What is Happening Are you Ready

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ACS Advocacy Agenda

• Budget Neutrality
• Medicare Physician Payment
• Trauma
• Surgical Workforce
• Quality Improvement

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Comprehensive Health Reform

• Different from health reform of the 1990s
• All major health issues on the table
• Delivery System Reform
• Coverage
• Financing

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Status of Reform on Capitol Hill

• Senate Finance Policy Options released with
  mark-up in June/July
• HELP Committee drafting legislation with multiple
  mark-ups beginning in mid-June
• House committees expected to address before
  August recess
• Rebasing - included in House and Administration
  budget resolutions

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Comprehensive System Delivery Reform Legislation
Must

• Properly allocate resources to improve patient
  access to trauma and emergency services
• Ensure that access to acute and surgicl care is
  included in a basic benefit package for all
  individuals
• Lower the administrative costs in our health care
  system and reallocate those resources to patient
  care
• Address the decreased access to care and the
  costs associated with the practice of defensive
  medicine caused by the lack of medical liability
  reform and
• Level the playing field between physicians and
  insurance companies by enacting antitrust reform.
  

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Delivery System Reform Must Address the Payment
System!

• Surgery responds to Senate Finance Committee
  policy options proposal
• College joined by 19 other surgical specialties
  in comment letter
• To reform Medicares payment system Congress must
  first immediately eliminate the SGR.
• Surgery opposes another short-term patch that
  only temporarily prevents Medicare payment cuts
  and does not directly address the problems with
  the SGR.
• Surgery opposes any measure that would finance
  increased payments for certain physicians by an
  across-the-board reduction in payments for all
  other services.
• Congress must incorporate a realistic budget
  baseline that provides physicians with positive
  updates.

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Addressing the SGR

• No magic bullet on the shelf for permanent SGR
  solution
• Separate conversion factors for service
  categories
• Concept took hold last year included by
  Chairman Stark in the CHAMP bill
• 4 service categories removes surgery from
  volume targets impacted by other specialties
• Primary care, EM (non-primary care), 10/90-day
  globals and other

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Trauma in Health Reform

• ACS leading effort on legislation in health care
  reform to help ensure the success of trauma and
  emergency systems, trauma centers, and providers
  - including trauma surgeons and specialists
• Specific Bills Sought through Senate HELP
  Committee
• National Trauma Center Stabilization Act
• Improving Emergency Care and Response Act
• Emergency Care Coordination Center (ECCC)
  authorization

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Surgical Workforce

• Addressing workforce shortages key component of
  comprehensive health care reform
• Redistribution of unused residency training
  positions - focus on primary care and general
  surgery
• Lifting residency caps - option for addressing
  emerging workforce shortages in other medical
  specialties
• Medicare bonus payments to general surgeons
  working in rural areas
• Expanding NHSC loan repayment program to surgeons

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Quality Improvements

• First step Stimulus legislation
• Included 400 million for comparative
  effectiveness research
• Opportunities for ACS NSQIP program
• Additional comparative effectiveness language
• Included in Senate Finance proposal
• Surgery supports well-designed clinical
  comparative effective research
• Opportunity for surgical clinical data registry

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Why do you need to become politically active?

• Your livelihood is at risk
• Your (and others) practice is threatened
• Your patients may not have a doctor
• You cant win if you dont play
• Even if you are on the right track, you will get
  run over if you just sit there.
• ? Will Rogers

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What Surgeons Can Do

• Participate in ACSPA-SurgeonsPAC
• Stay informed
• Come to Washington, DC
• Communicate with Representatives and Senators
• Get other surgeons involved

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ACSPA SurgeonsPAC

• Sits at the Table
• Covers the Big Issues
• Gets our Candidates Elected
• Gets our Lobbyists in the Door

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ACSPA-Surgeons PACGoals

• Created to
• Contribute to the campaigns of those Members of
  Congress who support the Colleges legislative
  goals
• Gain BETTER access to high profile Legislators,
  especially Committee Chairs and Leadership
• Build grassroots and fundraising potential to
  affect elections favorable to our legislative
  goals.

