“As an organized subspecialty, neurosurgery believes that the debate on health care too often begins and ends with the high cost of health insurance and expanding coverage to the uninsured or underinsured. While both are critically important, they are only part of the equation,” remarked Dr. Bean.

It will do little good to provide everyone with "universal coverage" if there are fewer physicians available to provide the quality medical care patients need.

Real reform must address the current liability system which drives good doctors out of medicine — or forces them to curtail vitally needed procedures — and a Medicare system that makes the treatment of elderly patients increasingly difficult. Key points communicated by Dr. Bean:

Medical Liability Issues

•About one-third of orthopedists, obstetricians, trauma surgeons, emergency room doctors and plastic surgeons can expect to be sued in any given year. Practicing neurosurgeons can expect to be sued even more often — every two years, on average.

•The medical liability situation has negatively affected patient access to care and the physician population. Among the repercussions are physician shortages (recruitment and staffing challenges), limiting practice — physicians turning down high-risk cases due to liability concerns, and emergency rooms diverting ambulances due to a shortage of specialists.

•Comprehensive medical liability reform, including reasonable limits on noneconomic damages, would greatly reduce national health care costs. Medicare spending alone would be reduced by $17 to $31 billion per year.

Medicare Issues

•About 77 percent of physicians say they will have to limit new Medicare patients if payments are cut 40 percent by 2016, as is presently forecast.

•The average 2008 Medicare physician payment rates are about the same as they were in 2001.

•The overuse of imaging services driven by medical liability fears was associated with an increase in total Medicare spending of more than $15 billion between 2000 and 2003.

•Physicians are being punished by participating in initiatives that encourage greater use of preventive care.

The conference was organized by the White House Writers Group, a communications firm formed by Reagan and Bush speechwriters, along with West Wing Writers, a communications firm formed by Clinton presidential writers. Information about the conference, including a complete list of speakers, is available online at http://www.healthcareatrisk.org.

Founded in 1931 as the Harvey Cushing Society, the American Association of Neurological Surgeons (AANS) is a scientific and educational association with more than 7,400 members worldwide.

The AANS is dedicated to advancing the specialty of neurological surgery in order to provide the highest quality of neurosurgical care to the public.

All active members of the AANS are certified by the American Board of Neurological Surgery, the Royal College of Physicians and Surgeons (Neurosurgery) of Canada or the Mexican Council of Neurological Surgery, AC.

Neurological surgery is the medical specialty concerned with the prevention, diagnosis, treatment and rehabilitation of disorders that affect the entire nervous system, including the spinal column, spinal cord, brain and peripheral nerves.