Board of Councilors Report

Dr. Gibson
Wilford K. Gibson, MD

 I hope everyone who attended the VOS Annual Meeting in Virginia Beach enjoyed it and found it to be a worthwhile experience.  Please mark your calendars now for April 30 - May 2, 2010 for the VOS 63rd Annual Meeting in Charlottesville.  For those of you at the Virginia Beach meeting, you have likely already heard my update from the spring National Orthopaedic Leadership Conference in Washington, D.C. April 29 through May 2, 2009.  I will give a quick summary and update you now on current developments.
Unfortunately, the spring meeting seems to always overlap our VOS Annual Meeting!  I arrived on April 29 and attended the BOC State Orthopaedic Societies Committee Meeting and caucused with Eric Guidi who attended the BOC Communication Committee Meeting.  We followed up on business from the AAOS Meeting in Las Vegas, including grant requests from the State Societies Assistance Fund.  We awarded $2,000.00 to VOS to help fund the members of the board and a facilitator in the process of developing a strategic plan for our organization.  A well-defined strategic plan was identified as one of our opportunities for improvement on the state societies annual survey.  I attended training for first-time NOLC attendees and verified appointment times with Eric for the following day.  This was followed by an address by Rep. Ron Kind (D-Wis.), who stressed the importance of communicating the issues we face to our legislators.  He discussed “pay-as-you-go” funding of current federal healthcare funding proposals.  He answered questions, pointing out the obvious discordant philosophy of economic bailout of banks and mortgage companies.   His position was that our national debt and budget is clearly not sustainable.  My perspective is that Representative Kind and members of Congress see our service-oriented business as an expense or cost and mortgage companies, banks and now, the auto industry, are seen as producers and worthy of economic bailout.  I see our practice of medicine as in the crosshairs!  We need to demonstrate the value of straightening crooked spines and clubbed feet so children can walk and enter the workforce and become productive members of society!  We need to show the value of repairing injured hands, broken bones and arthritic hips so adults can return to the workforce!  We need to explain the value of fixing grandma’s hip so she can spend her twilight years at home with her family where she wants to be, rather than being bedridden in a nursing home for the final weeks of her life with strangers at tremendous expense!  I am passionate about this and now is the time for all of us to make certain we have our representatives ear.

We visited with Senators Warner and Webb’s staff and with Representatives Moran and Nye’s staff the following day and I came to the conclusion that the Republicans really had no idea what was going on in the House or the Senate with respect to health care reform.  It was clear the Democratic majority in the House did not have a “Health Plan” and if they did it was not being shared.  There was mention of a Baucus (D-MT) plan in the Senate.  This was being worked on with Senator Grassley (R-IO) as a bipartisan effort.   It was clear to me from our discussions with Senators Webb and Warner’s health policy staff that there were many ideas in this plan that were being discussed.  We also learned that the President wanted a Health Care Bill to sign by October.  The House would need to approve a bill by this summer and the Senate would need to approve a bill by August.  The Democrats have a majority in the House and this was considered a done deal.  This may explain why the Republican’s in the House were in the dark.  The Democrats in the House are looking for the Senate Baucus bill to guide them in their efforts.  Of tremendous interest is the fact that Sen. Jack Reed (D-RI) shared with us that the Senate agreed on a procedural issue to go with a simple majority vote on any healthcare plan, so they could expedite the process and meet the President’s goal of having legislation to sign by October.  No filibuster or 2/3 super majority vote.  Not a bad idea until Arlen Specter, former Republican and now Democrat, moved over to the new majority in the Senate!  You can see that whatever ideas are put into the bill will most likely be signed into law in October!  If that is not worrisome enough, remember the economic bailout bill that was signed into law and the majority of the Congress had not read it.  Some provisions for you to think about are the concepts of a cost neutral plan and “accountable” healthcare.  The mission from the President is to take the Medicare funding and provide insurance for Medicare beneficiaries, Medicaid beneficiaries and the 48 million uninsured in a cost-neutral method.  Never mind that 20 million are uninsurable for various health reasons and 10-20 million are illegal immigrants.  This is going to be a daunting task.  The concept of “accountable” healthcare may be more troubling.  The idea is to take the federal money and distribute it to the 12 members of the Council for Comparative Research and Effectiveness, which was created in the Economic Stimulus (Bailout) Plan that was signed into law in February.  These individuals will oversee their respective region of the country and distribute the money to hospitals based on undefined terms of accountability.  If you are a good steward of the government’s money, the hospitals will decide how much to distribute to the physicians!  I hope this is enough to spark your interest and keep you involved in the process!
That evening we did have a reception with Congressman Price (R-GA) and Senator John Barrasso (R-WY) (both orthopaedic surgeons) who gave some hope that we have a voice in this process.

We left all of our legislators our message that we wanted to participate in the process and to let us advocate for access to healthcare for our patients with musculoskeletal conditions and injuries.  We promoted the Access to America’s Orthopaedic Services (AAOS) Act championed by the American Association of Orthopaedic Surgeons and co-sponsored in the House by Congressmen Burgess (R-TX) and Green (D-TX).  We are still looking for a sponsor in the Senate.

I hope this summary is helpful and has provided some food for thought and ideas for action. It has been interesting to see some of the ideas “floated” and “shot down” over the last few days.  We were informed that liability reform or caps on malpractice would not be on the table.  I heard the President share that he was open to liability reform days ago, only to hear hours ago that it would not be fair to injured Americans to limit this right!  I have also heard in the last 1-2 days the idea of taking 200 billion dollars in payments to hospitals to help fund the expected 1 trillion dollar expense for a federal health plan over the next ten years.  Clearly the hospitals and the American Hospital Association are not happy with this idea.  The Congress will be looking for a way to pay for any federal health plan, and I was told that the reform will be bigger that the Omnibus and Reconciliation Act of 1964 that created Medicare.  In times like these, we need to keep communication lines open and stay involved.  Support your Virginia Ortho-PAC, AAOS Ortho-PAC and your specialty PAC.  I hope to have better news in the fall!

CLICK HERE!                                   CLICK HERE!
For  the latest proposal on Health Care Reform                 To view the August 2009 AAOS State Newsletter     
and how to get involved, provided by AAOS

Wilford K. Gibson, MD