Washington Welcomes President Obama and Gets to Work
In front of an estimated 1.8 million persons on the National Mall, stretched from the Capitol to the Lincoln Memorial – a distance of two miles – President-Elect Barack Obama became President Barack Obama on January 20. Thus began a new era in Washington in which the Administration will attempt to convert the campaign focus on “change” and “hope” into public policy.
The Economic Stimulus Bill
First up on the congressional agenda in response to the new Administration was an economic stimulus bill designed to put Americans back to work quickly and revive a moribund economy that has been non-responsive to other stimuli and incentives. The bill, as crafted by the House of Representatives, contains a number of provisions of interest to AACOM members. Among these are:
|
Training for Primary Care Physicians and Nurses |
$0.6 billion |
|
National Institutes of Health Research Funding |
1.5 billion |
|
Comparative Effectiveness Research Funding |
1.1 billion |
|
Pell Grants |
15.6 billion |
|
Higher Education Repair and Modernization Funds |
6.0 billion |
The House passed its version of the stimulus package on January 28. The Senate passed its version of the bill on February 10. The Senate version includes:
|
Training for Primary Care Physicians and Nurses |
$0.0 billion |
|
Construction and Renovation of University Facilities |
0.5 billion |
|
National Institutes of Health Research and Construction Funding |
9.5 billion |
|
Comparative Effectiveness Research Funding |
1.1 billion |
|
Pell Grants |
13.9 billion |
|
Higher Education Repair and Modernization Funds |
0.0 billion |
The differences in the House and Senate bills will have to be reconciled and the bills passed in both houses in identical form. The goal is to have a bill to the President’s desk for his signature before Congress recesses on February 13 for its annual Presidents’ Day Recess. If that date is not met, it is possible Congress will remain in session until the bill is completed.
The Election that Won’t End
Slightly reminiscent of the 2000 Presidential election, with its hanging chads and Supreme Court rulings, the 2008 Minnesota Senate race continues to be unresolved. Democrat Al Franken leads Republican Norm Coleman by 225 votes out of 2.9 million cast. His victory has been certified by election officials in Minnesota, but the Senate has not seated him due to court challenges that have been filed.
At issue are about 12,000 ballots that were disqualified for one reason or another. The Minnesota Supreme Court will have to rule on their validity before the race can be finalized. In the meantime, the Senate stands at 58 Democrats, 41 Republicans, and this one vacancy. (Coleman was the incumbent and thus had to vacate the seat when the new Senate was sworn in on January 6.)
All other Senate seats have been resolved with the appointment of Congresswoman Kirstin Gillibrand and former Denver schools chief Michael Bennet to the seats vacated by Secretary of State Hillary Clinton and Secretary of the Interior Ken Salazar, respectively, and the decision to swear in former Illinois Attorney General Roland Burris to the seat vacated by President Obama.
Duncan, Daschle Confirmation Updates
The two Cabinet nominees of most direct import to AACOM members have taken different paths.
Arne Duncan, the former head of the Chicago Public School System, was nominated to serve as Secretary of the Department of Education by President Obama. His nomination was well-received in Congress and he was confirmed on January 21, the day after the inauguration.
Former Senate Majority Leader Tom Daschle, who had been nominated by President Obama to head the Department of Health and Human Services, has withdrawn his name from consideration following the revelation that he recently paid $128,000 in unpaid taxes and penalties.
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MedPAC Reduces IME
On January 8, MedPAC, the panel that advises Congress on Medicare issues, met to discuss Medicare payment updates and other issues. During its meeting, the committee voted to decrease the current 5.5 percent indirect medical education (IME) adjustment by one percentage point to 4.5 percent and to redirect the funds to support implementation of a value-based purchasing (VBP) system. VBP requires that a portion of a hospital’s reimbursement be dependent on the hospital’s performance in pre-defined quality measures. The reduction of IME was introduced based on the committee’s findings that there was only a 2.2 percent cost increase for every 10 percent increase in teaching intensity in a hospital, whereas the current payments showed a 5.5 percent increase for every 10 percent increase in teaching intensity. The direct impact of this reduction in medical education has not been evaluated overall, but several teaching hospitals are very concerned about what this 20 percent reduction in IME payments will mean for the future. The state of New York estimates that its teaching hospitals will lose more than $200 million a year if these new recommendations are implemented.
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AACOM Sends Letter of Priorities to AOA
In anticipation of the issuance of the AOA’s agenda for the 111th Congress, AACOM sent a letter to Dr. Marcelino Oliva, Chairman of the AOA Bureau of Federal Health Programs, outlining AACOM’s current public policy priorities. The letter covers several issues, including graduate medical education, health care workforce, Title VII reauthorization and appropriations, scholarships and loans, osteopathic medical research, and diversity. AACOM works with the AOA’s government relations department to coordinate efforts on issues of mutual interest. Read the full letter. (pdf)
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Partnership for Primary Care Workforce Holds Capitol Hill Briefing
On January 12, the Partnership for Primary Care Workforce (PPCW) held a congressional staff briefing in the Capitol, featuring three presentations. Kevin Grumbach, MD, of the University of California San Francisco School of Medicine, discussed training the next generation of primary care providers and presented evidence of the decline of and growing need for a primary care workforce. Robert Berenson, MD, of The Urban Institute, spoke about developing a payment system that reflects the value of primary care. The briefing was concluded by Andrea Anderson, MD, of the Upper Cardozo Health Center, who is a National Health Service Corps member. She related personal stories about how being a primary care physician has enriched her life and the lives of her patients in an underserved area of Washington, DC.
The PPCW is a non-partisan, nationwide effort by key professional, provider, and educational organizations, including AACOM, AOA, ACOFP, and more than a dozen other organizations, to strengthen and improve the nation’s primary care workforce. The partnership has three core principles: (1) building a primary care infrastructure; (2) enhancing workforce development through training, education and professional opportunities; and (3) payment system change that reflects the value of primary care.
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AACOM Meets with NCCAM Director and Recommends Experts for Panel
AACOM President Stephen C. Shannon, DO, MPH, and other AACOM staff met with Josephine Briggs, MD, Director of the National Center for Complementary and Alternative Medicine (NCCAM) of the National Institutes of Health, to build upon AACOM’s relationship with NCCAM and foster increased collaboration. Drs. Briggs and Shannon discussed osteopathic medicine, research and education, and agreed that increasing osteopathic clinical research capacity is an important priority.
Dr. Briggs requested assistance from AACOM in identifying experts for a panel discussion NCCAM is planning to sponsor on low back pain. AACOM has suggested several individuals for this panel.
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