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ACSPA-Surgeons PACCriteria for Political
Contributions

• The Board considers the following criteria
• in determining political disbursements
• 1. Leadership Position
• 2. Committee Assignment
• 3. Past Voting Record on OUR Issues
• 4. Medical Profession MD, DO, FACS
• 5. Likelihood to Win Polls, District

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Why Support the ACSPA SurgeonsPAC?

• Unified Voice for Surgeons on the Big National
  Issues
• Larger Constituency
• Established Access to Congressional Offices
• Gets our Candidates Elected to Congress
• Subspecialty PACs are important for focal issues
• Regional PACs are important at state level

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Important SurgeonsPAC Facts

• Only U.S. members can donate to the PAC
• Need for personal funds, not corporate
• ACSPA-SurgeonsPAC can solicit from over 55,000
  Members
• In 2005, SurgeonsPAC raised 511,644
• (average contribution 300)
• In 2006, SurgeonsPAC raised 442,700
• (average contribution 277)
• In 2007, SurgeonsPAC raised 639,000
• (average contribution 276)
• In 2008, SurgeonsPAC raised 684,509
• (average contribution 293)

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ACSPA Surgeons PAC Financial Overview

• 2007/2008 Election Cycle
• 1,322,759 raised for the 2008 cycle
• (includes both federal and non-federal receipts)

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ACSPA SurgeonsPAC Financial Overview

• 2009
• 220,283 raised so far in 2009
• (includes both federal and non-federal receipts)
• 801 Individual Contributions
• Average donation 275

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Maine Overview

• There are 293 eligible PAC donors in ME
• In 2006 9 members contributed 2,075
• 3 (231 average contribution)
• In 2007 21 members contributed 3,757
• 7 (179 average contribution)
• In 2008 17 members contributed 3,225
• 6 (190 average contribution)

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SurgeonsPAC Donations to Candidates in the
2005/2006 Election Cycle

• Contributions made to 172 Candidates, Leadership
  PACs and Party Committees
• Total of 594,750
• 73 given to Republicans
• 27 given to Democrats

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SurgeonsPAC Donations to Candidates in the
2007/2008 Election Cycle

• Contributions made to over 189 Candidates,
  Leadership PACs and Party Committees
• Total of 908,500
• 58 given to Democrats
• 42 given to Republicans

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ACSPA-Surgeons PAC

• In our second election cycle, 2007/2008, the PAC
  contributed to 144 candidates up for re-election,
  and 135 won.
• This gives the PAC an 94 success rate in
  congressional campaigns for the cycle.

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• Where do we stand?Physician Specialty
• PAC Receipts
• 2008 Cycle

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2008 Election Cycle Specialty Physician PAC
Rankings(Federal Receipts Only)
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Staying Informed

• Bulletin, Surgery News, NewsScope
• Advocacy in Action
• Special Alerts
• Webinars/ conference calls
• Web portal discussion forums

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Come to Washington, DC

• Joint Surgical Advocacy Conference Jointly
  sponsored with 18 other surgical groups (March
  2010)
• Opportunity to be educated on issues and meet
  with Senators, Reps and their staff
• SurgeonsPAC events
• Become Surgeon Advocates

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Contact Your Senator and RepresentativeFive
Minute Rule

• You have 2 Senators and 1 Representative
• Each has a legislative assistant for health care
• Spend 5 minutes each week and call one of them
• Offer to be a resource
• Provide them with information about what is going
  on in state, district and/or hospital
• Before you know it, they will be calling you for
  information!

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On the Horizon for ACS in Washington

• Work is underway to construct a new Washington
  office building
• Will serve as a House of Surgery
• Move in date June 2010
• Joint Surgical Advocacy Conference
• March 2010

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For more information

• Please contact
• Kristin McDonald
• kmcdonald_at_facs.org
• 202-672-1509