he members of the Committee on Governmental Affairs have been busy collectively and individually on the many projects that the committee has taken on this year.

First, the 2006 Legislative Conference was a huge success. With nearly 500 registrants, the availability of continuing medical education for the first time, great speakers and our effective meetings with our representatives, I do not think we could have asked for more.

We heard from William G. Horton, M.D., our first Lansdale Public Policy Fellow, about his experiences on “the Hill” (see article on page 22 of this NEWSLETTER). It is time to start looking for our next fellow. Would you like the experience of a lifetime, being a Washington insider and helping to shape health policy as an anesthesiologist? Link to the “Governmental Affairs” section of the ASA Web site for more information and an application.

The saying “all politics is local” was never truer than for the politics of health care. Even though at times it may seem that the federal government is dictating huge payment and scope-of-practice issues for physicians, increasingly important decisions are being made state-by-state by legislators, judges and regulators. ASA leadership anticipated this when the Legislative Chair position was created. An individual from each state was designated to be available to the governmental affairs leadership. Availability, continuity and the ability to communicate were the prerequisites. Fast-forward four years, and these individuals have served ASA repeatedly and well. The entire group has met three times (twice at the legislative conferences and once at last year’s Annual Meeting) and will meet again at this year’s Annual Meeting (Sunday, October 15, after the House of Delegates meeting). A listserve links the group at all times. The first three-year term is coming to a close, and, hopefully, by having each component nominate (or renominate) great people, the strength of the Committee on Governmental Affairs will grow (See list of chairs below).

The relationship between the committee and the ASA Political Action Committee (ASAPAC) has been strengthened. ASAPAC will utilize the legislative chairs as part of a grassroots campaign for fundraising. Members of the Committee on Governmental Affairs are often tapped for local check presentations of political candidates that ASA has chosen for support. Many “key contacts” have started this way.

As political advocacy consultant Melinda Farris described in her session “Strategies for Advocating Effectively to Congress” at our Legislative Conference in May, legislators have systems for keeping track of their correspondence. One of her first jobs was doing this for former House of Representatives Speaker Newt Gingrich. He had four baskets into which she sorted mail. The first was “Other” and included everything coming from within Washington. She revealed that most of this basket was filed in the circular file. The next was “State,” in this case, everything coming from Georgia. Next came “District,” and this was for the always-important constituents who could vote for Rep. Gingrich. The last basket, which was presented to the congressman directly every day, was “Friends of Newt.”

Other than corresponding and meeting with your elected official, how do you get into the “Friends of ___” basket? The easiest way is to support the official’s election campaign. Elected officials give special credit to their earliest supporters, so it is a good idea to identify people you like in early local races.
Supporting someone for election takes several forms. (I hope you are not surprised by that.) Obviously there is financial support in the form of campaign contributions, including 1) personal, 2) from a PAC to which you contribute (and you have called someone with the PAC to suggest your elected official) and 3) from your friends.

Your support can be in your time (or your kid’s time). What better lesson in civics than getting involved in a political campaign? Stuff envelopes, put a sign in your yard or march in your local community Fourth of July parade with your representative.

When a busy, respected, dedicated member of one community (you in your hospital) gets together with one busy, respected, dedicated member of another community (your elected official), magic can happen. Seriously, your elected official would really like to have you be a “Friend of ___.” You will find yourself getting calls from his/her office with questions about health care and hospital activities. This is where local and personal contact comes into play. The foundation of any personal relationship is trust. If your elected official knows that he/she can call you and either get an opinion, information or feedback, or that you will give them the honest answer that you do not know how to answer him/her but you will find out and call him/her back, both of you have gained immeasurably.

Why do we do what we do? This is a good question that a great many people try to answer. One group of people is the Committee on Governmental Affairs and ASAPAC. We try to figure out politicians and medical regulators and how what they do will impact working anesthesiologists and their ability to give good patient care. That part, frankly, is very easy. ASA’s Washington Office does an incredible job. Director of Governmental Affairs and General Counsel Ronald Szabat, J.D., LL.M., Associate Director of Governmental Affairs and PAC Director Manuel Bonilla, M.S., Associate Director of Professional Affairs Karin Bierstein, J.D., M.P.H., and State Legislative and Regulatory Issues Manager Lisa Percy, J.D., know what to do and how to do it. For example they know exactly how to get the onerous teaching anesthesiologist payment rule changed. This rule, which singles anesthesiologists out for unfair treatment compared to other physicians, is slowly but certainly eroding the foundations of our specialty. Why can’t our Washington staff get this changed? The answer to this question is found in YOU. You have not equipped them properly; and just as a country that does not equip its military properly cannot expect immediate victory, neither can you. Our Washington Office has next to no political power without you. Why have you not helped? The incredibly successful Alabama Society of Anesthesiologists calls them “PACuses” — excuses for not giving to ASAPAC. “I’m too busy,” “My income’s fallen” (which I say is a good reason to help), “I don’t do politics,” “The PAC supported a candidate once that I didn’t like” or “I don’t know how to help.” We have heard them all.

We are an organization of volunteers. We are an increasingly rare medical Society that is a democracy with representative government. We do not hire some executive director to decide things while we then go back to work. We decide things.

We have an amazing volunteer army. In the ASA committee structure alone, we have 95 committees chaired by 89 people. If we look at our committee chairs, however, only 55 of them have contributed to the PAC since October 2005. Given that our overall society’s rate of giving is only 10 percent, 56 percent should sound great. But I would like to think that committee chairs are members of the choir who get it. Other than the fact that they are already doing work for our Society, I do not understand their excuses. This group should be at 100 percent.

If you want something, you usually have to do some work to get it. “You get what you pay for” unfortunately applies to governmental affairs as well. If every member once a year sent in to the PAC the equivalent of his/her reimbursement for his/her smallest case, or for one hour of one day of his/her salary — or for that matter, for what is spent on one meal out at the Annual Meeting — ASA’s work and the mission of supporting anesthesiologists would be simple.

I would like to thank all of you who “do the work,” especially the members of the ASA Washington Office, the members of the committees and ASA leadership. I look forward to the upcoming leadership of Jane C. K. Fitch, M.D., on the Committee on Governmental Affairs.

Patricia J. Davidson, M.D., is Staff Anesthesiologist, The Ohio Surgery Center and Columbus Children’s Hospital, Columbus, Ohio.