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              Carbon capture draws millions in lobbying, billions in federal subsidies

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              United leads soaring airline industry lobbying spending

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              Deep-pocketed dairy industry continues war on plant-based milk as FDA hears comments on new draft guidance

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              Shein’s lobbying spending soars amid supply chain probes

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              Virginia legislative candidates in Richmond and Hampton Roads raked in millions in final primary sprint

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              Manchin outraises GOP challengers but has yet to announce 2024 plans

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              Gallego outraises Sinema but falls far short of incumbent’s war chest in Arizona Senate race

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                  Mistakes To Avoid When Starting Your Online Store

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                  Ways To Reduce Safety Hazards in the Office

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                  Los Angeles implemented a new tax on luxurious real estate to finance affordable housing and combat homelessness

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                  Working shorter hours: 38 companies in the USA are testing the 4-day week

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                      Energizing Foods and Drinks To Consume Before a Workout

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                        Florida Gov. Ron DeSantis Injects Presidential Politics Into the Covid Vaccine Debate

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                        Tips for Fitting a Doctor’s Visit Into Your Busy Schedule

                        The Shrinking Number of Primary Care Physicians Is Reaching a Tipping Point

                        The Shrinking Number of Primary Care Physicians Is Reaching a Tipping Point

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                        Activist Misuses Federal Data to Make False Claim That Covid Vaccines Killed 676,000

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                        Illustrated Report: How Gun Violence Goes Viral

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                        A New Medicare Proposal Would Cover Training for Family Caregivers

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                        New Alzheimer’s Drug Raises Hopes — Along With Questions

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                        Blood Test That Screens for Cancer Raises Hopes, and Worries

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                        Medical Debt Is Making Americans Angry. Doctors and Hospitals Ignore This at Their Peril.

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                          Common Dog Owner Mistakes and How To Avoid Them

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                          3 Reasons To Give an Antique or Vintage Engagement Ring

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                          Outdoor Luxuries To Add to Your Backyard

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                          Why the Friend of My Enemy is My Enemy

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                          Huge Money Mistakes New Parents Fall For

                          Energizing Foods and Drinks To Consume Before a Workout

                          Energizing Foods and Drinks To Consume Before a Workout

                          Hobbies That Stimulate Cognitive Function

                          Hobbies That Stimulate Cognitive Function

                          How To Prevent Mold from Growing in a Sauna

                          How To Prevent Mold from Growing in a Sauna

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                          • Politics
                            Carbon capture draws millions in lobbying, billions in federal subsidies

                            Carbon capture draws millions in lobbying, billions in federal subsidies

                            United leads soaring airline industry lobbying spending

                            United leads soaring airline industry lobbying spending

                            Deep-pocketed dairy industry continues war on plant-based milk as FDA hears comments on new draft guidance

                            Deep-pocketed dairy industry continues war on plant-based milk as FDA hears comments on new draft guidance

                            Shein’s lobbying spending soars amid supply chain probes

                            Shein’s lobbying spending soars amid supply chain probes

                            Virginia legislative candidates in Richmond and Hampton Roads raked in millions in final primary sprint

                            Virginia legislative candidates in Richmond and Hampton Roads raked in millions in final primary sprint

                            Manchin outraises GOP challengers but has yet to announce 2024 plans

                            Manchin outraises GOP challengers but has yet to announce 2024 plans

                            Gallego outraises Sinema but falls far short of incumbent’s war chest in Arizona Senate race

                            Gallego outraises Sinema but falls far short of incumbent’s war chest in Arizona Senate race

                            Elon Musk outmuscled by Mark Zuckerberg’s money in politics

                            Elon Musk outmuscled by Mark Zuckerberg’s money in politics

                            Amazon lobbyists tout workplace safety improvements ahead of Senate investigation

                            Amazon lobbyists tout workplace safety improvements ahead of Senate investigation

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                            • Real Estate
                              Ways To Invest in Real Estate With No Experience

                              Ways To Invest in Real Estate With No Experience

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                              How To Make Your Rental Property More Eco-Friendly

                              Things To Consider Before Investing in Real Estate Overseas

                              Things To Consider Before Investing in Real Estate Overseas

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                              Incredible Areas in Florida To Buy a Vacation Home

                              Helpful Home Staging Tips for Virtual Tours

                              Helpful Home Staging Tips for Virtual Tours

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                              Ways To Decorate and Design a Lake House

                              Challenges To Managing a Rental Property

                              Challenges To Managing a Rental Property

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                              The Best Landlord: How To Show Tenants You Care

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                              After Staying Away During Pandemic, Doctors Return to Lobby Congress

                              by Staff Writer
                              February 21, 2023
                              in Health
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                              By Phil Galewitz

                              WASHINGTON — Dr. Timothy McAvoy, an internist from Waukesha, Wisconsin, held his infant granddaughter Tuesday while standing in the Longworth House Office Building, waiting to talk to a congressional aide about increasing Medicare pay for doctors.

                              Facing a highly partisan Congress where Republicans have vowed to cut federal spending, McAvoy hoped his Midwestern charm, along with a dose of supporting data, would sway members to remember physicians’ cause.

                              “’Wisconsin nice’ is a real thing,” said McAvoy, who graduated from medical school in 1973. “Whether it will translate to the votes we need, we will have to see.”

                              McAvoy was one of about 350 physicians who came to Capitol Hill this week to lobby Congress on behalf of the American Medical Association. Although they left their white coats at home, they were still there as doctors. Their goal was to build support for the organization’s “Recovery Plan for America’s Physicians” — a wish list that includes a pay raise, relief from insurance company prior-authorization demands, and more federally funded residency slots to train more physicians.

