EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.
Issue link: https://digital.eyeworld.org/i/82503
September 2012 EW NEWS & OPINION A call to action from our Government Relations Committee by David F. Chang, M.D. Dr. Chang: Describe your experi- ences and thoughts from attending your third Alliance Fly-In in Washington, D.C. A lthough virtually all physicians have strong opinions about our system of healthcare, we continue to be a fairly apathetic group when it comes to political advocacy, whether measured by PAC contributions or by grassroots efforts to engage our legislators. Be- yond our marathon workweeks, we spend so much nonclinical time on continuing education and administrative drudgery that it is understandable why we would rather have others fight the advocacy battles for us. Fortunately, many individuals are willing to roll up their sleeves and get involved, and ASCRS is blessed to have a dedicated group of well-informed members serving on its Government Relations Committee (GRC) under the leadership of Brock Bakewell, M.D., and Nancey McCann. This month, I interviewed Sandy Yeh, M.D., an ASCRS member who epitomizes the attitude and moxie of our GRC—largely unseen and unsung, but altruistically determined to make a difference on behalf of our profession. Like many of our members, Sandy is a general ophthalmologist in private practice, but she is probably busier than most as the founding director of a large multi-doctor, multi-office private practice and ASC, the Prairie Eye Center in Springfield, Ill. Nevertheless, Sandy attends all of the ASCRS GRC meetings and Legislative Fly-Ins and has donated to and hosted fundraisers for her congressional representatives. Although she may not enjoy the reputation or stature of a well-recognized podium lecturer, Sandy has unmistakable leadership qualities. At the 2012 Alliance of Specialty Medicine Fly-in in Washington, D.C., Sandy impressed all of us with her enthusiasm and spirit. Mired in our current state of partisan gridlock, it is difficult to not grow cynical, but Sandy's energy and positive attitude are infectious, and she kept us all smiling with her homespun humor and wisdom. We need more politically engaged physicians like Sandy. Following this interview, I then asked four other GRC members and Fly-In participants, Frank Price, M.D., Mark Michelson, M.D., James Bryan, M.D., and Ken Rosenthal, M.D., to each discuss one of the four key issues that were deemed legislative priorities for specialty medicine by the Alliance. Please read and heed their comments. Finally, the GRC has prepared a downloadable educational handout that can be given to our patients regarding the dangers of the IPAB (ascrs.org/download/gov/lettheadipab.pdf). –David F. Chang, M.D., chief medical editor Dr. Yeh: As everyone should already know, this is a critical time for the entire healthcare profession in the U.S. President Obama's Affordable Care Act (ACA) is now the bonafide law of the land, and love it or hate it, we all have to live with it, and we should all learn how this law will change our lives. As part of the Fly-In, we had nu- merous presentations from elected members of Congress and their staff. I learned a great deal about this new law and the government process as a whole. I learned that presently, 15 members of Congress are doctors and they understand fully the challenges we face and are trying to minimize the harm and maximize the good in this time of dramatic change. Unfortunately, these people are in the minority. I also learned that there are many more members of Congress and their staff who are quite clueless as to the challenges we face, and these people are in charge of making policies that will dictate how we work and live. The one spark of hope is that they appear to be willing to listen and to learn, and therefore, we must be the united voice of reason. Dr. Chang: What are some of the most adverse measures of the ACA for physicians? Dr. Yeh: One of the worst parts of the healthcare act is the future cre- ation of the Independent Payment Advisory Board (IPAB). This will be a 15 member non-elected board appointed by the President whose sole job is to cut Medicare spending. Their power is nearly absolute as they can retroactively cut payment without any approval and can only be repealed by two-thirds of Con- gress (which according to experts is nearly impossible in the very short timeline given). This board is also highly unjust because it is forbidden to cut hospital or nursing home rates until 2020, only doctors whose fees comprise less than 10% of Medicare's total expenditure. In my opinion, IPAB is a total departure from the democratic process where 15 non-elected bureaucrats will have complete control of doctors' reimbursement by Medicare. The Government Relations Committee strongly feels that this is unaccept- able, and we should put maximum effort into getting IPAB repealed continued on page 30 29 From left to right: Nancey McCann, Francis Price, M.D., Stephen Lane, M.D., Eric Donnenfeld, M.D., Dr. Yeh, Congresswoman Marsha Blackburn (R-TN), Dr. Chang, Parag Parekh, M.D., Brock Bakewell, M.D., Kenneth Rosenthal, M.D., Marc Michelson, M.D., and James Bryan, M.D., at this year's Fly-In