Congressional Focus on Pain
Ronald Szabat, J.D., LL.M.
Executive Vice-President – External Affairs
and General Counsel
fter
years of pushing, lobbying and general cajoling,
Congress is turning to the issue of pain with new
interest and in concerted ways. In doing so, ASA
is helping to lead the way in educating legislators
and the public about pain medicine and what needs
to be done to address and relieve patient suffering.
Along these lines, ASA was honored in early October
to accept an invitation to a Washington, D.C. hearing
to testify on Veterans Administration (VA) research
programs before the House VA Health Subcommittee.
As a representative of our partners in the Pain
Care Coalition, then-President Mark J. Lema, M.D.,
Ph.D., made a compelling case for increased pain
research and funding in the VA. The Pain Care Coalition
is a national advocacy effort of the American Academy
of Pain Medicine, American Pain Society, American
Headache Society and ASA. Collectively, these organizations
represent more than 50,000 physicians and other
clinicians, researchers and educators who provide
clinical leadership in the increasingly specialized
field of pain management.
In his written and oral statements, Dr. Lema strongly
recommended that the VA’s so-called Pain Management
Strategy be accompanied by and integrated with a
significant research commitment to advance the science
of pain care and to translate developments in the
science to improved clinical care throughout the
system. Noting that the VA has had a long and continuing
research interest in a range of important topics
from phantom limb pain to neural repair to a recent
successful study of the effectiveness of a shingles
vaccine in older veterans that validated research
findings elsewhere, Dr. Lema strongly supported
new and increased efforts within the VA’s
research, education and clinical care programs to
ensure that our brave men and women returning from
combat receive the best pain care possible.
 |
| ASA Past-president Mark J. Lema, M.D.,
Ph.D., and others meet with Rep. Henry Brown
(R-SC) prior to testifying before the House
Committee on Veterans' Affairs Subcommittee
on Health. |
The House VA hearing is but one of a number of exciting
congressional developments indicating that Congress,
across an array of federal programs, is taking seriously
the need for increased education, research and funding
for pain. For example, earlier this year, Congresswoman
Lois Capps (D-CA) and Congressman Mike Rogers (R-MI)
introduced H.R. 2994, the “National Pain Care
Policy Act of 2007.” The bill would combat
pain in four ways. First, it would authorize an
Institute of Medicine Conference on Pain Care. Second,
it would authorize a Pain Consortium at the National
Institutes of Health. Third, it would provide for
comprehensive pain care education and training for
health care professionals. Lastly, it would institute
a public awareness campaign on pain management.
ASA fully supports H.R. 2994 and urges ASA members
to contact House members to add their names as co-sponsors
of the measure.
On the Senate side of the Hill, interest in pain
has been no less intense. In recent weeks, the Senate
VA Committee held a public hearing on S. 2160, the
“Veterans Pain Care Act of 2007,” a
bill sponsored by committee Chairman Sen. Daniel
Akaka (D-HI). Much of the testimony from the pain
community in the Senate hearing echoed many of the
points recently made by Dr. Lema in the House hearing.
At the Senate hearing, the panel also received testimony
from Michael Kussman, M.D., the current Under Secretary
for Health. Dr. Kussman expressed the Administration’s
opposition to S. 2160 as being too disease-specific,
indicating that it appears duplicative of other
VA efforts. On a more open note, the Under Secretary
showed a willingness to meet with advocacy groups
or with the committee to talk about how the VA could
improve what it is doing on pain. ASA must pursue
this invitation.
 |
| ASA Past-president Mark J. Lema, M.D.,
Ph.D., testifies about pain research before
the House Committee on Veterans' Affairs Subcommittee
on Health. |
S. 2160 would call for the establishment of a
pain care initiative in health care facilities of
the Department of Veterans Affairs and establish
a program of research and training on acute and
chronic pain in the medical and prosthetic research
service of the VA. As Sen. Akaka stated on the introduction
of S. 2160, “the bill we are introducing would
enhance VA’s pain management program on a
national, systemwide level, by requiring VA to establish
a pain care initiative at every VA health care facility.
Every hospital and clinic would be required to employ
a professionally recognized pain assessment tool
or process and ensure that every patient who is
determined to be in chronic or acute pain is treated
appropriately.”
Indeed, these are positive developments that would
not occur without widespread involvement and leadership,
particularly from ASA. Please watch ASA’s
Web site for opportunities to get involved and make
anesthesiology’s voice heard in Congress on
pain issues! The representatives and senators are
listening! Let’s urge them to act!