BY TONI LAPP
Physicians need to galvanize their patients to action -- engage them in the lobbying effort to change the Medicare reimbursement landscape, said keynoter Morton Kondracke during the Scientific Assembly's opening ceremony, a highlight of the Oct. 1 - 5 meeting in New Orleans.
 "Why not enlist patients to do lobbying now (for changes in Medicare) rather than wait till they've been denied treatment?" keynote speaker Morton Kondracke asks attendees at the Assembly's opening ceremony. |
Kondracke, executive editor of the biweekly political newsletter Roll Call, brought this and other insights to his address, delivered in the casually droll manner seen in his appearances as a panelist on the TV discussion forum The McLaughlin Group.
Other topics up for discussion included the "perfect storm" that is brewing as more Americans lose insurance in a climate of rising health care costs, the role health care will play in presidential candidate platforms and the reimportation of drugs from Canada.
Medicare
Kondracke said it was unlikely that Congress would produce a Medicare prescription drug bill by Oct. 17. It's important politically and could be a campaign issue, he noted, but President Bush himself would have to roll up his sleeves and work on it because of the significant differences between the House and Senate on the issue. He added that it was likely a smaller measure would be passed offering a discount card for seniors.
Regarding declining reimbursements for physicians, the formula being worked on in Congress probably won't include a fee schedule fix for physicians, but it probably will include one for hospitals, Kondracke said. His advice to physicians was simple: "Lobby like crazy if you want to change this picture."
"If reimbursements keep going down, physicians won't take new Medicare patients," he said. "Why not enlist patients to do lobbying now rather than wait till they've been denied treatment?"
Reimportation of drugs
Governors see reimportation as a way to decrease Medicaid costs and ease their own budget crises. Although the Bush administration opposed the reimportation bill when it was going through Congress, Kondracke said, Bush "won't veto it if this is the only legislation he can hold a Rose Garden ceremony around."
Kondracke said his experience on behalf of his wife, a Parkinson's disease patient, made him sensitive to the issue, but he said Congress' attempts to legislate a remedy were "odious." Such legislation would discourage research for new drugs, he said, noting that it was difficult to name the last drug to be developed in Canada.
"The next 'John Q. Public' (movie) will be about drug companies," he said.
When it comes down to it, however, he sees little for lawmakers to do to alleviate the situation. Look for pharmaceutical companies to develop public image problems like those that HMOs had in the 1990s, he said.
Election 2004
It's going to be a close election, Kondracke predicted, offering candid comments about the presidential candidates -- and Bush:
Kondracke recommended that physicians visit the Web site of the Commonwealth Fund (http://www.cmwf.org/) to see the various candidates' health care proposals.
"Unfortunately, there are so many candidates, and health care is so complicated, that it rarely gets debated, so the public can't get educated about medical economics," he said. "The details are lost to the average voter."
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