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June 2003
Volume 67
Number 6

Washington Report


Presentations by Senators Clinton, Dole Highlight Legislative Conference Program

Michael Scott, J.D., Director
Governmental and Legal Affairs



 

Hillary Rodham Clinton

Attendees at the ASA Legislative Conference on May 5-7 in Washington, D.C., were treated to a seminal occurrence for such conferences: the appearance of two female Senators as speakers, Hillary Rodham Clinton (D-NY) and Elizabeth Dole (R-NC). The only female Senator previously to speak at an ASA Legislative Conference was Maria Cantwell (D-WA), who appeared last year.

(Of interest, at least to history buffs within the ASA membership, is the fact that almost half the females elected or appointed to the Senate (33) are currently serving (14) with the first having been appointed to serve in 1922, for one day, and the second having been elected to two terms beginning in 1932. In the 108th Congress, females hold both Senate seats in three states: California, Maine and Washington.)

Senator Clinton gained considerable favor with the 2003 attendees by offering strong praise for ASA’s leadership role among the various specialties in reducing medical errors. She expressed optimism that Congress would pass patient safety legislation this year that would permit the voluntary reporting of adverse incidents on a confidential basis. She also expressed concern about the current shortage of anesthesia personnel and the impact of the shortage on access to necessary care and reiterated her concern for support of adequate federal funding of teaching programs. In the context of the steeply rising cost of Medicare, the Senator said that the time had come for us to “demystify death,” noting that the high cost of care in the last days of life was often the result of the incapacity of family members to “let go.”

Elizabeth Dole

Senator Dole, who was elected last November, entertained attendees with a comparison of her husband’s office when he was Senate Majority Leader and the “bunker” to which she was assigned when first taking office last January. The Senator expressed her profound gratitude to anesthesiologists in North Carolina and elsewhere who strongly supported her bid for the Senate. She underscored her belief that professional liability reform should be a high priority in the current Congress and expressed support for the concept of association health plans as a means to provide health coverage to the uninsured, many of whom work for small companies.

Also appearing on the conference program was Barry Jackson, Deputy Assistant to the President in the White House Office of Strategic Initiatives. Mr. Jackson emphasized the President’s strong support for professional liability reform, giving examples of cases where physicians were abandoning or limiting their practices in the face of rising liability premiums. In response to a question, he acknowledged that his office was “very much aware” of the patient access problem potentially created by the predicted negative cut in Medicare reimbursement levels for 2004 and beyond.

Attendees visiting Capitol Hill offices during the conference reported that nurse anesthetists visiting Washington the previous week had touted a recent anesthesia outcomes study by Michael Pine, M.D., financed in part by the American Association of Nurse Anesthetists. Our attendees were able to carry with them to the Hill, however, an ASA position paper noting that Dr. Pine’s results were consistent with those found by other researchers — that mortality rates are lower when an anesthesiologist is involved.

Hill visits by conference attendees also disclosed that nurse anesthetists were seeking congressional opposition to a proposal by the Department of Defense to permit anesthesiologist assistants to provide care to TRICARE patients. TRICARE is a regionally managed health care program for active duty and retired members of the uniformed services, their families and survivors. A copy of the Department of Defense proposed regulation appears on the ASA Web site in the “Members Only” section; ASA and numerous individual anesthesiologists provided written comments to the Department of Defense supporting inclusion of anesthesiologist assistants in the program.

New York Society members with Senator Hillary Rodham Clinton, center, and ASA President James E. Cottrell, M.D., right center.


North Carolina Society members with Representative Richard Burr, middle center.


Texas Society members with Senator John Cornyn, left center.


Alabama Society members with Representative Jo Bonner, front row, third from right.


Pennsylvania Society members with Representative James Greenwood, front row, third from right.


Illinois Society members with Representative Bobby L. Rush, center.


South Carolina Society members with Representative Joe Wilson, fourth from left


Washington Society members with Senator Maria Cantwell, far left.


A\Manuel Bonilla, ASA Assistant Director of Governmental Affairs (Federal); Senator John Ensign (R-NV); and Danial O. Laird, M.D., Chair of ASAPAC.




Liability Reform, Medicare Formula Ongoing Concerns

As Congress recessed for Memorial Day, there has been no recent movement on the two principal federal legislative issues currently of concern to ASA and its members: professional liability reform and elimination of the current Medicare update formula.

There are some indications that congressional committees with Medicare jurisdiction are considering possible temporary measures to forestall a reimbursement cut next year, but to date, there has been no indication that Senate Democrats will temper their uniform opposition to professional liability reform along the lines passed by the House earlier this year.



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The views expressed herein are those of the authors and do not necessarily represent or reflect the views, policies or actions of the American Society of Anesthesiologists.

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