 June 2002 • Volume 8 • Number 6 |
They jawboned. They cajoled. They told it like it is -- on behalf of their patients as well as themselves. About 50 family physicians and AAFP chapter staff stormed Capitol Hill April 15 16. In small groups, they visited more than 60 senators' and representatives' offices.
 Medicare cases are often very complex, says Maryjean Schenk, M.D., right, explaining the need to reverse plummeting Medicare pay rates. Schenk and Peter Scuccimarri, M.D., center, lobby Sen. Debbie Stabenow, left, a member of the Senate Budget Committee. |
Many groups targeted the Bush administration's proposal to cut funds for the Agency for Healthcare Research and Quality from $299 million in 2002 to $251 million in 2003. The White House budget also calls for National Institutes of Health funds to increase from $24 billion in 2002 to $27 billion in 2003.
Maryjean Schenk, M.D., of Detroit and Peter Scuccimarri, M.D., of Ann Arbor, Mich., talked with Sen. Debbie Stabenow, D-Mich., and her aides about declining Medicare payments and the need for more funds for AHRQ. Stabenow serves on the Senate Budget Committee.
"There is such a lack of primary care in the Detroit area that folks go throughout most of their adult lives without medical care. Suddenly, they turn 65 and have coverage, and they're very complex cases," said Schenk. She asked Stabenow to restore the funds cut this January from Medicare payments to physicians.
Regarding AHRQ, Schenk said, "AHRQ research is done through practice-based research networks; it's done in our offices. It translates research into practice."
Scuccimarri suggested, "We should be bringing the AHRQ budget up to $1 billion to keep pace with the NIH research and development work, which is reaching astronomical levels. The extensive wealth of medical science is not being applied to the general public."
Stabenow replied, "Bush prepared a defense budget that is way over what is needed for the war on terrorism. Security is more than tanks; it's teachers. Security is more than helicopters; it's health care."
In another congressional office, Elissa Palmer, M.D., of Altoona, Pa., told Peter Stein, an aide to Sen. Rick Santorum, R-Pa., "NIH has so much funding it can give about 74 grants a month. AHRQ can give about 74 grants a year. We need more funds for AHRQ to be able to translate those NIH biomedical studies into practice."
"I'll pass that on to the senator," said Stein.
Bradley Fox, M.D., of Fairview, Pa., and Mark Burd, M.D., of Bradford, Pa., also visited Santorum's office. Fox asked that Santorum defend Title VII funds for family practice training.
"The senator sits on the Senate Rural Health Caucus. Title VII is one issue we'll take up in the budget appropriations process," said Stein. "We hope to help you find a stable funding level."
Sharing perspectives from rural Missouri, Bruce Preston, M.D., of West Plains visited with Annissa McDonald, an aide to Rep. Roy Blunt, R-Mo. "I'm in a town of 10,000, and we've had two physicians leave, so our office has four or five people calling each day, asking us to see them. They're the older people with more problems," said Preston. "If we correct the reimbursement problems, people will be more able to come to the doctor's office."
 Elissa Palmer, M.D., says AHRQ needs more funds -- not less -- to be able to translate biomedical research into practice. Palmer talks with (from left) Mark Burd, M.D.; Peter Stein, an aide to Sen. Rick Santorum; and Brad Fox, M.D. |
In a briefing for the family practice lobbyists, John McManus -- staff director for the health subcommittee of the House Ways and Means Committee -- said Medicare regulations are four times as long as IRS regulations. Preston repeated that information to McDonald, saying, "For a lot of physicians, it costs them money to see Medicare patients. We need regulatory reforms to save our costs."
In the office of Sen. Kent Conrad, D-N.D., family physicians discussed plummeting Medicare payment rates with aide Louis Kazal, M.D., an FP doing a Robert Wood Johnson health policy fellowship in Conrad's office.
"Sen. Conrad sees problems with the Medicare reimbursement formula -- it's not fair -- and he recognizes it needs to be fixed," said Kazal. "How you do that when there's a budget deficit is the challenge."
The Hill visits were highly successful this year for three reasons, said Kevin Burke, director of the AAFP Government Relations Division. First, many visitors were first-timers. "This experience trained a new set of congressional contacts," said Burke. Second, the timing of the visits worked well -- legislators were already focusing on Title VII, AHRQ and Medicare issues.
Third, many FPs asked Congress to support AHRQ. "Family doctors are the only large group speaking up for AHRQ," said Burke. "Legislators understand family doctors are promoting AHRQ not because they expect to get a grant -- they're talking about their patients."
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Copyright © 2002 by
American Academy of Family Physicians.