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"The AMA supports President Clinton's goal of reducing health system errors and improving patient safety, and we agree with many of his proposals. However, we are concerned that the proposal for mandatory reporting will not improve patient safety and may, in fact, have the perverse result of driving errors underground. Effective aviation safety programs have taught us that a culture of safety is created by avoiding a culture of blame. The same principle holds true for the health system.

"The AMA and the medical specialty societies have been pioneers in the effort to reduce health system errors. Based on our work, we agree with many of the President's proposals for steps the private sector and government can take to improve patient safety. We support the President's call for increased funds to research errors and disseminate the findings to improve health care. We also concur with the proposal to modify pharmaceutical packaging and marketing practices to reduce medication errors. Prompt action is needed on many consensus areas for improving patient safety.

"However, the AMA is opposed to the expansion of mandatory reporting of medical errors. There is no evidence to show that mandatory reporting improves patient safety. Before we expand data collection activities we need to analyze existing state systems to determine the most effective use of finite resources.

"The AMA appreciates President Clinton's statement of support for protecting the confidentiality of peer review activities. But we are concerned that the protections do not go far enough to promote the type of information sharing that would help create a culture of safety where all members of the health system can learn from and prevent errors."

AAHP Statement on Administration's Patient Safety Proposal

Statement from Karen Ignagni, American Association of Health Plans

"The patient safety proposal put forth by the Administration today is a call to bipartisan action on a pressing national emergency. We look forward to reviewing both the Administration's proposal and similar efforts from the congressional leadership on this critically important issue.

It is time to pierce the veil of secrecy that has shrouded the health care system for too long. Consumers deserve the peace of mind of knowing that the system is safe and effective. To that end, a national information, data collection and reporting effort would go a long way in helping medical professionals and policymakers identify medical errors, ascertain how and why they occur, and determine how they can be avoided in the future.

As equally important, we must recognize that the tort system has contributed much to the culture of blame and secrecy in health care. National efforts to improve patient safety and protect patients should not be vitiated by further exposing the health care system to an already aggressive trial bar. The Administration's announcement today is a much-needed step in the right direction."

Karen Ignagni is President & Chief Executive Officer of the American Association of Health Plans (AAHP).

AAHP is the largest national trade organization representing health maintenance organizations (HMOs), preferred provider organizations (PPOs), and other similar health plans that provide health care coverage to more than 140 million Americans.