“We have met the enemy, and he is us.”
— Pogo, 1971
Earlier this month, Invacare CEO Mal Mixon reminded a bunch of us press folk of this famous quote from Walt Kelly's legendary comic strip “Pogo.” But Mixon wasn't talking about the goings-on in Georgia's Okefenokee Swamp, where the cartoon possum lived. He was talking about the HME industry and its divide over oxygen reform, and that's not a subject for the funny papers.
With health care reform at the top of the agenda when Congress returns to work in September, virtually every other health sector with any kind of stake is revving up the noise, just like this industry.
The difference, Mixon said, is that other groups — such as hospitals, doctors and pharmacies with powerful, well-funded lobbies — are all on the same message. HME proponents are not, airing their differences over reform of Medicare's oxygen benefit in full view of the nation's lawmakers.
The irony is the industry now has a perfect platform at the right time, Mixon said. Home care is the “trifecta of health care,” a message he took to the White House at a roundtable discussion on health reform: It's patient-preferred, has better clinical outcomes and — drum roll, please — it saves money versus institutional care. A lot of money.
“We're finally getting the story of home care out,” Mixon said, pointing to President Obama's mention of home care at a town hall meeting in Shaker Heights, Ohio, in July. (Check “Notable & Quotable” on page 8.)
At issue is H.R. 3220. Introduced by former HME owner Rep. Mike Ross, D-Ark., the bill would make sweeping changes to the oxygen benefit, including moving from “supplier” to “provider” status and requiring cost-reporting measures. Opponents, including NAIMES and CSI:HME, say the proposal is too complicated, too burdensome for small providers and perhaps too much to tackle right now; supporters, including AAHomecare, say it's the only way the industry will ever break the cycle of year-after-year cuts to oxygen.
One of the things I admire most about this industry is the commitment of the providers in it, those whose unflagging care for their patients makes it possible for the nation's seniors and people with disabilities to remain in their homes and live as they wish. Staying profitable in order to keep providing that service takes owners who are willing to go to the mat to do what they think is best for their businesses.
There are numbers of those passionate providers on either side of the oxygen issue. They've got strong opinions, and they believe their solutions are best. It will take even more strength to come to terms on what's best for all.
At press time, there were signs of progress in closing the gap, and both sides seemed willing to keep working at consensus. That's another thing I admire about providers: They will always go the extra mile to get the job done. And that's good, because it's going to take a loud voice — one united HME industry voice — to be heard above the din for any sort of oxygen reform to become part of the nation's health reform plan.
I'm not sure whether this is one of those “teachable moments,” as the president called his recent gathering over beer at a picnic table outside the White House. But the oxygen debate has been tough, so maybe those involved could use a cool one. With all the legislative and regulatory challenges brewing, maybe we all could.
