Moving the HME Industry Forward

Legislative/Advocacy

We’ve Got the Best Government Money Can Buy

December 15, 2014

BIRMINGHAM, AL – Speculate with taxpayer-insured funds? Sure, why not. Donate ten times as much as before? Of course; someone has to pay for those elaborate conventions, recounts, and stuff like that.

But it’s bi-partisan AND bi-cameral—isn’t that what you wanted? Compromise? Cooperation? And you have seen the announcement about the new bidding time line, which is still mostly target dates, nothing firm.

Since my first lobbying visit to Washington, D.C., in 1975, to the last one this spring, two things have never changed: politicians want credit for benefits provided to voters without taxing their donors to pay for them, and the bureaucrats who manage the Medicare program, can’t. That’s why it is so very important for our industry to understand and practice the limited ability we have to influence legislation.

We will never have the funds required to compete with donations, so we must be better at building relationships with legislators. Our national association has the best team ever, doing more with less, and becoming the source for both legislators and bureaucrats who want or need information about our industry.

We have a larger group of well-equipped local associations, doing a better job than ever before, both in building relationships and producing the vital grass roots activity that at least gives legislators a strong indication that we can influence a large number of voters.

If you are among those providers who are active members of both national and local associations, whose names are known to your Representative and both Senators, good for you! Keep doing what you are doing, only more of it. In addition, make it a regular part of your business to get to know others in our industry, both peers and vendors, and invite them to become part of the community.

Local associations should do more to promote membership in AAHomecare; encourage yours to do so. Reward the vendors who support the industry, and let others know that you do so. Don’t be afraid of teaming up with your competitors to fight a common enemy (if that’s not too strong a word).

The ideal size and composition for a visit to a legislator when they are at home is three to five providers who are clearly competitors. Legislators and their staff are much more likely to believe you are providing accurate information if competitors all want the same thing. Get together before your visit and agree on who will address which topic(s). Use the excellent materials provided by AAHomecare and others to make your case, so we are all working on the same goal. Above all, always tell the truth.

Legislators are not likely to believe the sky is falling every time the Medicare program is altered, but surely we can do better at getting referral sources and beneficiaries to report their “horror” stories, preferably without whining. They should emphasize the avoidable costs that are incurred when the most cost-effective benefit is not readily available.

As a provider before Medicare existed, and now as a Medicare beneficiary, I am convinced that, specifically planned or not, the predictable result of the current course is reversal of the relationship between program payments and out-of-pocket expenses. Users pay 80% and the program will cover 20%. Of course we can survive without Medicare, but please do not ignore the enormous impact that Medicare program changes have on other payers and expectations.

We are, and should fight to remain, a service industry, not a commodity provider, and it’s going to take a lot more effort to preserve that position. Please increase your efforts to get more industry members to join in the fight. Numbers count, and when you can’t make huge campaign contributions, relationships and voter influence are the only effective weapons in your arsenal. Use them!

Michael Hamilton is executive director of the Alabama Durable Medical Equipment Association.