Message from the CMS President

Advocating on the Hill

YOUR CHICAGO Medical Society was back in Washington Feb. 12-14 to engage lawmakers in one-on-one conversations about physician priorities and the future of healthcare delivery. Our national Capitol Hill advocacy reinforces CMS’ year-round work with local governmental bodies.

Prior to our visit, I invited you, our members, to share with me specific concerns the CMS leadership should address on your behalf with Congress. My thanks to all who responded. The outpouring of feedback—from physicians of all ages and specialties and practice types, as well as students—helped us fine tune and focus our message. CMS came armed with fresh data, statistics and real-life examples.

Here is what you asked us to address: administrative burden and burnout; insurance preauthorization and narrowing of networks; prescription drug price gouging and PBM oversight; physician workforce and GME funding; higher payment for primary care and generalists; tort reform and defensive medicine; coverage for non-pharmacologic pain control; and mental healthcare funding.

Some of you said the time had come for single payer healthcare, or an expanded and improved Medicare-for-All. Poor reimbursement by Medicare and Medicaid always ranks near the top of your concerns. Members also cited low pay for cognitive knowledge and for medical doctors who take thorough histories and physical exams, and spend time counseling patients. Some of you said Medicare Advantage plans create confusion because they don’t always provide coverage identical to Medicare. Also, insurers engage in take-backs for patients seen one year ago because the doctor is “not in network.” You also pointed to problems with Medicaid Managed Care. These plans change often, forcing patients to switch. Yet patients often miss the letter informing them of changes or lack the ability to respond appropriately. Not a small logistical problem.

All your concerns above were folded into our packed Washington agenda. Prior to meeting with lawmakers, we always plan and establish clear goals. Our team strives to engage personally with each member of the Cook County Congressional Delegation, as well as Illinois’ own U.S. Senators Durbin and Duckworth. We also allot time to renew our relationships with influential legislators from other states, such as our colleagues in the Congressional Doctors Caucus.

Old-fashioned one-on-one advocacy, where you shake a lawmaker’s hand and look them in the eye, is critical to advancing physicians’ priorities. Given legislators’ busy schedules and competing interests, we physicians must make our message clearly, simply and early. Legislators want to hear how issues impact patients, their constituents. They also listen more attentively when physicians present a solid, unified front.

With attempts to repeal the Affordable Care Act behind us, the coming year promises more turbulence. How will elected leaders restore stability to the individual insurance market, balance safety net and public health funding with a massive tax cut? On the bright side, Congress and the Administration appear open to easing the administrative and regulatory burden on physicians, thanks to our advocacy.

Whatever direction and shape federal healthcare reform ultimately takes, physicians must be at the vanguard, not in the rear, or left behind. We are facing a defining moment in our nation’s history, and we must speak up for our patients and our profession.

Vemuri S. Murthy, MD
President, Chicago Medical Society