ASA Legislative Conference

[Ventil8]

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I just got back from D.C.-- 3 days being shown how bleak our future is in the worst case scenario... I'm happy to share info with folks, but perhaps PM is the best venue. Meeting with our senators and congressmen was simultaneously encouraging and disappointing.

Dems and Reps both agree that the "reform" bill has huge holes in it and will cost 300-400 BILLION more than stated without any question... why is this? SGR fix wasn't included because it would have unbalanced the bill; every single representative apologized for having all these two month SGR patches, but said they'll always be approved (and paid for), but to actually fix it under Obama's pay-as-you-go would require accounting for this very same money with cost saving or revenue generation they cannot find... It was insulting, almost, how passe they were that they all know there is 400B missing from the internal estimates (cost to permanently fix SGR).

Outlooks posed interesting scenarios.

If anyone else was there, I'd love to trade impressions.

Make it while you can...

 

[IDBasco]

I just got back from D.C.-- 3 days being shown how bleak our future is in the worst case scenario... I'm happy to share info with folks, but perhaps PM is the best venue.

Private forum perhaps?

 

[Slack3r]

Not allowed to post it?

 

[ProRealDoc]

I just got back from D.C.-- 3 days being shown how bleak our future is in the worst case scenario... I'm happy to share info with folks, but perhaps PM is the best venue. Meeting with our senators and congressmen was simultaneously encouraging and disappointing.

Dems and Reps both agree that the "reform" bill has huge holes in it and will cost 300-400 BILLION more than stated without any question... why is this? SGR fix wasn't included because it would have unbalanced the bill; every single representative apologized for having all these two month SGR patches, but said they'll always be approved (and paid for), but to actually fix it under Obama's pay-as-you-go would require accounting for this very same money with cost saving or revenue generation they cannot find... It was insulting, almost, how passe they were that they all know there is 400B missing from the internal estimates (cost to permanently fix SGR).

Outlooks posed interesting scenarios.

If anyone else was there, I'd love to trade impressions.

Make it while you can...

I was there also and came away feeling that we have two choices. First, if we allow the status quo to continue by being apolitical (like many anesthesiologists) we can rest assured anesthesia salaries in general (Physicians and CRNAs) will drop by as much as 50% from current rates as explained by the ASA chair of the committee on economics.

Or, we make sure we continue to relentlessly make our case to the politicians regarding the unfair 33% medicare reimbursement rule. I spoke with a well-known, liberal congressman who, despite the fact he was a strong supporter of the public option, agreed that it is unfair and illogical that Anesthesiologists receive only $0.33 on the dollar from CMS compared to private insurance. This is where we need to focus our efforts. I know some here will frown upon medicare and the utility of asking for increased rates. However, unless you are about to retire, you will see more and more medicare patients replace your private insurance patients.

If we are able to reverse this rule and have our reimbursements rates be on par with other physicians, we'll still be looking at decreased reimbursements but not in a much lower and acceptable scale.

The other concerning issue was the provision on the healthcare bill for the creation of the IPAB (independent payment advisory board). This board could be a nightmare for all health care providers as it will have unfettered powers in dictating reimbursement rates.

I was happy to learn that the ASAPAC is the #1 medical PAC in Washington and I was proud of the effort and work those guys do for us.

 

[Southpaw]

I was there, had several great discussions with ProReal and others, and took away the following points:

1) The ASA LC is by far the best conference I've been to, and I encourage every resident to make their best effort at attending. I assure you, you will leave feeling like it was worth it. I hope to attend next year.

2) Every resident should donate $20 to the ASAPAC. Right now!

3) Every single congressperson I spoke with agreed the SGR is a joke and needs a permanent fix. For now, they'll continue to prolong it month by month.

4) Every single congressperson I spoke with agree the 33% Medicare problem for anesthesiologists needs correcting. I was also extremely surprised at how many congresspeople knew nothing about this issue. They do now!

5) The IPAB is scary. This is a board that will determine reimbursement rates for the public option, and this board will have complete control. It's pertinent that anesthesiologists make their voice heard and advocate! Once IPAB sets the rates for reimbursement, it'll take a 67% congressional vote to change what IPAB sets. Imagine how tough that will be!

I urge all residents to start right now, become active and advocate for your field. If we don't do it, I can promise you that no one else will and you'll leave people who know absolutely nothing about what we do making decisions for us. If you're just not this type of person, if you just want to go to work, go home, study, and not be part of the political process, then please, at the very least give your $20 to the ASAPAC.

 

[ProRealDoc]

If you are the apolitical type that's fine and dandy. Just make sure you write that check to the ASAPAC and make it a big one.