DO Day on the HillInformation Session

Wed. April 6Wed. April 6thth

5pm5pm

Ginsburg AuditoriumGinsburg Auditorium

What is your role at DO Day on the Hill? You will be in a group of 20 You will be in a group of 20

physicians/students from your voting physicians/students from your voting districtdistrict

AOA has set up appointments to meet with AOA has set up appointments to meet with 2 Senators and 1 Representative 2 Senators and 1 Representative (as available) (as available)

You will be “lobbying” for the 3 issues that You will be “lobbying” for the 3 issues that the AOA has chosen and supportsthe AOA has chosen and supports

Why are you here today?

To become more familiar with these 3 To become more familiar with these 3 issuesissues

Find out what YOU should do to prepare Find out what YOU should do to prepare yourself (..who are your representatives?? yourself (..who are your representatives?? How did they vote on those issues??)How did they vote on those issues??)

To be come a more affective lobbyist To be come a more affective lobbyist

The 3 Major Issues

1.1. Medical Liability Reform (HEALTH Medical Liability Reform (HEALTH ACT)ACT)

2.2. Higher Education ActHigher Education Act

3.3. Medicare Physician PaymentsMedicare Physician Payments

I. Medical Liability Reform

Top legislative priority of AOATop legislative priority of AOA What’s the Problem? What’s the Problem?

Increasing liability costs are Increasing liability costs are pushing physicians out of certain pushing physicians out of certain specialties and geographical locationsspecialties and geographical locations

Physicians are practicing “defensive Physicians are practicing “defensive medicine” due to fear of lawsuitsmedicine” due to fear of lawsuits

Medical Liability Reform

Patients are suffering too!!!! Patients are suffering too!!!! due to loss of due to loss of access to essential health care services (ex. access to essential health care services (ex. OB/GYN and Neurosurgery)OB/GYN and Neurosurgery)

The The HEALTH ACT (Help, Efficient, Accesible, HEALTH ACT (Help, Efficient, Accesible, Low Cost Timely, Health Care Act)Low Cost Timely, Health Care Act) of 2003 of 2003 passed in the House of Representatives, but has passed in the House of Representatives, but has failed to do so in the Senate.failed to do so in the Senate.

You can help lobby Congress to pass this You can help lobby Congress to pass this important act!!important act!!

Medical Liability Reform AOA’s 6 ProvisionsAOA’s 6 Provisions::1.1. Limitations on Non-Economic DamagesLimitations on Non-Economic Damages2.2. Joint and Several Liability ReformsJoint and Several Liability Reforms3.3. Collateral Source ReformCollateral Source Reform4.4. Establish Uniform Statues of LimitationsEstablish Uniform Statues of Limitations5.5. Periodic Repayment of Future Expenses Periodic Repayment of Future Expenses

or Lossesor Losses6.6. Limitations on Attorney FeesLimitations on Attorney Fees

II. Higher Education Act

(HEA) Higher Education Act(HEA) Higher Education Act of 1965, of 1965, expired in 2003, and was reinstated in 2004 expired in 2003, and was reinstated in 2004 with some provisions.with some provisions.

Goal of HEA is to make medical education Goal of HEA is to make medical education more affordable for EVERYONEmore affordable for EVERYONE

This includes: loans, interest rates, This includes: loans, interest rates, repayment etc.repayment etc.

Higher Education Act

How does this affect you ?How does this affect you ? Osteopathic medical students graduate with $128,000 Osteopathic medical students graduate with $128,000

in debt (HIGHEST of ALL health professions!!!!)in debt (HIGHEST of ALL health professions!!!!) >60% become family practitioners (“soul” of the >60% become family practitioners (“soul” of the

osteopathic profession)osteopathic profession) Due to financial pressures, many medical students Due to financial pressures, many medical students

pursue medical specialties, with a higher earning pursue medical specialties, with a higher earning potential.potential.

This is not helping the national “shortage of family This is not helping the national “shortage of family physicians.”physicians.”

