Flex Your Advocacy Muscles

Forty years ago, our government made a promise to Americans living with End Stage Renal Disease (ESRD). Congress assured dialysis patients that the cost of treatment would be covered by Medicare regardless of the patient’s age. ESRD is the only disease that conveys this automatic Medicare benefit. Since the creation of this benefit, this unique “public-private partnership” has required a healthy working relationship between dialysis providers and the policymakers who determine Medicare reimbursement rates.

 

As most of you know, Congress and the Centers for Medicare and Medicaid Services (CMS) recently proposed dramatic ESRD payment cuts that would gravely affect dialysis patients as well as the medical professionals who care for them. This proposed cut in reimbursement has mobilized the industry, providers, patients, and patient families to speak out about the potential consequences of this cut to access to dialysis care. One important way to communicate concerns and dissatisfaction is through lobbying Congress, which is not a familiar activity for most health care providers.

 

Take a cue from Mr. Smith and go to Washington

 

Some of you may be nervous about lobbying and may have questions like: How does it work? What do I say? With all the current debate regarding health care policy, how do I get my point across about ESRD cuts? Visiting “The Hill” isn’t as daunting or complicated as most of you may think, but it is probably even more important than you can imagine.

 

Members of Congress and their staffs are reasonable and willing to listen to the concerns of nephrologists. When you meet with these representatives, you may be surprised at the depth of detail they are able to grasp with regard to both the clinical aspects of ESRD as well as the mechanics of Medicare reimbursement. It is important for practicing nephrologists to take the time to go to Washington to share concerns with Congressional offices.

 

If you ask around your local community, you may be pleasantly surprised to find that you are more “connected” to the Members of Congress than you thought. You may know someone representing you in Congress or you may be connected with someone in Congress through a co-worker, a neighbor, or even a patient. A connection like this makes it even easier to schedule a visit and talk to a Member of Congress or their staff.

 

Here are a few tips for contacting your representatives:

1. Congress really does want to hear from you. Policymakers can only act on the information they receive, and no one is better situated to convey these messages about ESRD policy than those who practice it. Whether the issue is Medicare reimbursement, vascular access, quality mechanics, or any other area that may arise, the Members and staff have to hear the issues from physicians first if they are to address them.
2. You can easily identify the Members of Congress who represent where you live or practice. Members of the House of Representatives can be located here by typing in a ZIP Code, and a list of Senators by state is available here. Each Member of Congress maintains his or her own website, and almost all of these sites include a Contact page. Consider visiting these pages to email, call, or request a meeting with the Member in your state or district through the process detailed on the site. You will want to say something along these lines when making your contact: “My name is Dr. X, and I practice nephrology and live in the Congresswoman’s district. I am contacting the Congresswoman to discuss an issue of great importance to me as a medical professional as well as to the district itself.”
3. Do not be discouraged if a Member cannot meet with you directly, but instead offers you a meeting with his or her staff. As you can imagine, Members have enormous demands on their time and frequently rely on key staff to brief them on important issues. Most likely, you will be referred to the Member’s health care advisor.

 

Your voice matters

 

Approximately 83% of nephrology patients rely on Medicare as their primary form of insurance. Government advocacy on behalf of the ESRD community is an ongoing and critical function of nephrologists.

 

Members of Congress need to know what effects the new rules or laws might have on the care of patients in their district or state. Tip O’Neil once said, “All politics are local.” In no way is that more evident than when you relay to a Member or his or her staff the potential impact of the ESRD cuts on patients and employees in their area.

 

 

If you’ve been to Washington and met with a representative or staff member about the ESRD cuts, we’d love to hear from you. Please share your experience and any additional tips in a comment.