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REMARKS BY: TOMMY G. THOMPSON, SECRETARY OF HEALTH AND HUMAN SERVICES, PLACE: The American Society of Interventional Pain Physicians, Arlington, Virginia DATE: October 6, 2001
I see some good friends from the great state of Wisconsin in the audience. Doctors Saini, Patel and Singh all hail from my wonderful home state. We did good work together while I was governor and I'm glad we can see one another here in our nation's capital.
Let me thank you, Dr. Singh, for your leadership of ASIPP and your commitment to quality health care for every American. And thanks to the University of Louisville for your role in the research of pain treatment and medications.
I'm so pleased to see so many of you here and enjoying the fall season here in our nation's capital. Let me thank you for coming and for not being deterred by the terrible events of recent weeks.
The spirit of unity in America has been wonderful to behold. We're no longer Irish-Americans or Pakistani-Americans, Republicans or Democrats, whites, blacks, Asians or Latinos - we're just Americans. We honor our heritage, but our pride is in our country.
Your pride in our country is evident by your presence here this weekend. As the President has reminded us, we can't let the terrorists intimidate us from conducting the business of America, and we won't.
In your case, that means meeting to discuss how to help people in pain. I applaud you for meeting to share your knowledge and learn about the latest advances in your field. My own passion for health care comes from the place I grew up. I'm from a small town in Wisconsin called Elroy, population 1,500. My dad owned the local grocery store so we got to know just about everyone in town.
People in small towns have long memories. In fact, while I was being confirmed as secretary of Health and Human Services, the FBI found a fellow guy who said I'd been in a fight with him when I was about 16 years old. I don't remember the fight, but he said nice things about me, so I guess he won.
But in a smaller community, your neighbors are also your friends, and when one person hurts, everyone hurts. If someone fell ill, we all knew it and we all felt it.
Pain is a critical national health problem. It is the most common reason for medical appointments and produces nearly 40 million visits annually. Pain costs its victims and the health care system as a whole more than $100 billion each year in health care and lost productivity.
Pain has a profound effect on the quality of human life. In addition to often destructive effects on the immune system, pain can cause disruptions in sleep, eating, mobility and a person's overall ability to function.
In the hospitalized patient, pain may be associated with increased length of stay, longer recovery time and poorer patient outcomes. We know the problem is real and serious.
At the Department of Health and Human Services, we take the problem of pain seriously. In 1996, the National Institutes of Health formed its "Pain Research Consortium" to enhance pain research and promote collaboration among researchers.
The Consortium meets to exchange information, propose topics for workshops and conferences and issue program announcements in the field of pain research. In fact, the NIH is developing an on-line textbook titled, Symptom Research. It includes chapters on clinical trials for the treatment of pain, various kinds of pain research and how to find various grant opportunities. I know it will be useful to you.
Now, let me highlight some good news that I know you've been anticipating for a long time. On September 21, the Centers for Medicare and Medicaid Services announced a specialty designation for pain management. It's called "Specialty Code 72," and becomes effective on January 1, 2002.
The code can be used in studies to determine procedure costs and practice expenses for pain management. It's adoption signals Medicare's recognition of the importance of "pain management" as an emerging medical sub-specialty. As time goes on, this will be useful in distinguishing between your specialty and specialties in fields such as anesthesiology, neurology or physical medicine.
I know how important that is to you and I actively supported this initiative. But I also know this is not everything you wanted. "Pain Management" is not the same as "Interventional Pain Management." The reason we haven't yet recognized Interventional Pain Management has to do with technical rules under the Health Insurance Portability and Accountability Act of 1996, or "HIPAA."
Under HIPAA, the only specialties that Medicare can recognize are those recognized by the National Uniform Claim Committee, also called the NUCC.
But don't lose heart. The NUCC uses an industry-led, consensus driven process to establish what specialties can be on its list. This is a process best left to clinicians and professional peer groups.
In other words, you have to keep pushing. You have to keep making your case. If I could, I would simply instruct the NUCC to act, but the rules prevent me from doing that. But I have taken action I believe will help significantly.
I have instructed the people at CMS to work with your organization to help move your application through the NUCC for inclusion in its list.
