Very few of us are immune to the changes taking place in the American health care system today. To name a few, the strains in Medicare, the movement to pay-for-performance, and the tightening of federal funding will touch nearly all of us in one way or another. There are dangers and opportunities in all of these changes. What comes out of them depends very much on how involved we—and you—are.
IDSA is opposing the losses in funding—either through cuts or inflation—contained in President Bush’s 2009 budget proposal for the National Institutes of Health (NIH) and the Centers for Disease Control and Prevention (CDC). CDC is looking at a cut of nearly half a billion dollars, while flat funding at NIH has already eroded 13 percent of its budget since 2003.
More junior researchers are rethinking careers in biomedical research or shying away from really innovative research that’s considered too risky to be funded . With federal funding increasingly hard to come by, our academician colleagues are becoming more familiar with billing and coding for third-party payers in order to help keep their departmental budgets in the black.
Meanwhile, bad news about one of the most important third-party payers, Medicare, continues to pile up. For the second year running, the federal government’s Medicare Trustees issued an official warning in March about the program’s shaky finances. As a result, the president is again legally obligated to propose ways to control spending and Congress is required to consider them “expeditiously.” Last year the proposals made no progress, however.
Also in March, the Medicare Payment Advisory Commission (MedPAC) voiced criticism of the series of physician payment cuts Medicare projects for the next several years. MedPAC’s report echoed IDSA’s long-held position that beneficiaries’ access to care ultimately will suffer. The threat of another payment cut looms this summer.
At the same time as funding is drying up, greater responsibility is falling on infectious diseases specialist to help contain costs. Facilities are coming under increasing pressure from both public and private insurers to reduce costly and preventable health care-acquired infections (HAIs), even as resistant organisms make it ever harder to do so. For the good of our patients, we wholeheartedly support the goal of reducing HAIs and many other pay-for-performance initiatives. Medicare in particular must change to value quality of care over quantity. But policies must be driven by science.
Promoting science-based policy is one of IDSA’S core missions. This issue of IDSA News reports on the Society’s success convincing Medicare to change a policy that increased the risk of catheter-associated infections.
IDSA also is gaining support in Congress for the Strategies to Address Antimicrobial Resistance (STAAR) Act, important legislation that aims to improve the federal government’s response to the growing epidemic of antimicrobial-resistant infections that we face every day.
IDSA is dedicated to fighting bad bugs and fighting bad policy—but the Society is only as strong as its members. It’s surprisingly easy for you to make a difference, and the Society is eager to help. I was fortunate enough to meet Sen. John Warner (R-VA) recently, and I took the opportunity to share with him the Society’s support for the STAAR Act. IDSA staff provided important background materials to give him. I am proud to say Sen. Warner is now a co-sponsor of the STAAR Act.
Other members have had an impact, too. Andrew Pavia, MD, FIDSA, was instrumental in winning the support of one of the original STAAR Act sponsors, Rep. Jim Matheson (D-UT). Board member Jan Patterson, MD, FIDSA and other state ID society presidents have also worked with IDSA staff to secure additional support for the bill. Several IDSA members have played key roles in policy-making at the state level on the issues of Lyme disease and the use of thimerosal in vaccines.
This issue of IDSA News reports another successful effort by IDSA and several of its key members: The Food and Drug Administration has raised the breakpoints for penicillin in the treatment of community acquired pneumonia.
These efforts demonstrate what can be done when the Society and its members work together on important issues. You have a role to play. IDSA is looking for members who can serve as key contacts with members of the U.S. Congress as well as your state legislatures. As a key contact, you would work with IDSA policy staff to engage federal policymakers on Capitol Hill. If you already have a relationship with a U.S. senator or representative from your state, your help could be invaluable. The Society will soon launch a survey to identify those members with these key connections who would like to serve an advocacy role. However, you can volunteer immediately by contacting IDSA Government Relations Associate Michael Ochs at firstname.lastname@example.org.
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