Capitol Hill Report: "If it was a gimmick, we would have already done it!"

May 20, 2011

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By Mike Amery, Legislative Counsel, Federal Affairs, (202) 506-7468, mamery@aan.com

Senator Snowe's Quote of the Week

Around Washington every discussion seems to focus on how far the US is in debt ($14.3 trillion to be exact). One way to address the debt issue is by requiring balanced budgets as state governments do.  As a Senate staffer in 1996, I sat in the gallery as the Senate came up just one vote short on an effort to pass a Balanced Budget Amendment to the Constitution. I've often wondered what the situation would be today if that amendment had been enacted.

More recently the topic of our national debt came up at a breakfast that several medical specialty representatives and I attended with Senator Olympia Snowe (R-ME), who lamented how difficult the country's financial situation makes everything, especially when it comes to agreeing on anything in the Senate. Snowe, who voted in favor of the Balanced Budget Amendment in 1996, said she had discussed requiring balanced budgets with many colleagues, with several saying it is "just a gimmick."

Snowe drew a raucous laugh when she said, "If it was a gimmick, we would have already done it!"  Many people feel that way about the Senate—gimmicks become law, but substantial policy more often does not. As they say, the Senate is where good bills go to die.

Progress Seen on Malpractice Reform

Will medical malpractice reform be the next issue to move through the House and die in the Senate? As predicted in the last Capitol Hill Report, medical malpractice took a step forward last week with passage of H.R. 5 by the House Energy & Commerce Committee, which approved the bill by a vote of 30-20, with two Republicans joining all Democrats voting no, except for Rep. Jim Matheson (D-UT).

Introduced by Rep. Phil Gingrey, MD (R-GA), the Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2011 would cap pain and suffering awards in medical malpractice lawsuits to $250,000, place a three-year statute of limitations on medical malpractice claims and limit attorney fees, and reduce federal health spending by $34 billion over 10 years. The legislation would pre-empt state laws, unless states provide greater protection to physicians. I believe that because H.R. 5 will save the federal government money, it has a real shot at becoming part of a federal deficit reduction compromise in the future.

Although federal tort reform remains an uphill climb, we are making progress. This issue will remain a top priority for the AAN until it is adequately addressed by Congress. If you haven't already responded to our recent action alerts on this issue, please contact your members of Congress today and let them know that you support H.R. 5.

Believe It or Not, We Are Succeeding on SGR

Physicians often express frustration that we cannot get a permanent repeal of Medicare's flawed Sustainable Growth Rate (SGR) formula, which now calls for a 29.5-percent cut in Medicare reimbursement on January 1, 2012, but I really think our lobbying efforts should be considered a significant success by the physician community.

These cuts have loomed since 2002 and, with one small exception in 2003, have not gone into effect.  Furthermore, while cuts are being called for at every department and level of government and in the private sector, no one in Congress is calling for cuts to physicians. Congressman John Fleming, MD (R-LA), a family physician, acknowledged to me and others recently that Congress understands if Medicare beneficiaries do not have physicians, there will be a flood of seniors into congressional offices.

Also, in a meeting last week with House Speaker John Boehner (R-OH) he pledged his support for a permanent repeal of the SGR. Interestingly, he suggested the repeal could be a part of a deal to raise the debt limit, which must occur before August 2 in order to prevent the US from defaulting on its financial obligations.

I think it is more likely we will be looking at a solution in December rather than a deal on the debt limit, but it was good to hear Boehner strongly call for a permanent repeal.

One Mind for Research Campaign

On May 23-25, AAN Executive Director and CEO Catherine M. Rydell, CAE, will represent the Academy at an event at the JFK Presidential Library in Boston to announce a 10-year blueprint to streamline federal brain research by focusing on veterans returning from Afghanistan and Iraq.  The One Mind for Research campaign being led by former Congressman Patrick Kennedy (D-RI) is timed to commemorate the 50th anniversary of John F. Kennedy's "moonshot" speech.  Vice President Joe Biden is expected to attend and announce a unified approach to the study of the brain by all elements of the federal government.  For more information on One Mind for Research see 1mind4research.org.

Standing Up For Neuropathy

Last week was Neuropathy Awareness Week and the Neuropathy Association hosted a grassroots on-line letter writing campaign to legislators to raise neuropathy awareness.  The Association's President and CEO, Tina Tockarshewsky, has been a good friend of the AAN and I encourage you to join their efforts by sending a letter to your legislators at all levels of government.