ASA May 2007 Newsletter

On Political Involvement

Ronald Szabat, J.D., LL.M.
Chief Operations Officer – External Affairs and General Counsel

he cherry blossoms have peaked and faded. Congress has come and gone from its Easter/Passover recess. ASA is holding another stellar Legislative Conference in Washington for motivated ASA members from our component societies. What are our anesthesiology activists finding as they come to the nation’s capital?

A return to regular order is the new order of the day in Washington. Democrats, true to their pledge, have re-opened committee proceedings with back-to-back hearings on anything and everything under their jurisdiction — that is, after the first 100 hours, when such “regular order” was conveniently brushed aside.

The nation’s capital also is still reeling from nonstop talk about the actions of the Attorney General and his handling of the firing of a large number of U.S. Attorneys. Predictably the discussion quickly progressed beyond the action in question to what the top law enforcement officer had said about his actions and when. Cover-ups never work, and similar cyclical scandals have occurred no matter which party has occupied the White House.

Congress also is still finding its sea legs with respect to the ongoing war in Iraq, with only a bare majority of the House supporting a troop withdrawal by a certain date, despite wider concern about our progress there. Congressional partisanship? Yes, generally, but without clear unanimity from either side. Democracy in action? Certainly, and given that we are six years into the eight-year term of “Bush 43,” as I am told our President agrees or likes to be called, it is not surprising now, as with any president skillful enough to be re-elected, that some cracks develop in his own party’s support.

But what about Medicare and government support for its overhaul and an end to the unfair sustainable growth rate (SGR) formula that threatens to destroy physicians’ ready willingness to treat the elderly? Where are health issues on the national agenda? Can we possibly do and say enough to overcome these other larger political “elephants” (and donkeys) in the room?

The simple answer is that we must. ASA, as it has in past years, is working with supporters in Congress to reintroduce major discrete bills and move them along. For example, one such new bill, H.R.1866, would allow Medicare “pass through” payments for anesthesiologists willing to compete for jobs in rural areas. This bill would address rural surgical access shortage issues by ensuring adequate payment to anesthesiologists just as has been enjoyed by nurses delivering anesthesia in such settings. Imagine how quality and patient safety could be increased in rural areas if this simple measure were enacted.

ASA has also labored hard to move reform for the Medicare anesthesiology teaching rule back to the front burner by working with past and new congressional supporters to advance a needed legislative fix. The very future of the specialty depends upon ensuring that the rigors of medical residency do not collapse in the face of government cost-cutting that would allow less rigorous nurse training to be deemed its equivalent, with Medicare patients being left at risk.

And what, too, of the all-important Medicare anesthesia conversion factor issue, which ASA continues to battle within the Centers for Medicare & Medicaid Services? This key issue is caught up in the underlying debate over how to fix the SGR, and our own battle is hard to reconcile without considering the special drag on Medicare physician payment caused by the need to overcome governmental deficit spending.

How we can move forward? The answer does not lie in partisan politics or rejecting politics because it requires us to “take sides.” As I have long told physician audiences, I do not care if you are a Democrat or a Republican, but I do care if you are not politically involved. Your highly capable Washington Office staff will always do all that it can to advance anesthesiology, but only you can bring the face-to-face reality of practice challenges to our legislators. Your ASA staff loves what it does, and we will never tire in advancing our ASA public policy advocacy agenda; but if your personal response is to brush aside what should be a professional responsibility to get involved politically, you are not doing all you can to advance and secure the profession.

Please visit our ASA Web site today and click the box in the very center called “Washington Alerts.” It will take you immediately to interactions with your members of Congress and your Senators. The time for action is now. Please do not wait.