Senate Does the Right Thing -- and Many of You Helped Tip the Balance

It was a rare day on Capitol Hill July 9. A critical vote was imminent. No one knew whether the Senate could muster the votes to end the filibuster of H.R. 6331, the Medicare Improvements for Patients and Providers Act -- the bill that would rescind the disastrous 10.6 percent cut in Medicare physician pay. Previously, the Senate had fallen just one vote short of stopping the filibuster before recessing for Independence Day. During that break, Republican senators who had voted against the bill faced tremendous heat for their vote, but none of them, even if they wanted to change their vote, wanted to be that one vote that would end the filibuster.

And then, on July 9, the tide turned when an old warrior walked into the Senate chamber. Sen. Ted Kennedy, D-Mass., had summoned up the will to return early from brain tumor surgery. In a rare show of bipartisanship, the Senate cheered Kennedy for several moments. "I return to the Senate today to keep a promise to our senior citizens and to protect Medicare," Kennedy explained. "Win, lose or draw, I wasn't going to take the chance that my vote could make the difference."

Since none of the Republicans already supporting the bill had switched their votes, Kennedy's "aye" was the 60th vote needed to kill the filibuster. But what happened next was even better: Nine additional Republican senators switched their votes to support the bill, giving it a veto-proof margin of 69-30. Republican leaders couldn't impose party loyalty to enforce opposition to a bill that was going to pass anyway.

Also incredibly significant to me was the sheer number of family physicians who cared passionately enough to lobby their senators about this bill. I think we've truly broken through the glass ceiling with this AAFP advocacy effort.

For example, we know that about 6,800 AAFP members e-mailed their senators in support of the bill, and 388 members sent letters to their local publications, many of which were published.

The letter of one member in particular drew senatorial attention. Scott Dunn, M.D., of Sandpoint, Idaho, distributed a letter to potential Medicare patients, explaining that his practice no longer could accept Medicare Part B for payment, telling them why and encouraging them to call their senators to express concern. When staff members in the office of Senate Majority Leader Harry Reid, D-Nev., learned about the letter, they asked for permission to use it as a visual aid during the floor vote on the bill. (Although they didn't get to use it at the last minute because debate on the bill was shortened, at least they had it available, thanks to one member's effort.)

As the July vote approached, the AAFP told members not to bother with e-mails, but instead to call their senators.

According to congressional sources, in the days leading up to the July 9 vote, Senate offices were flooded with calls, with voice mailboxes filling up daily. Callers endured long waits as calls backed up. Senate staff members couldn't respond to all their e-mails because of the tremendous volume. Campaign fundraisers were getting calls from physician political action committees (including ours) saying that fundraising events were being canceled for senators opposing the bill. The Senate was rocked back on its heels by the fervor of the bill's supporters!

I could go on and on about this successful advocacy effort, but I'll leave you with just one thought: Several thousand AAFP members helped change the fate of this bill -- but imagine what we could do if all 60,800 active members lobbied this fervently! I hope that will be the case in the coming months, as Congress grapples with developing an appropriate replacement for the sustainable growth rate, or SGR, formula responsible for the Medicare pay cut we just derailed.

Please join with us to win a victory over the SGR. I know we can prevail with your help.