WASHINGTON — In a move that sparked some cautious optimism among home medical equipment stakeholders, President-elect Barack Obama last week named former Sen. Tom Daschle of South Dakota to head up the Department of Health and Human Services.
Daschle, the former Senate majority leader before losing his bid for re-election in 2004, served as Obama's campaign health care advisor and will also head a policy work group charged with developing health care proposals, according to the president-elect's transition team.
The announcement drew a sigh of relief from many in HME who view current HHS Secretary Michael O. Leavitt as a foe rather than a friend.
"I would say certainly he is going to be better than Leavitt," said John Gallagher, vice president of government relations for Waterloo, Iowa-based VGM Group, adding that Daschle is "a pretty sharp guy" who, during his tenure in office met with providers and knows "at least something" about the industry. "He's certainly not wedded to the concept of competitive bidding, and that will always be a plus to our industry."
Cara Bachenheimer, senior vice president of government relations for Elyria, Ohio-based Invacare, said recent discussions with Daschle were positive.
In September, Mal Mixon, Invacare chairman and CEO, met with Daschle.
"It was very encouraging, because there is clearly an appreciation for what home care can bring to the table—besides just cost, there is also quality," Bachenheimer said at the time, noting that Daschle was "very emphatic" about Obama's support of home health care.
American Association for Homecare officials described Daschle as likely to be a "big-picture secretary" and said he was familiar with HME issues. Meanwhile, the 23,000-member National Community Pharmacists Association lauded Daschle's appointment, saying he "embraced common-sense policies."
While Daschle will clearly hold some sway in what happens with health care, Gallagher cautioned that "it's not like he is going to be out in front, Mr. DME. He's going to be at 10,000 feet. We're at 100 feet. He's going to be looking at how to provide universal health coverage and working with the House and Senate on ramming that through very quickly. And that is not necessarily good for us."
With the pending 36-month oxygen rental cap, the 9.5 percent reimbursement reduction and competitive bidding still threatening the industry, Gallagher said it is imperative that providers talk to their legislators.
The new Congress will have until February to overturn any regulations from May 2008 that were made by the Bush administration—and that includes the oxygen rules and possibly some competitive bidding rules, according to AAHomecare. (See "Industry Girds for Battle over Oxygen Rules" in this issue.)
"We need to develop champions that are willing to stand up and say, 'This is bad policy, this is bad for the industry and it's bad for the beneficiary,'" said Gallagher.
He pointed to three committees that are likely to be instrumental in the health care reform package—the Senate Finance Committee chaired by Sen. Max Baucus, D-Mont., with Sen. Charles Grassley, R-Iowa, as ranking member, both of whom voiced strong approval for Daschle's appointment; the House Ways and Means Committee led by Rep. Fortney "Pete" Stark, D-Calif. (who earlier this year opened the door for the delay of competitive bidding); and the Senate Health, Education, Labor and Pensions Committee chaired by Sen. Ted Kennedy, D-Mass, who last week announced formation of three work groups to design health care legislation. (See "Kennedy Groups to Tackle Health Care Reform" in this issue.)
"Between now and when Congress reconvenes after the inauguration in January, we've got to meet with members of Congress so they can go back and at least talk to Daschle," Gallagher said. "That said, our focus is not so much on Daschle as it is on Baucus, Grassley and Stark—and the health panel that was formed by Kennedy."
Those committees, Gallagher said, are "going to be the driving force, and that's where our focus should be."
Another key player in the unfolding health care saga is likely to be California Democrat Rep. Henry Waxman, who last week unseated Rep. John Dingell, D-Mich., as chair of the House Energy and Commerce Committee. Waxman has already said the committee's agenda includes health care reform as well as environmental protection and a new energy policy.
There's no sign as to how Waxman will wield his newfound power with respect to HME. He's known as a strong supporter of universal health care, Gallagher said, "and I don't see him as being a big proponent of competitive bidding."
However, Gallagher said providers will need to seek out legislators who are near to Waxman to get the message through to him about HME.
There's another reason for providers to get aboard the political train, stakeholders said. The Democrats now have in their sights the 60 seats that would make the Senate filibuster-proof. The number of Democrats currently stands at 58, but two races are still up in the air: Georgia's race between incumbent Saxby Chambliss, a Republican, and Democrat challenger Jim Martin, which will be determined in a runoff election Dec. 2; and Minnesota's race between Republican incumbent Norm Coleman and Democratic challenger Al Franken. The latter is so close it is set for a hand recount, which is unlikely to be concluded much before the end of the year.
Whatever happens, providers must be politically active—and they must work together to present the industry message, Gallagher said.
"It's key for providers to work with state associations and other providers. You can't do it by yourself," Gallagher said. "If you get a meeting with your congressman, call everyone you know and get a large number in there. Find those providers who say, 'I'll talk to Grassley' or 'I'll talk to Stark' or 'I'll talk to Baucus.'"
The point is, he said, to create awareness and to make the industry's "very good argument" that it can be an integral, economically viable piece of health care legislation—but not with competitive bidding or slice-and-dice reimbursement.
View sample letters to members of Congress on VGM's Web site.