Higher Education Act

Title Title IV of HEAIV of HEA was added in Oct. 2004 was added in Oct. 2004 It included (Stafford loan increase limit It included (Stafford loan increase limit

from $10,000 to $12,000; allowed for from $10,000 to $12,000; allowed for moving of all loans to a variable rate, moving of all loans to a variable rate, eliminating the “single holder rule” and eliminating the “single holder rule” and reducing fees from 3% to 1%reducing fees from 3% to 1%

Higher Education Act

““Higher Education Affordability and Equity Higher Education Affordability and Equity Act” (HEAEA)Act” (HEAEA) was passed in March 2005 was passed in March 2005

Current Provisions of the HEAEACurrent Provisions of the HEAEA Student loan interest deductionStudent loan interest deduction Higher Education ExpensesHigher Education Expenses Room and Board Tax TreatmentRoom and Board Tax Treatment Hope Scholarship Tax CreditHope Scholarship Tax Credit And Others…..And Others…..

III. Medicare Physician Payments

Enacted in 1965, with the goal to ensure Enacted in 1965, with the goal to ensure health care services to millions of health care services to millions of AmericansAmericans

40 million Americans currently depend on 40 million Americans currently depend on the system, but as the population “ages,” the the system, but as the population “ages,” the system has become STRAINEDsystem has become STRAINED

Medicare Physician Payments

How are physicians affected?How are physicians affected? Reimbursements for physicians have Reimbursements for physicians have

continuously decreased over the years (in continuously decreased over the years (in 2002 decreased by 5.4%)2002 decreased by 5.4%)

Looking to the future?Looking to the future? According to the “Medicare Trustee According to the “Medicare Trustee

Report” we face reductions of at least Report” we face reductions of at least 5%/yr from 2006 through 2012.5%/yr from 2006 through 2012.

Medicare Physician Payments

Although Congress in 2004 and 2005, with the Although Congress in 2004 and 2005, with the MMA (Medicare, Prescription Drug MMA (Medicare, Prescription Drug Improvement and Modernization Act)Improvement and Modernization Act) slightly slightly increased physician payment rates, MORE reform increased physician payment rates, MORE reform is needed.is needed.

As more medicare services (ex. Preventative As more medicare services (ex. Preventative medicine) are being provided, physicians are medicine) are being provided, physicians are being financially penalized by the system.being financially penalized by the system.

This needs to STOP!!! This needs to STOP!!!

What should you do before the Day?

Find out who are your representatives and Find out who are your representatives and senators?senators?

www.capwiz.com/aoa-aoiawww.capwiz.com/aoa-aoia ***MAKE SURE YOU GO ON THIS******MAKE SURE YOU GO ON THIS*** Tells you how they voted on “our” issuesTells you how they voted on “our” issues Do your own research on these topics!!!Do your own research on these topics!!!

read agenda e-mailed to you last week…lots of read agenda e-mailed to you last week…lots of great links to learn more about the issues and your great links to learn more about the issues and your representatives.representatives.

What should you do before the Day?

Check to see if your member of Congress is on one of Check to see if your member of Congress is on one of these 4 Committees:these 4 Committees: Senate Health, Education, Labor and Pensions Senate Health, Education, Labor and Pensions

Committee JurisdictionCommittee Jurisdiction Senate Finance Committee JurisdictionSenate Finance Committee Jurisdiction House Committee on Energy and Commerce House Committee on Energy and Commerce

JurisdictionJurisdiction House Committee on Ways and Means JurisdictionHouse Committee on Ways and Means Jurisdiction http://www.gpoaccess.gov/cprints/http://www.gpoaccess.gov/cprints/ (check this or other (check this or other

similar links to find out)similar links to find out)

What should you do before the day?

Learn about the Process.Learn about the Process.How a law is made: How a law is made:

http://thomas.loc.gov/home/lawsmade.thttp://thomas.loc.gov/home/lawsmade.toc.htmloc.html

Enactment of a law:Enactment of a law:

http://thomas.loc.gov/home/enactment/ehttp://thomas.loc.gov/home/enactment/enactlawtoc.htmlnactlawtoc.html

The Do’s and Don’ts of Meeting with a Member of Congress/Staff Do’sDo’s

Be polite and personableBe polite and personable Stay focusedStay focused Be ready to answer questions on your Be ready to answer questions on your

issueissue Use anecdotal situations to support your Use anecdotal situations to support your

issueissue Leave packet with every officeLeave packet with every office

The Do’s and Don’ts of Meeting with a Member of Congress/Staff Don’tsDon’ts

Don’t misinform. Don’t be afraid to say I don’t Don’t misinform. Don’t be afraid to say I don’t know. If you are asked a question and you are know. If you are asked a question and you are unsure, take note of the question and give the unsure, take note of the question and give the info to an AOA staff memberinfo to an AOA staff member

