design the health care system to improve services for low-income groups. Second, he spoke of the importance of investing in a national health care information technology system. Such a system would have aided displaced New Orleans residents, who received health services in different parts of the country following Hurricane Katrina. Third, the medical liability system is in need of reform. Senator Vitter noted that he is a cosponsor of the Access to Emergency Medical Services Act, which would provide liability protection and increase compensation for emergency providers. Finally, Senator Vitter discussed the movement toward pay for performance under Medicare, advocating for a system in which physicians receive higher reimbursement for reporting quality measures.

Several members of the audience posed questions to the senator. Domenic Esposito, from the University of Mississippi, discussed a recent Harris Poll showing that when Americans were informed about the function and efficacy of trauma centers, they were willing to pay a tax to support trauma systems. However, the federal program for trauma was eliminated from the federal budget. In response, Senator Vitter said that he believes that EMS is best handled at the local level and best supported by local taxes.

Tina Coker of Lakeview Regional Medical Center raised a suggestion that health departments expand services using advance practice nurses to help alleviate ED crowding. Senator Vitter said that he did not have the expertise to comment but that he was open to the suggestion.

Ricardo Martinez of the Schumacher Group thanked the senator for his support of the Access to Emergency Medical Services Act and inquired about its chances for passage and ways for providers to show support for the bill. Senator Vitter said that its passage is directly proportional to Republicans’ success in the November 2006 elections.


Regional Perspectives

A panel of state and local representatives participated in a conversation about the reports based on a series of questions set in advance. The discussion was moderated by Dr. Eastman, chief medical officer of ScrippsHealth. Respondents included Bill Brown, executive director of the National Registry of Emergency Medical Technicians (EMTs); James Moises, an emergency physician at Tulane University Hospital and president of the Louisiana Chapter of the American College of Emergency Physicians; Sandra Robinson, deputy director of the New Orleans Health Department; and Suzanne Stone-Griffith, assistant vice president of quality at the Hospital Corporation of America.

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