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AAFP Blinks on Single-Payer and DTC Drug Ads

— AAFP delegates stopped short of making new policy on single-payer and a ban on DTC ads

MedpageToday

ORLANDO -- The American Academy of Family Physicians punted on publicly espousing two key healthcare policy reforms Tuesday, as the Congress of Delegates voted that advocating for a ban direct-to-consumer drug and device advertising, as well as support for a single payer health care system should be decided by the AAFP board rather than the Congress.

Considering a proposal calling for AAFP support for tougher regulations or an outright ban of direct-to-consumer advertising of prescription drugs and medical devices, delegates voted 78-32 to refer the issue to the Board, following a short debate.

The vote was the second, and potentially fatal, blow to a resolution that had been debated before the practice enhancement committee Monday. Proponents had called for AAFP to support a ban originally discussed by the American Medical Association. But prior to the referral, the committee amended the resolution to read "support regulation up to, and including, a ban on direct-to-consumer advertising."

Calling for a ban could tread on First Amendment rights, a committee member said (the U.S. Supreme Court has upheld the adverting based on free speech, according to the committee's report), while a Pennsylvania delegate worried about the PR ramifications.

Calling the issue complex, the committee noted that AAFP has a policy on such direct-to-consumer advertising, according to its report, and it "is sensitive to the fact that the AAFP partners with pharmaceutical and health related companies to support patent education efforts, including www.familydoctor.org." (The AAFP-run site offers health information and resources for patients, including

A delegate with the sponsoring Oregon chapter opposed punting on the issue: "This is an important statement we should make," he said.

Alas, the only statement AAFP made was no statement at all.

Nor did the Congress rule on the contentious single-payer issue.

The AAFP advocacy committee referred to the board two resolutions supporting a single-payer model (endorsing a national, single-payer health care system, with rates and administrative processes co-determined by the payer and providers; and devising a plan to protect members from "unilateral decisions by the payer"), as well as a resolution calling for AAFP to study the single payer model and submit a report in time for next year's Congress.

As envisioned by supporters such a system would be publicly financed and privately administered.

"The reference committee believes members could benefit from the information," according to its report, issued late Monday, "but determined the Board of Directors would need to address the potential costs of commissioning such a study." In addition, single-payer studies already exist, a few delegates had pointed out Monday.

While the single-payer rulings followed much debate during Monday's committee hearing, the only drama Tuesday concerned the vote on whether to refer the study idea. That referral lost a 49-48 vote, but at least one delegate yelled towards the speaker that her electronic clicker did not work. The Congress called for a re-vote, and an old-fashioned standing head count passed the referral 64-55.