Healthcare Professionals for Healthcare Reform

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My trip to Capitol Hill

I am writing this on the train heading back from Washington DC but will post it tomorrow (May 22nd). I took the Accela first thing this morning in time to make a noon appointment with Chris Murphy. Unfortunately, Murphy was at a vote (or actually a series of votes that included Cap & Trade, moves to censure Pelosi and even motions to adjourn), and I was not able to meet him until 12:45. While waiting in the office I got to talk to the receptionist who mentioned that the Congressman had had a slew of groups over the past couple of months coming through to discuss healthcare reform. She said she thought ¾ of all the visits in the past month have been for HCR. This set the tone for the rest of the day…

Chris Murphy and his legislative aide (Paul Kidwell) met me in an office next to the Energy and Commerce committee (of which he is a member) Conference room and had to get up a couple of times to vote. Despite all the distractions and very limited time, we did have a very detailed discussion on EMBRACE and healthcare reform in general.  Although he admitted that he had not read the paper, he claimed he understood the gist of our plan and felt that it was in essence a single payer system. I attempted to explain the differences (and that we had actually created it as a “not a single payer plan with the advantages of a single payer plan”) but in the end he felt that “it would still be perceived as a single payer system”.  I spent some time with Mr. Kidwell, when Murphy was voting, discussing some of the other features and he seemed genuinely interested in how we handled several political and financial issues. Then Murphy seemed to imply that for all intents-and-purposes the healthcare bill is mostly written, and from the gist of how he stated it, I suspect it will have a component of a privately subsidized public plan to compete with the private insurance companies.  Although they claim that there will be some provision to keep re-imbursement high for providers, we didn’t really have time to discuss any details.

It was what Murphy said when we ended our meeting that I think was most disturbing to me. He said that with the exception of the delegation from the ACP that came the day before, none of the doctors’ groups that have come by have actually wanted to discuss healthcare reform!!! They were more concerned with petty battles with other doctors/medical specialties than with reform!

All I could think was: we (doctors) blew it again: The ACP and I got here too late to influence the drafting of the legislation that seems to be all but written. I truly got the feeling, as we ended our session, that Murphy would have liked to have helped us, but it seems that other groups have been more consistent in their advocacy and united in their points.

John Larson was not available to meet with me but I did meet with his Legislative assistant, David Sitcovsky. He had read the EMBRACE article in the Annals (I sent all of the aides a copy before going down), and seemed to understand the gist of the plan. After listening to me explain the advantages of EMBRACE and taking down careful notes, he proceeded to tell me, in essence, that we are too late: he explained that “there will be a healthcare reform bill by July.” He seemed to confirm that it will contain the insurance reform that Murphy described. When I asked what kind of provisions there were to improve outcomes and reduce bureaucracy for the provider he mentioned the “Medical Home” model advocated by the ACP the day before. When I asked him how the primary care doctors, who would have to direct the Medical Home, would get reliable guidelines, he mentioned that there would be a department in HHS that would be responsible for developing guidelines. What mechanism this department/committee would use to develop the guidelines though is not clear.  

My final meeting was with Dodd’s staff. I was already informed that neither Dodd nor his healthcare aide, Jeremy Sharp, would be able to meet with me, but that I would be able to meet with Monica Feit and Rebecca Davidson. Ms. Feit is a PHD and a Public Health Fellow in Dodd’s office and Ms. Davidson is a Legislative Correspondent a year out of GW. They were both quite happy that two key pieces of legislations that Dodd held near and dear (the Credit card bill and tobacco regulation) had just been passed/promoted and it was clear that they were swamped with work. Neither had had the chance to read the material I sent so I spent a few minutes explaining EMBRACE. Unfortunately, before I could even finish explaining the plan (let alone discuss its assets), Ms. Feit was called away by Mr. Sharp for an important meeting. However, before she left, Ms. Feit told me that I would be happy to know that the Senate already has a bill being developed “that has many of the features of your plan”, but did not have time to go into the details. I spent the remaining time with Ms. Davidson discussing the advantages of EMBRACE.

With all of these meetings, seeing that we missed the boat with EMBRACE, I pleaded that whatever legislation is passed must reduce the financial and bureaucratic burden on the healthcare provider and put in measures to improve the health of our patients.

Now as I sit on the train going back home, I have a feeling of regret that I/we did not make the trip earlier and a feeling of foreboding that what will be passed in Congress will not be healthcare reform as much as health-insurance reform; and that we providers (and our patients) will get screwed again. Unfortunately all we can do now is just sit back and see what we get!

Gil

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May 22, 2009 - Posted by | Uncategorized

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