In a recent New York Times article, health writer Jane Brody wrote, “Perhaps the most frightening symptom one can experience is being unable to inhale enough air to perform even the simplest activities, like walking from the bedroom to the bathroom or even talking. But that is the ultimate fate of millions of Americans with chronic obstructive pulmonary disease.”
Added to the personal suffering are enormous health care and financial consequences of COPD, which are summarized in an American Association for Homecare white paper on the disease. The direct medical costs in the United States total $18 billion annually.
Thankfully, Sen. Michael Crapo (R-Idaho) has launched the Congressional COPD Caucus to advocate policies that encourage prevention and detection of the disease. Co-chairs of the caucus are Sen. Blanche Lincoln (D-Ark.) and Reps. John Lewis (D-Ga.) and Cliff Stearns (R-Fla.).
In announcing the new caucus, for which AAHomecare is a partner organization, Crapo said the group is “a necessary first step” to tackle this expanding health care crisis. Crapo said that as co-chair of the Congressional Heart and Stroke Coalition, co-chair of the Task Force on Telehealth and as a member of the Medical Technology Caucus, “I've witnessed first-hand the good things that can come out of these groups.”
The senator spoke about the disease at AAHomecare's annual Washington Legislative Conference last month. He urged the more than 200 conference participants to encourage other senators and representatives to join the COPD Caucus — good advice that we should all heed.
Putting COPD in perspective, he said, “While the age-adjusted death rate from coronary heart disease, stroke and other cardiovascular diseases has fallen dramatically from 1965 to 1998-59 percent, 64 percent and 35 percent, respectively — COPD's death rate has risen 163 percent. One integral part of treating COPD and preventing acute episodes is, of course, COPD home care, particularly pulmonary and respiratory therapy.”
As an AAHomecare white paper on the disease shows, home care is the lowest-cost alternative as well as the most effective option for controlling the rising cost of treating COPD. Clinical studies have demonstrated a reduction in expensive, short-stay hospitalizations following the start of long-term oxygen therapy (LTOT). Despite the rise in incidence of COPD and growing use of home care services by patients, the percentage of total health care dollars spent on long-term oxygen therapy and DME has declined or remained consistent since the early 1960s.
Yet, there is continuing pressure to cut payments further for DME and long-term oxygen therapy. As a result of the Medicare Modernization Act (MMA), oxygen is again a target for payment reduction. Of course, wholesale payment reductions for LTOT is a short-sighted, short-term solution that will ultimately drive up costs by shifting from low-cost, effective care for patients who reside at home to high-cost, acute-care environments.
Let's spread this message to members of Congress. When you ask your senators to join the caucus, mention that their staffs can contact Elizabeth MacDonald in Sen. Lincoln's office or Barrett Thornhill in Sen. Crapo's office. On the House side, they can contact Tammy Boyd in Rep. John Lewis' office or Lauren Smith in Rep. Cliff Stearns' office.
While you are contacting members of Congress, remind them to cosponsor the bill that would repeal the oxygen price cuts, H.R. 4491, recently introduced by Rep. David Hobson (R-Ohio) and Rep. Harold Ford, Jr. (D-Tenn.). The Hobson-Ford bill would repeal cuts in Medicare reimbursement for oxygen, wheelchairs, nebulizers, diabetic supplies, beds and air mattresses.
Kay Cox is president and CEO of the American Association for Homecare, Alexandria, Va. For more information about AAHomecare, visit www.aahomecare.org, or call 703/836-6263.