Don’t argue or antagonizeDon’t argue or antagonize Don’t steer away from the issuesDon’t steer away from the issues Don’t be offended by inconvenienceDon’t be offended by inconvenience

Words of Advice: Issues:Issues: Be brief. Don’t let the representative or staffer side-track Be brief. Don’t let the representative or staffer side-track

the meeting. the meeting. Be prepared when you arrive. Know what you are going to Be prepared when you arrive. Know what you are going to

say. say. Present your opinion, bolstered by facts, figures and a Present your opinion, bolstered by facts, figures and a

PERSONAL STORY. PERSONAL STORY. Know and understand opposing arguments. Be prepared to Know and understand opposing arguments. Be prepared to

discuss themdiscuss them Gently remind your representative that you’re a constituent Gently remind your representative that you’re a constituent

and that you always vote. All politics is local. and that you always vote. All politics is local. Be passionate (not emotional), and never leave in anger. Be passionate (not emotional), and never leave in anger.

Words of Advice:

ClosingClosing Leave when your time is up. Leave when your time is up. Ask for a commitment from the member to Ask for a commitment from the member to

support your position-but do not apply support your position-but do not apply pressure or be threatening. pressure or be threatening.

After every contact with a legislator, be sure After every contact with a legislator, be sure to say the magic words -- THANK YOU.to say the magic words -- THANK YOU.

Words of Advice

Choose a leader! This person is responsible for Choose a leader! This person is responsible for facilitating the meeting and will introduce the facilitating the meeting and will introduce the group.group.

It’s important to establish a “relationship” between It’s important to establish a “relationship” between the 3 parties: the staff member (let’s call him the 3 parties: the staff member (let’s call him “John”), the leader, and the group.“John”), the leader, and the group.

Don’t be afraid to step up and take the leader Don’t be afraid to step up and take the leader position.position.

Step 1: Introduction

Thank the staff member (“John”) for his Thank the staff member (“John”) for his time!time! Who we are?Who we are? Who are you?Who are you? Can we introduce ourselves?Can we introduce ourselves?

–Home, school, political activity..Home, school, political activity.. What is John’s reaction?What is John’s reaction?

Step 2: Hopes for the Session

The Leader must establish with “John” what The Leader must establish with “John” what he or she hopes to receive from session.he or she hopes to receive from session. How much time do we have?How much time do we have? John, how much do you know about John, how much do you know about

these issues?these issues? John, What are your goals from this John, What are your goals from this

session?session?

Step 2: Hopes for the Session

John…These are our HOPES for this John…These are our HOPES for this session..session.. 1.offer prospective from med school 1.offer prospective from med school

student, future physician, on these issuesstudent, future physician, on these issues 2.tell you our concerns2.tell you our concerns 3.tell you why these issues are important 3.tell you why these issues are important

to us and to the “voting” constituency to us and to the “voting” constituency back in our home states.back in our home states.

Step 3: Discuss the Issues

Is John ready to listen?Is John ready to listen? Ask John, “Is it OK if I start here?”Ask John, “Is it OK if I start here?” Clarify the situation and continuously Clarify the situation and continuously

“CONTRACT” with John what you as a “CONTRACT” with John what you as a group will be discussing.group will be discussing.

Ask John, if the Senator would like or is Ask John, if the Senator would like or is available to meet with us, as we are available to meet with us, as we are discussing these issues.discussing these issues.

Step 4: Closing

At 5 Minutes to the end, the Leader must At 5 Minutes to the end, the Leader must inform John that “our meeting ends in 5 inform John that “our meeting ends in 5 minutes, but we can continue our minutes, but we can continue our conversation if you would like.”conversation if you would like.”

At the end: Remember to always THANK At the end: Remember to always THANK “John” and don’t forget to leave the “Hill “John” and don’t forget to leave the “Hill Packet” with him.Packet” with him.

Consider leaving a small gift with the officeConsider leaving a small gift with the office

Thanks for your time!!!!

Look for an e-mail with a complete list of Look for an e-mail with a complete list of links of the web-sites mentioned.links of the web-sites mentioned.

E-mail me if you have any problems finding E-mail me if you have any problems finding the necessary information on these topics.the necessary information on these topics.