Legislative: Capitol ideas: Derms lobby Congress, discuss concerns, priorities with legislators

November 1, 2008

Early in September, a group of dermatologists descended on Capitol Hill, where they met with members of Congress to discuss their concerns and priorities and sought to increase awareness among lawmakers of the importance of dermatology to their constituents.

Key Points

By all accounts, it was a highly successful conference. Members of the American Academy of Dermatology (AAD), which sponsored the conference, heard presentations on such matters as inter-operable healthcare technology infra-structure, legislative developments in skin cancer awareness, and effective practices for lobbying at the state level.

Certainly, dermatologists were on Capitol Hill after the pressure was off in terms of Medicare funding - at least for the coming year - as a result of legislation approved by Congress late this summer.

Included in that future direction will be critical decisions regarding healthcare that will affect every American (including every physician and other healthcare provider across the nation), such as

Setting the agenda

All of those matters and more will be on the agenda next year and the groundwork laid during the September Capitol Hill visits. Also helping when dermatologists ask representatives and senators to consider their positions will be AAD's efforts with its political action committee, as well as participation at the Democratic and Republican conventions and ongoing lobbying efforts.

As one healthcare lobbyist told us recently, "If there is a back-room meeting, we need to be at that meeting. We need to have a seat at the table."

Establishing relationships

Every healthcare organization - every specialty group in the country that works Capitol Hill - takes that position, and it is those organizations, such as AAD, that aggressively seek to create relationships with lawmakers who will have the edge when all of those issues and more are considered in the coming year and beyond.

With the economic meltdown that occurred this fall and the consequential impact that it will have on government finances in 2009 and beyond, it will be more important than ever for such organizations to make sure their positions are known, and to back up those positions with solid information and facts from healthcare providers from the home states and congressional districts served by lawmakers.

Medicare crisis

The Medicare funding crisis has been well documented, and while the emergency action taken by Congress this summer eases the crisis for a time - with a 1.1 percent average payment increase on tap for next year instead of a massive reimbursement decrease - the time bomb still ticks. There will be no escaping the need to find a solution to the Medicare funding crisis, and what that will mean to coverage for specific services and procedures is anybody's guess.

Meanwhile, the American Medical Association (AMA) has put forth a proposal to provide healthcare coverage for the millions of Americans who are now uninsured. According to AMA President Nancy Nielsen, M.D., "Next year we need to come together to find common ground and a real solution."

How will that happen? As the politicians like to say, "The devil is in the details." What will those details entail? Who will pay the tab? How will that affect physicians?

Also in September, noting that Congress has "created a window of time to fix the fatally flawed Medicare physician payment system," AMA urged lawmakers to find a solution.

"Millions of baby boomers will begin aging into Medicare in three years, making it imperative that we solve this problem once and for all while we have the chance," Dr. Nelson said in testimony before the House Ways and Means health subcommittee. "By 2020, the government predicts a shortage of 85,000 physicians in many medical specialties."

Insurance relief

AMA, AAD and other specialty groups will also continue their longstanding efforts to obtain liability insurance relief. They will continue to focus on the cost of excessive meritless lawsuits and the effect of liability cost on medical students when they decide on their specialty, threatening patient access to high-risk medical services such as surgery.

All of this and more will be on the agenda when the new Congress convenes in January and when the new president takes office. It will be a critical year for healthcare and for every physician - dermatologists included.

Former congressional aide Bob Gatty covers Washington for businesses specializing in healthcare and related issues. He has written Dermatology Times' Washington Report for more than 20 years, and welcomes comments and suggestions. Mr. Gatty is available at: bob@gattyedits.com