                              The campaign motto packs a pat on the back for these medical professionals: “You took care of the nation. It’s time for the nation to take care of you.”

                              The AMA represents about 250,000 doctors, roughly a quarter of the U.S. physician workforce. And sending its members in droves to Washington to make their case is nothing new. But this was the first organized group effort in more than three years, because of the covid-19 pandemic.

                              In that time, many congressional offices have been claimed by new members with different legislative aides. As a result, physicians say, they need to spend in-person time teaching them about the complexities of Medicare payment rules and other topics important to the practice of medicine.

                              While the AMA has a full staff of lobbyists in Washington, association officials say their best weapon is often doctors themselves, who wrestle with insurance company red tape and bureaucratic reimbursement rules every day. “There is nothing quite like telling members of Congress how things work in their district,” said Dr. Jack Resneck Jr., AMA president and a dermatologist at the University of California-San Francisco.

                              Before they met with House and Senate members and their aides, AMA staffers briefed the doctors at a downtown hotel on how to deliver their message for maximum effect. The main lesson: Show how these changes will help their patients, not just their business practices.

                              Detail how patients are facing delays getting drugs and services because insurer approval is required first. Mention they know of doctors retiring early, selling their practices to hospitals or private equity firms, and how this makes it difficult for patients to find a doctor. “We have the policy and data, but it’s these stories that will stick in their heads,” an official AMA lobbyist told them.

                              They also were advised to listen and seek common ground with members of Congress.

                              “When you go up on the Hill, let those congresspeople know how much you care about your patients and want to keep doing your job,” an AMA staffer said, sounding almost like a coach outlining how a strategy should work on game day. “Let them know how we care about our patients and want to improve the health of the nation.”

                              But it was also a pitch about money, coming from some of the country’s well-above-average income earners. (A government estimate for the category “physicians and surgeons” set the median 2021 annual income at $208,000.) Tell Congress that with higher payments from Medicare they could deliver better care and service to patients, the doctors were urged. “No one wants a system that is not fiscally stable, and no one wants to see doctors busy filling out paperwork to fight denials from insurers,” one AMA staffer said.

                              They were also told to remind Congress that Medicare payments to doctors do not include an automatic adjuster for inflation, even though hospitals and nursing homes get that. “Medicare beneficiaries are at real risk of not getting care,” Resneck said.

                              While Medicare payments are still a vital issue for many doctors, most physicians today work as employees of hospitals, insurers, and other corporate entities and often are paid a salary rather than a fee for each patient service.

                              AMA lobbyists cautioned them that asking for higher pay has met pushback in recent years. That’s largely because the Medicare Payment Advisory Commission, which advises Congress, has repeatedly said Medicare rates were high enough and there was no sign Medicare patients were having widespread trouble finding doctors.

                              Indeed, in its latest report, in March 2022, MedPAC wrote: “The Commission’s analyses suggest that Medicare’s aggregate payments for clinician services are adequate.” At their January meeting, however, MedPAC members signaled a change in this position by approving recommendations to link physicians’ payments to 50% of the Medicare Economic Index, which is a measure of  practice cost inflation.   

                              In the 2022 report, MedPAC also noted that during the pandemic Congress provided tens of billions of dollars in relief funds to clinicians, and predicted demand for their services would reach or exceed pre-pandemic levels by 2023.

                              Dr. Tosha Wetterneck, an internist from Madison, Wisconsin, who joined McAvoy in Tuesday’s meeting, said after a session with Wisconsin Republican Rep. Mike Gallagher’s legislative aide that she felt satisfied he had heard their message about needing help to keep physician offices open and fully staffed. She stressed that doctors need more money to pay nurses, medical assistants, and receptionists when they are being lured away with higher pay from other employers.

                              “It’s not a one-time thing,” she said about this week’s lobbying. “It’s about forming relationships. We are in it for the long term.”

                              Wetterneck said the aide told her group Gallagher supports changes to insurer prior-authorization rules. Asked whether he would support higher payments to doctors, she said: “Everyone supports us trying to keep the lights on, but it all depends on how the sausage gets made.”

                              The aide told the doctors about Gallagher’s bill to stop anti-competitive tactics that would limit employers’ use of noncompete clauses in contracts, which the physicians said would help them when they change companies, Wetterneck said.

                              Over two days, the Wisconsin physicians met with nine members of Congress from their state, though it was mostly aides in the House, as the lower chamber was on recess.

                              They met Wisconsin Sen. Ron Johnson, one of the most conservative members of Congress, who often rails against increased government intervention and spending.

                              Wetterneck said Johnson spent nearly an hour with them, during which he explained that he wanted doctors to be the trusted profession again rather than be crushed by rules and red tape. The senator told them he understands that physician practices need money to pay staff members and care for patients. But that doesn’t guarantee he will vote for an increase, she said.

                              Dr. Melissa Garretson, a Fort Worth, Texas, pediatric emergency medicine specialist, clutched a Diet Coke as she left a House cafeteria and headed to her fifth of eight meetings in the House and Senate.

                              She said the payment issue resonated with members of Congress, particularly when the message focused on helping doctors keep practices open in rural Texas.

                              She was ready with a story from just last week: An insurer refused to cover a liquid medication for her 4-year-old patient and would pay only for a pill too big for the child to swallow. “Prior authorization is a roadblock to patient care,” she said.

                              While treating emergency patients is her job, she sees lobbying Congress as an extension of her role.

                              “Our patients need the care they need when they need it, and to not advocate that is not to do my job as a doctor,” Garretson said as she walked into a Texas House member’s office.

                              This story was produced by KHN (Kaiser Health News), a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.

                              KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.

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                              This story can be republished for free (details).

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                              Tags: HealthcareHealthy LivingPublic Health
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