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President's Column

Leadership Day 2000: a view of election year politics at work

From the July/August 2000 ACP-ASIM Observer, copyright © 2000 by the American College of Physicians-American Society of Internal Medicine.

At the College's annual Leadership Day this year, I got an inside look at the complex interaction of politics and health care in an election year.

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I have attended Leadership Day in prior years and have been involved in legislative issues at a state level. I am not exactly a newcomer when it comes to these types of events.

But this year's Leadership Day, which took place May 16-17, was a very different experience. With the presidential election less than six months away and health care issues looming large on the political landscape, legislators seemed more interested than ever in hearing about health care issues from physicians.

I have always felt welcome when visiting legislators, which I attribute to the College's impressive advocacy efforts on behalf of internists and their patients. In the prior years that I have participated in Leadership Day, for example, I have watched the College's stature among elected officials grow. Internists have learned their way around the lawmaking process, and many legislators and staff members remember and recognize us both as physicians and as representatives of the College.

Legislators tend to welcome College leaders because, as internists, we have a plethora of anecdotal evidence illustrating problems that legislators grapple with on a largely abstract level. We help legislators put a face on complex issues and bring those issues to life. Washington loves a story, and ours are true, real-life experiences forged in the crucible of America's health care system.

Critical issues

So what made this year's Leadership Day so different? One important difference was that, in face-to-face meetings with legislators, one could almost feel the tension between their desire to pass meaningful legislation that will help patients today and the desire to find issues that will help them and their colleagues win elections. The Democrats and Republicans are jockeying for position and trying to score political points with voters at home, and a number of key health care issues are at the heart of those efforts.

While we were visiting Capitol Hill, for example, legislators were wrangling over the fate of the patient's bill of rights legislation, which must clear some serious hurdles if it is going to be passed. Legislators were also working to determine the best way to add a much-needed prescription drug benefit to Medicare and to address patient safety in a way that will create a culture of care and safety, not fear. Even universal coverage was a major topic among the legislators.

With so many of the College's priority issues in the limelight, Leadership Day occurred at a critical time. As College leaders visited legislators, we tried to seize this opportune time to present our concerns and views.

During my time on Capitol Hill, I visited Rep. Charlie Norwood (R-Ga.), a dentist from Augusta who has sponsored the patient's bill of rights legislation; Sen. John McCain (R-Ariz.); and Rep. Louise Slaughter (D-N.Y.), chair of the Congressional Caucus on Women's Issues' Health Task Force.

Speaking with Dr. Norwood was a special pleasure. He clearly understands the plight of physicians and patients in a managed care system that at times elevates the financial interest of the payer over what is best for the patient. Fresh from his presidential primary campaign, Sen. McCain also offered his support for the patient's bill of rights. Rep. Slaughter was pleased and encouraged by the College's women's health initiative.

ACP–ASIM's reputation

Working with other internists to advocate for our patients against the backdrop of our Capitol is a patriotic, moving and exciting experience. The only downside is that after hearing such positive comments from elected officials, we still must face the reality that the political process takes time. Legislation too often seems to move at a snail's pace, despite the urgency with which we make our case to legislators.

Nevertheless, I am optimistic that our efforts will help resolve important health care issues. With each year's Leadership Day, the College continues to gain strength as the voice in Washington for internists and their patients. The College is now regarded as a respected and reliable source of information on health care.

Perhaps more importantly, we are known for putting our patients first, and this reputation makes a real difference in ensuring our views are heard. As some who make their living on Capitol Hill would say, the College definitely has the "big mo" (Hill speak for momentum) going for it.

Leadership Day is a rare and wonderful opportunity for College members to feel the excitement of advocating on behalf of our patients in a setting permeated with the rich history and traditions of our republic. Volunteer for Leadership Day next year and experience this special time firsthand! Our country needs the experiences and insight we internists can bring to Capitol Hill. (For more information, go to www.acponline.org/home/policy.htm.)

—Sandra Adamson Fryhofer, FACP

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