What do our representatives in Washington think of the battles over health care now raging in our nation's capital? In mid-September, several congressmen involved in these issues took time from the House floor to speak at the Legislative Conference hosted by the National Association for Medical Equipment Services. They shared what they perceive to be the key problems facing the home medical equipment industry, and gave the audience some practical lobbying advice. Below are some highlights from three presentations.

Rep. Charles Rangel, D-N.Y. a member of the House Ways and Means Committee

"When you say health care, you have some of the same problems as politicians, as far as reputation goes," Rangel said. "You have to undo the bad name of fraud and abuse, even though you have gone a long way toward making it abundantly clear that what you're about is providing products and personal service that patients can depend on at anytime.

"I know unfair shots have been taken against you. I know your feelings about the Florida competitive bidding [demonstration project] and its possible expansion," he continued. "But [members of] the Commerce Committee and the Ways and Means Committee believe it's working.

"The only way to get their attention is to talk not about your costs but about if there's denial of access to care. Patient access to care is the key-that and quality of service. Your presentation is key. And people in Congress would rather hear from constituents. Were they denied equipment? Were they institutionalized? Do they have access to service 24/7?

"I'm sympathetic and want to help," Rangel concluded, "but you have to give me something to work with. What impresses me and other members of Congress if we have no numbers is, 'How does this impact patients-our constituents? What is being denied them?' What would grab my attention is some kind of report on how people are not getting services."

Rep. Sherrod Brown, D-Ohio a member of the House Ways and Means Committee and the House

Commerce Committee's Subcommittee on Health and Environment

"Looking at the prospects overall for getting Medicare reform, I suggest you stay in touch locally," Brown advised. "Get Congress people into your place of business. These issues are extraordinarily complex, so it's important that you patiently sit down and explain.

"Earlier this year, I thought there would not be real discussion of the [Balanced Budget Act of 1997]. But people are working on introducing Medicare reform bills. There has also been a massive lobbying effort by hospitals, skilled nursing facilities and home health agencies.

"But the most difficult aspect of this is that we don't have enough facts," Brown said. "We may have cut more than we meant to, but that doesn't tell us about what we should pay. So in your lobbying blitz, you must keep your eye on the short term and the long term-especially when you're talking about tinkering with Medicare."

Rep. Ben Cardin, D-Md. a member of the House Ways and Means Committee

"You have gotten people out of the hospital and living at home-at less cost to people and the government," Cardin said. "But reimbursement costs are going up because of this, and you're being penalized. You've never gotten credit that this is a service industry, not just an equipment industry.

"We need a BBA fix passed by Congress this year because it's hurting constituents-and because we can afford to do it," Cardin declared. "We made a mistake in '97 and need to help not just equipment providers but also skilled nursing facilities, RTs and outpatient services.

"And you play a pivotal role in this. You put faces on the statistics. We talk numbers on the Hill, and we need you to tell us about the people, how they're being affected by what we do inside the Beltway."