If we were doing David Letterman’s Top 10 List of “Important Issues in 2009,” health care reform would be number one. President Obama made the issue the cornerstone of his legislative agenda, and it generated a tremendous outpouring of emotion on both sides of the issue.

ACEP believes that the current system is unacceptable and unsustainable. We have made that clear in testimony before Congress, in our discussions with Bush and Obama administration officials, and in our public outreach efforts.

We have also been very clear that the country needs a strong emergency care system not only for disasters and pandemics, but also for the commonplace emergencies that produce more than 119 million patient visits in our EDs every year.

To ensure that our country has a strong emergency care system, we support comprehensive health care reform that includes:

• Meaningful and affordable health insurance coverage for every American.
• Significant medical liability reform.
• Elimination of boarding admitted patients in emergency departments.
• Development of a national surge capacity plan for a public health crisis or other catastrophe.

In addition to representing emergency medicine in the health care reform debates, we continued to advocate for passage of the “Access to Emergency Medical Services Act” and worked to get various provisions of that legislation included in the bills being discussed in Congress.

We were, and continue to be, serious about tort reform and worked closely with Rep. Bart Gordon (D-Tenn.) on an amendment providing tort relief for all physicians who provide EMTALA-related care.

2009 was also a busy year for our 911 Legislative Network. ACEP’s grass roots advocacy group grew by 14%, and it tirelessly worked on campaigns to encourage legislators to cosponsor ACEP’s legislation and hold hearings on emergency medicine issues.

Last summer, the College gained ground in the health care reform debate with the release of a survey on the public’s interest and support of emergency care as an essential component of health care reform.

Two-thirds of those polled said the government should increase funding to emergency departments in order to hire more doctors and expand vital lifesaving services. An overwhelming 81% said emergency care benefits should be a part of any government-sponsored health insurance. ACEP will continue to work on the inclusion of emergency care as a benefit in ALL health insurance packages.

ACEP reached another goal last year when our political action committee, NEMPAC, experienced record-breaking fundraising success, moving up the ranks to become the fifth largest medical specialty PAC. Your support of NEMPAC has been phenomenal, and the access it provides has been invaluable in our advocacy efforts.

the real work—and the real battles—will occur as regulations are developed to implement the statutory changes.

In one of our largest public outreach efforts to date, ACEP brought emergency medicine to the public’s attention in a high-profile way with the September launch of our “Emergency Medicine Myths and Realities” campaign. Centered on an “Open Letter from America’s Emergency Physicians,” the campaign provided a public forum to dispel the myths surrounding emergency care and advocate for our positions on health care reform.

Targeting every key stakeholder in the health care reform debate, nearly 40,000 letters were mailed to Congress, the White House, pharmaceutical and insurance companies, medical societies, foundations, and influential grassroots organizations. Full-page, color ads ran in the print and online versions of Politico, Roll Call, Congressional Quarterly, and USA Today.

Also included was a public Web site, www.ACEP.org/realities, that continues to generate a steady stream of traffic.

The Myths and Realities campaign did raise ACEP’s public profile, and four days after it launched, Sen. Debbie Stabenow (D-Mich.) offered an amendment to the Senate Finance Committee health care bill asking for a 5% Medicare reimbursement bonus for services provided by emergency physicians or on-call specialist services performed in an emergency department for fiscal years 2010-2015.

Although the amendment was not included in the final legislation, it was an accomplishment for emergency medicine.

2009 was a busy year. 2010 promises to be even busier.

Whether you personally agree with the final product of health care reform legislation or not, it is important to remember that health care delivery will not change overnight. Most of the provisions of health care reform legislation will not be implemented until 2013.

The real work—and the real battles—will occur as regulations are developed to implement the statutory changes.

If true reform does happen, it will be a long term process. We will not wake up to a new reality the morning after a bill is signed. There will still be much work to be done.

Rest assured that ACEP will be vigilant and active, every step of the way.