Capitol Hill Report: Congressional Testimony: What's It All About?

April 6, 2009

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By Mike Amery, Legislative Counsel, Federal Affairs, (202) 349-4299, mamery@aan.com

The mission of the Academy is to be "indispensable to its members." One way the Academy fulfills this mission is by representing of neurology in the halls of Congress. Capitol Hill Report presents regular updates on legislative action and how the AAN ensures that the voice of neurology is heard on Capitol Hill. The Academy's legislative counsel in Washington, DC, Mike Amery, offers weekly updates on advocacy for neurology and neurologic concerns.

I hope you have had an opportunity to read the story and actual testimony of AAN's incoming President Elect, Bruce Sigsbee, MD, FAAN, before the US House Energy & Commerce (E&C) Health Subcommittee. Having the opportunity to address a congressional committee is a significant accomplishment for anyone. It only comes by invitation and only when the committee feels you have something significant to say.

In a previous post, I described the day that Dr. Sigsbee and I spent on Capitol Hill talking to members of Congress and their staffs in advance of the Academy's Neurology on the Hill event. It was clear to us early on that day that the message Dr. Sigsbee was presenting was unique from the perspective of cognitive medicine. It was also very good timing that the E&C Health Subcommittee had a hearing come up. Interestingly, Dr. Sigsbee received an invitation to testify from both Democrats and Republicans and appeared as a "bipartisan" witness.

So what really happens when you receive an invitation to testify?

Dr. Sigsbee received the official invitation to appear at the Thursday, April 2, hearing on the evening of Friday, March 27. He was given a deadline of Tuesday, March 31, at 10 a.m. to deliver written testimony—with that, Dr. Sigsbee's weekend was suddenly spoken for.

The written testimony is seven pages long and goes into some detail about how several facets of the health care system are working and could be improved. This document was delivered to the majority Democrats on time, along with copies that were distributed to all E&C Committee members. If you watch Dr. Sigsbee's actual testimony (his testimony begins at 02:42:00 in the video), it is right at the committee-allotted time limit of five minutes. No, Dr. Sigsbee could not read a seven-page document in five minutes. This meant that more work was required from the time the written testimony was delivered until Dr. Sigsbee gave his oral presentation. The key of the oral presentation is to hit the main points and hope that it comes close to the written document, which, after a lot of editing and a great deal of practice, I think Dr. Sigsbee did very nicely.

Fortunately, staff and some members of the Committee actually do read the written testimony prior to the hearing and have an understanding of the points a witness is going to make prior to the testimony. This was clear in a conversation that Dr. Sigsbee had during a break with Congressman Phil Gingrey (R-GA) who is an obstetrician. It was also clear from staff who contacted us prior to the hearing to run potential questions that members of the subcommittee might ask. Each was based on comments in the written testimony.

AAN Board member Bruce Sigsbee, MD, FAAN, discusses the issues raised in the April 2 hearing with Congressman Phil Gingrey (R-GA).

At the actual hearing the panelists take a position at the hearing table and face the dais, which has a nameplate set in front of a chair for each subcommittee member. Republicans (14 members) sit on the right and Democrats (23 members) on the left from the viewpoint of the witnesses. The hearing is opened by the subcommittee chair Frank Pallone (D-NJ) who sits in the top middle, flanked by ranking member (lead Republican) Nathan Deal (R-GA). From the beginning it is a constant shuffle of members coming and going as each member is offered the opportunity to make an opening statement on the subject of the hearing. Most welcome the witnesses, thank them for their participation and then expound on their views on what they hope to hear from the witnesses. Some stay to hear from the witnesses, but others leave for constituent meetings and even other committee meetings occurring at the same time.

The dais was never close to having the full complement of 37 subcommittee members. Several with the most seniority, including the chair and ranking member, remained for most of the hearing, but several seats were vacant throughout. This might disappoint some who come to testify, but I think it goes to show that the written testimony is just as important as the oral. When it comes to an issue like health care reform, members of Congress (working with their staffs) must hammer out the compromises that will allow Congress to pass a final bill, likely many months from now. Written testimony like Dr. Sigsbee's will be there to help guide the subcommittee members' efforts, and follow up from other neurologists throughout the process will help reinforce the message.

With that, Dr. Sigsbee's efforts and those of all the Academy members who attend events like Neurology on the Hill, or send letters to their members of Congress, will be heard and hopefully, patients with neurological conditions will receive the access to care that they deserve.

Read all of Mike Amery's reports on the Capitol Hill Report page.