“I am not interested in politics!”
Dr. Coffer replied, “Well, politics is interested in you!”
So said one of the strongest advocates for medicine, Bertram “Bert” Coffer (1941 – 2008), who walked the hallways of the University of North Carolina Hospitals in Chapel Hill, just a few years before my first year of Medicine/Pediatrics there. Dr. Coffer was an anesthesiologist who advocated for advancements in critical care, pain management, and total patient care. His guiding philosophy was "Act like a physician first and always make yourself indispensable and worthwhile.”
Dr. Coffer understood how politics was changing healthcare even then, and thus became a “relentless” advocate, offering his informed medical perspective in both public and political policy. Elected officials, including those in Congress, often sought his counsel. Dr. Coffer also knew well the advocacy “formula” consisting of time, talent, treasure, and personal engagement. He recognized the value of amplifying his voice by combining his resources with county, state, and national organizations.
State and federal legislative and regulatory bodies are still “changing healthcare” in current times. Just two of many examples demonstrate why it has never been more important for every physician to consider their role in advocacy for our profession and patients:
Medicare Payment
Physician practices must prepare for an 8.42 percent decrease in Medicare payment rates in 2023. The projected Medicare cuts will also affect Medicaid and private payer rates, which are often contracted as a percent of Medicare rates. As Medicare reimbursement continues its nosedive, physician practice revenues will decrease, thereby reducing their ability to provide timely, high-quality care to patients.
The AMA is engaging with CMS about this ongoing and growing financial instability of the Medicare physician payment system. “The payment system is on an unsustainable path that is jeopardizing patient access to physicians. The resulting discrepancy between what it costs to run a physician practice and actual payment, combined with the administrative and financial burden of participating in Medicare, is incentivizing market consolidation”.[1]
Your SCMA and 100+ plus other signatories [pdf], including the AMA, have outlined essential principles for putting healthcare on a sustainable financial footing and to support physician practices. The SCMA — through its federal lobbyists at Physicians Advocacy Institute (PAI) — is also lobbying against the decreases and focusing on stabilized Medicare payments that do not harm physicians’ ability to practice.
In July, the American Hospital Association learned of Medicare proposed cuts (net) to inpatient prospective payment system (IPPS) rates for hospitals and health systems. By August 2, Medicare issued a final rule magically increasing these hospital and health system IPPS rates by 2.6 percent for 2023![2] Talk about effective Medicare reimbursement advocacy!
Legislative Action(s) for Reproductive Healthcare
State legislatures across the country have been changing access to and treatment for reproductive services. Imagine how the discussions and results of hearings and voting at our State House might be different if every legislator was seeking your advice and counsel?
Individual and unified voices of medicine provide critical physician input in shaping laws and regulations. Strong member participation equates to strong representation, creating stronger influence. Your SCMA, specialty medical organizations, and the AMA, have responded to preserve the physician patient relationship and protect our patients on this and so many other issues.
Economics powers healthcare and politics. It supports our clinical care, research, education, and professional development. It greases political machinery. Strong individual and PAC contributions provide oxygen for communicating with elected leadership. It is not ideal, but the loudest and best-funded voices dominate at both federal and state levels.
Recently, the House Speaker from a neighboring state offered praise for our profession but also a plea. He unequivocally shared that legislators want and need our input. They truly welcome our professional knowledge and insights to help govern wisely. And yes, they need financial support.
I want to thank every reader for your advocacy efforts, big and small. The impact and importance of your direct involvement in the political and regulatory landscape does significantly impact laws and regulations. Your participation with SCMA membership and in our PAC raises our collective voice to educate and support informed political/regulatory leadership.
Thank you for reading and know that your SCMA is working every day for the profession of medicine. Together we are stronger! Please share any feedback with your voice to scmayeakel@gmail.com.
References
[1] "Proposed 2023 physician pay schedule deepens Medicare’s instability" (Sep 8, 2022) Kevin B. O'Reilly AMA Website https://www.ama-assn.org/practice-management/medicare-medicaid/proposed-2023-physician-pay-schedule-deepens-medicare-s
[2] "CMS issues hospital IPPS final rule for FY 2023" (Aug 02, 2022) American Hospital Association https://www.aha.org/news/headline/2022-08-02-cms-issues-hospital-ipps-final-rule-fy-2023
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