Law makers moving at turtle speed

[SteakandPODtatoez]

Hey everyone! Wanted to get a thread going to hear everyone's thoughts about the progression of various laws that have been introduced to enhance the field of podiatry, such as the Hellpp act. This law has been introduced to allow podiatrists to be recognized as physicians under medicaid and this would allow expansion of care for many patients, especially those in need of diabetic limb saving care. In the same fashion, there has also been a law introduced to increase the pay off podiatrists in the VA to be on par with other physicians and dentists. It seems like a lot of these laws can have slim chances of making it to the senate to eventually become enacted based on previous trends. How can the current podiatry students or residents come together to propel the efforts of these proposed laws? If these laws are passed, it would be a significant leap for the profession. Just doing some thinking on this Monday morning.....

---

Members don't see this ad.

 

[MaxPayneDPM]

Well, you got me thinking, atleast. I think the chances of legislation being passed in the last year of an administration with a divided Congress are pretty low. I also think passing more health care related legislation this administration is also really slim. Also, all of the craziness with regard to the future presidential election is shining an unfavorable light on everything medicine-related—as anyone who owns drug stocks can attest to. But it’s Washington and you never know who knows who.

I think you speak to a broader issue, though, when you mention federal policies with regard to podiatry. So much of what I read on this site and others is very state-centric…scope, license, laws, resi-programs, parity efforts. Given the wackiness of the candidates and the current economics of medicine, I think podiatrists and emerging podiatrists need to be ready for pretty much anything.

I guess at this point I am considered an old-timer—having graduated about 25 years ago—but I remember in 1991-92 after GHW Bush took over he was looking for ways to cut the budget and the OIG or OMB recommended kicking podiatry and chiropractic out of the HEAL loan program which was how most of the podiatry students paid for school at the time. Nobody was expecting to hear that! And while the students might have been sweating, the schools were freaking terrified. The loan money was in fact interrupted while they worked things out and the loan program continued for another couple of years with reforms before it was shutdown. Maybe others remember when, all of the sudden, the school had to debt counsel everyone, everyone needed to have an exit interview, etc. It was all part of reforms to the HEAL program.

I think from that day on I have lived with the fear that, from a federal level, things can turn on a dime. Hopefully for the good and not just the not-so good. Stay nimble.

 

[heybrother]

I always figured our best bet was for the legislation to get jammed into some sort of omnibus pork-mobile with a killer primary component that no one wants to say no to so our little bill can slide through.

 

[SteakandPODtatoez]

Well, you got me thinking, atleast. I think the chances of legislation being passed in the last year of an administration with a divided Congress are pretty low. I also think passing more health care related legislation this administration is also really slim. Also, all of the craziness with regard to the future presidential election is shining an unfavorable light on everything medicine-related—as anyone who owns drug stocks can attest to. But it’s Washington and you never know who knows who.

I think you speak to a broader issue, though, when you mention federal policies with regard to podiatry. So much of what I read on this site and others is very state-centric…scope, license, laws, resi-programs, parity efforts. Given the wackiness of the candidates and the current economics of medicine, I think podiatrists and emerging podiatrists need to be ready for pretty much anything.

I guess at this point I am considered an old-timer—having graduated about 25 years ago—but I remember in 1991-92 after GHW Bush took over he was looking for ways to cut the budget and the OIG or OMB recommended kicking podiatry and chiropractic out of the HEAL loan program which was how most of the podiatry students paid for school at the time. Nobody was expecting to hear that! And while the students might have been sweating, the schools were freaking terrified. The loan money was in fact interrupted while they worked things out and the loan program continued for another couple of years with reforms before it was shutdown. Maybe others remember when, all of the sudden, the school had to debt counsel everyone, everyone needed to have an exit interview, etc. It was all part of reforms to the HEAL program.

I think from that day on I have lived with the fear that, from a federal level, things can turn on a dime. Hopefully for the good and not just the not-so good. Stay nimble.

You touched on some great points and I think you hit it right on the head that we "need to be ready for pretty much anything." It's always good to receive some insight from those who have invested years into the field.

 

[MaxPayneDPM]

I agree about the porked-up bill, and I don't think the timing could have been worse for this latest push. One thing that has bothered me over the years--and I don't mean to shift attention away from the original post--is what effect the school mergers have had on a podiatry school's ability to be politically active. Our school used to parade in some distinguished seniors now and then who would tell us stories of how they went to Washington to get podiatry into the Medicare laws. It seemed that, on both a state and local level, political connections and progressive ideas emanated from school boards of directors and distinguished professors (be they in Chicago, Philly, or NYC, etc).

How politically active or how much can a pod school vocally push for parity or expanded scope when they are staring across the campus at an "associated" medical school? As an example, TUSPM is not listed on the Temple Medicine website and I don't think that is an accident. If you search podiatry on the Temple Med website most of what you get are references to the fact that the faculty teaches podiatry students--there's not even a link. TUSPM is listed on the Temple University website under graduate and professional schools and I am not sure Temple University/Temple Med would tolerate a very vocal faculty or student-led push to MD parity. Different versions of this loss of autonomy are found in other schools who were absorbed and their boards of directors dissolved--except I guess NYCPM. I'm not sure the schools had a lot of choice at the time, but it never struck me as an "it's all good."

I DO believe many pod students have benefited from these mergers, so that's good, but the actual profession of podiatry? We shall see.

 

[Foot_Funguy]

The HELLPP Act is awesome, but more than for just nomenclature of title. It provides an easier path for Medicaid/Medicare recipients to seek palliative care directly with a podiatric physician, and not as a referral. Solid statistics in the largest population base of California show that fewer and fewer primary care physicians are accepting new enrollees. This, as the numbers are projected to reach 3 million NEW recipients over the next few years (especially as the Baby Boomers retire). APMA is a great way to get involved at each school. Find out when your student body is heading to any legislative conference and find out who in your state government you should be contacting for whatever initiatives are important to you as an individual. Medicine and politics go hand-in-hand and we physicians (and aspiring physicians) can't be passive about the ever-evolving system.