It's important that Medicare recognize emerging medical technologies and practices that yield measurable improvements in patient care - in other words, specialties like yours. I know the process for achieving this recognition can be frustrating. But you are incredibly persistent and innovative. I know you will succeed.
In addition, we are continuing to work hard to provide you with the tools you need to help people in pain. Just a few days ago, we announced a $6.7 million grant to study how to help a severely injured body begin the journey to recovery.
This funding will go to a virtual army of researchers and practitioners - from critical care physicians and cell biologists to mathematical modelers and biomedical engineers. They will work to evaluate how "acute events" like serious auto accidents or severe burns affect the immune system.
As a result of this study, we are hoping to develop some standard operating procedures to help caregivers know how best to treat people who are in sudden and profound pain. And, in the long term, we hope that the research will enable scientists to predict patient outcomes based on molecular measurements, such as genetic fingerprints.
This is just one example of how science at the molecular level is on the verge of transforming the way we treat pain. At HHS, we have done, and are continuing to do, extensive research on the molecular mechanisms of pain.
Here's another example: The FDA is reviewing a drug derived from a South Sea snail toxin that keeps pain nerves from releasing neuro-transmitters in the spinal cord. Think of that - a snail from the South Pacific could provide relief from suffering for people here in America and around the world. We're truly living in a remarkable era.
We know that electrical stimulation of the spinal cord gives partial relief of complex regional pain syndrome, Type I. At Johns Hopkins in Baltimore, they are studying electrical stimulation for patients who have pain persisting after back surgery, with controlled trials. And at the NIH and also at the University of Pittsburgh, researchers have shown that gene therapy relieves pain in rats, which holds tremendous promise for human treatment.
The possibilities are great, but research is needed. Let me assure you that we're providing funding for the research. The President's budget is in the process of doubling funding for the NIH. By 2003, N-I-H funding will be twice what it was in 1998.
Research is moving forward. But research and treatment and medical care of all kinds have benefit to patients only if they can be delivered effectively. For older Americans, that's where Medicare comes in.
Virtually all of you who are practicing physicians deal with patients who are on Medicare. That means lots of paperwork, more forms than you would like to see and regulation compliance that demands time you could better use to care for the hurting people who come to see you.
I abhor the status quo. Coasting along is not my style. Public service means exactly what it implies - serving the people. And the people deserve a sound return on their investment in their government.
That's why, when it comes to Medicare, we are working to bring significant change to the whole program. The President is committed to modernizing Medicare, to improving the way the system runs and strengthening it for both present and future beneficiaries.
President Bush has laid out his vision for Medicare reform. It includes a prescription drug benefit. It gives patients more options for specific types of plans that best meet their individual needs. And the President is committed to making sure that everyone who wants to stay in the current system can do just that.
But even as we work for long-term changes to the system, we can make changes now to help our seniors enjoy a higher quality of care and to will help physicians and caregivers use the system more effectively and efficiently.
We are committed to regulatory relief that will enable physicians, nurses and other caregivers to spend more time with patients. I have instructed CMS to hold listening sessions in the field to better understand what both physicians and their patients are thinking. In fact, CMS officials have already held some sessions and many more are being planned for coming months.
We are creating eight private sector health industry working groups to suggest improvements to the way CMS interacts with physicians, healthcare providers and beneficiaries.
And we are forming a group of experts from the wide array of Medicare's program areas within HHS. I am charging them to think innovatively about how we can reduce administrative burdens and simplify our rules and regulations.
We are already taking some significant steps. CMS will eliminate unnecessary data that have been demanded of hospitals and skilled nursing facilities in their Medicare Cost Reports. We will eliminate these reporting requirements as soon as we can to help shrink cost reports by about ten percent.
We are also doing away with redundant questionnaires and getting rid of time-consuming cost calculations that we have demanded of nursing facilities.
So, we are working to make the practice of medicine less bureaucratic and effective for you. And we're working to provide you with the knowledge you need to serve your patients more effectively.
As we work to provide you with that knowledge, we are always mindful that we are working not just for today but for tomorrow, as well.
One of my great heroes is Abraham Lincoln, who once said, "The struggle of today is not altogether for today -- it is for a vast future also."
In your work to heal and bring release from pain, you are serving patients today and you are building a vast, stronger and healthier future for everyone.
Thank you for all you are doing for your patients and for America. I'll be glad to take a few questions.