Public Policy & Advocacy
Health & Public Policy Committee Report-Summer 2007
Submitted by Robert McLean, M.D., FACP
The ACP's annual "Leadership Day" in May has been a major advocacy event when ACP delegations from most states (about 300 participants from over 40 states) spend a day on Capitol Hill meeting with legislators and their staffs to advocate for improvement in our dysfunctional health system and for specific legislative initiatives. As well, the ACP at this event has recognized the "Top Ten Key Contacts" for the previous year - those ACP members who made distinguishing efforts related to their state chapter's general advocacy efforts or to specific contact made with their legislators in advancing the ACP health policy agenda.
This year's event was particularly exciting for me as I was recognized with the award as the "Top Key Contact of the Year". I had the good fortune in early 2006 to introduce to Rep. Nancy Johnson the then just-released ACP policy paper on the "Advanced Medical Home". Rep. Johnson became quite interested in the concept and was able to steward pilot testing of the AMH concepts into a Medicare bill passed in late 2006. Rep. Johnson's influential position as chair of the Health sub-committee of the House Ways and Means Committee was crucial to the process, and the relationship our ACP chapter had fostered with Nancy Johnson and her staff over many years enabled us to have the opportunity to present her with credible policy suggestions, which ultimately became enacted into legislation.
The ability to see our advocacy work result in tangible legislation is exciting and has further solidified my strong beliefs in the importance of our advocacy work.
For this year's "Leadership Day", our Connecticut delegation consisted of myself, Chapter Governor Eric Mazur, Norwalk Hospital Chief Resident Philipp Olshausen, and Governor Council members John D'Avella, Meaghan McNulty, and Keith Vom Eigen. The topics discussed included:
- Expansion of coverage for the uninsured - the Health CARE Act (H.R. 2351)addressing the crisis in primary care through:
- Developing an equitable and predictable physician payment system by eliminating the problematic SGR formula and by following MedPAC recommendations
- Restructuring physician reimbursement to emphasize care coordination & prevention - implement the "Patient-Centered Medical Home" concept, as in the Geriatric Care Management Act (S. 1340) and in H.R. 2351
- Medical student loan debt relief through the Medical Education Affordability Act (S. 1066)
- Impact on Connecticut health clinics of recent cuts in Ryan White Act funding.
Our delegation met with staff members for each Connecticut legislator and had the opportunity to personally discuss issues with Rep. Chris Shays, on the steps of the Capitol between votes. Our voice with legislators is crucial, and unfortunately the process of policy becoming enacted into legislation is slow and arduous. Several of our legislators seem particularly interested in health care issues, and we are hopeful that they will use recent ACP policy papers on the dysfunctional physician payment system, the crisis in primary care, and the advanced medical home to help develop legislative proposals.
At the state level, the General Assembly in Hartford has finally addressed the problem of the uninsured this year. As of early June, an effective program for universal access to affordable health insurance has not yet passed. Our ACP chapter has worked with other specialty societies under the leadership of the state medical society (CSMS) to provide testimony this past spring on this important issue, as well as the issue of advanced practice nurses establishing independent practice without requirement for "collaborative agreement" with a licensed physician. Actual testimony which was presented is available on our chapter web site. At the state level, our ACP Chapter has found that working with and through CSMS and its lobbyist efforts on many areas of common interest has been our most effective strategy. ACP members are thereby encouraged to be members as well of their county medical societies and CSMS.