There were representatives from Parkland Hospital, UT Hospital System, Methodist Hospital System and the Baylor System, as well as the Children's Hospital in Dallas discussing the problems of access to medical care. The CEOs of various hospital systems were very supportive that their physician-hospital joint venture relationships which resulted in better, more efficient care for their patients.

Congressman Hoyer stated emphatically that the new healthcare plan would have choice of hospitals, choice of insurance and choice of doctors. He stated that Congress is looking for a healthcare reform that is more economical and provides not only better coverage and care, but access to care. He discussed the manpower shortage of physicians. Graduate medical education and funding for residency programs were discussed. Congressman Hoyer emphasized a plan to  use foreign medical graduates and allied health professionals to fill in the gap where there were not sufficient physicians.

Congresswoman Eddie Bernice Johnson, who was a head psychiatric nurse at the VA before becoming a congresswoman, fully understands the problems of medical care and access to that care. She has joint venture specialty hospitals in her district.

It is very important for you to fax or call your Congressman, as well as Congresswoman Eddie Bernice Johnson and Congressman Steny Hoyer your concerns about healthcare reform. Both Dr. Gill and Dr. Kant are concerned that there has not been sufficient attention paid to the funding of residency programs, the expansion of residency programs, and the manpower shortage of physicians. We are also concerned that the draft legislation contains restrictions on physician ownership when statistics clearly demonstrate that physician owned hospitals are efficient, economical, employ many people, have low infection rates, and high patient satisfaction rates and are top rated hospitals in Texas and the nation.

The CEOs of the hospitals and hospital systems as well as the physicians present emphasized that one of the major problems that physicians are experiencing is the inability to cover their costs of continuing to provide medical care in the present economic climate. All agree that physicians need to be adequately reimbursed.

Quotes

1. Affordable quality healthcare for every American.

2. Getting the treatment you need when you need it.

3. Delaying a doctor visit or test equals delay in treatment.

4. Not all patients fit within the guideline. Care must be individualized to the patient and the disease.

5. Healthcare is a personal issue, not only an economic issue.

6. Science and research should enhance and improve healthcare, not limit choices.

Things not discussed

1. Why are there so few private physicians not associated with academic centers or large healthcare institutions on the various healthcare reform committees?

2. Family physicians are not omnipotent. They cannot possibly know everything. The gatekeeper theory did not work in the past and it will not work in the future.

3. Physician joint venture specialty hospitals are more economical, give higher satisfaction rates, have lower infection rates, and have shorter hospital stays.

4. Large hospital complexes and corporations both for-profit and not-for-profit still deal with corporate profits as the bottom line.

5. There is no savings in stopping physician investment in joint ventures for hospital ownership. Cases will continue to be done at other institutions that are probably more expensive. Only about 50% of the healthcare premium received by insurance companies actually is paid out for patient care.

6. There are hundreds to thousands of backlogs in the VA system for patients needing care.

7. Pay for performance may affect smaller hospitals since their ability to do certain procedures is limited and tests are not available.

8. IT systems do not talk to each other, which can be directly fixed with a mandate. The real reform will be in the delivery of healthcare, but this will require increased access and many more physicians.