ACOEM pushing Congress for confidentiality
The American College of Occupational and Environmental Medicine (ACOEM) in Arlington Heights, IL, is pushing for several legislative actions that the group says would improve confidentiality for occupational health patients and give physicians more power to negotiate their contracts with insurers.
In a separate move, the group is calling for more research into the phenomenon of multiple chemical sensitivities.
ACOEM representatives have been lobbying Congress to vote on the Quality Health Care Coalition Act of 1999 (H.R. 1304), a bill sponsored by Rep. Tom Campbell (R-CA). The bill would allow doctors to join forces to negotiate the terms and conditions of their contracts with insurers, and it promotes competition by permitting doctors and health plans to negotiate from more equal positions. The bill would not allow doctors to go on strike or engage in price fixing.
Robert McCunney, MD, president of ACOEM, says the bill ultimately benefits patients.
"The Quality Health Care Coalition Act will protect patients by helping to return physician autonomy in medical decision making," he says. "It quite simply lets doctors put patients first. It creates a balance of power between doctors and managed health care insurers that will enable doctors to safeguard the best interests of the patients."
McCunney says the bill addresses inequities he says were created when health plans used a special exemption in antitrust laws to exert leverage over physicians when negotiating contracts. Insurers often present contracts with objectionable conditions, such as gag clauses that restrict doctors from discussing all treatment options, but the size of the health plan can make it difficult for the doctor to refuse, he says.
Bill would set up grievance process
ACOEM also has endorsed the Managed Care Reform Act (H.R. 719), marking the first time the ACOEM board of directors has ever formally endorsed proposed federal legislation. Introduced by Rep. Greg Ganske (R-IA), the bill would allow physicians to determine what treatment is medically needed and establish an external grievance and appeal process for patients and physicians.
Also, ACOEM has appealed to Congress not to waive the federal government’s responsibility to protect workers and children from tobacco use. In a letter to Congressional leaders, ACOEM urged Congress to pass emergency legislation to require states to spend a significant portion of the $208 billion they received in tobacco company settlement funds on programs to reduce tobacco use.
On the research front, ACOEM is calling for more study of multiple chemical sensitivities (MCS). MCS is a puzzling condition in which patients report recurrent non-specific symptoms referable to multiple organ systems that the sufferers believe are provoked by exposure to low levels of chemical, biological, or physical agents. The condition has been the subject of some controversy, with some arguing that the reactions are psychosomatic, having nothing to do with physical exposure to certain chemicals.
"ACOEM concurs with many prominent medical organizations that evidence does not yet exist to define MCS as a distinct entity," according to a position statement released recently by the group. It further stated: "ACOEM recognizes that data have accumulated that support some tentative conclusions about MCS. Evidence points strongly against an immunologic basis for MCS. Research has noted overlap between MCS, chronic fatigue syndrome, fibromyalgia, and other historic nonspecific conditions."
ACOEM is encouraging more research into the phenomenon, but the position statement notes that research is unlikely to produce clear distinctions between physiologic and psychologic disease.
"ACOEM continues to support the position that the relationship of MCS to environmental contaminants remains unproven," the position statement says. "No scientific basis currently exists for investigating, regulating, or managing the environment with the goal of minimizing the incidence or severity of MCS. On the other hand, ACOEM recognizes that measurable indoor air quality problems can exist that cause human illness and discomfort."
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