Colorado Medical Society

http://dev.cms.org/articles/the-final-word-david-ross/

The final word: In politics, not knowing your right from left is a good thing

Saturday, September 01, 2012 01:42 PM

David Ross, DO, Chair
Colorado Medical Political Action Committee

While none of us were trained as political activists in medical school or residency, and for many of us it’s probably not even in our DNA, one need look no further than our almost annual clashes with the trial lawyers or the SGR debacle to embrace the political engagement imperative. Politicians are making calls that impact our patients and practices in a tribalized partisan environment. Otherwise thoughtful public officials can face the unrelenting demands of party leaders and major donors. Absent our presence in the political arena others have, and will continue to, take up our slack.

The rules of engagement require us to have working, sustainable relationships with the public officials on both sides of the aisle who are responsible for setting the course of health policy. Adhering to this rule is an imperative during this time of rapid transformation and upheaval in our profession.

At CMS we, like other medical societies, struggle with political crosscurrents that sharply diverge between the more traditional conservative policy options, such as medical liability, and the decidedly center-left polices that drive health care spending, like Medicaid reimbursement, coverage and eligibility. The basis of medicine’s support of a candidate or incumbent takes into careful consideration the balance of those views –respecting their constitutional duty to make choices that can’t possibly please every constituency or interest group. Whatever our personal beliefs, COMPAC simply does not have the luxury of accommodating all of our individual views in determining CMS’ political course if we want to achieve “the art of the possible,” as past CMS president Lynn Parry, MD, puts it.

Physician advocacy in the public policy space requires a level of pragmatism and partisan agnostics that will make some of us uncomfortable on any given position. This is because our policy agenda spans such a wide range of issues, from liability reform one day, to Medicaid reimbursement the next.

When I meet with national and state legislators, I am sometimes asked why CMS’ official policy may differ from that politician’s view on an issue. I always preface my reply by stating that CMS is a politically pragmatic organization that advocates for what works in the real world of medicine. This has less to do with doctrine and more to do with the pursuit of evidence-based policies. We know from experience as clinicians, the conventional scientific wisdom will evolve and require revision – and it has to be that way.

But that certainly doesn’t mean we don’t listen to the political views of our members. They are vitally important. Based directly on our members’ local review and recommendations, we have defended our legislative champions not just at election time but also from those in their own party in their primaries. And, when we have encountered legislators whose views are sufficiently and unrelentingly anti-physician, right or left, we have staunchly opposed them. We have taken these positions regardless of payback risk or our prospects of winning.

The choices COMPAC makes to support, or oppose, are home grown and locally-owned by our participating members and drawn from the legislator’s voting and non-voting record – actual or anticipated. There are no wrong choices, merely consequences for each fight we pick, or avoid. We look for a pattern of support for medicine and patients – right and left. Our choices are never drawn from a purely partisan or ideological well.

Whether you want to participate individually or join our movement, there is a graduated scale of political activism:

1. Join our movement financially. A modest contribution to COMPAC and the special Small Donor Committee are funds we tailor for specific candidate needs. They are vital to the success of our friends at the ballot box.
2. Join your local “Breakfast Club” by contacting CMS. You will be surprised how much more you have in common with your area legislators, well beyond being carbon-based organisms.
3. Host or co-host local support events for the legislator of your choice (even if we haven’t taken sides). Receptions, coffees, block walks, mini internships, and all the varied means of engaging your legislator/candidate in the face-to-face interactions during the election season strengthen those relationships and the mutual understanding that follows.

At COMPAC, your perspective and participation are critical to us. Thanks for all that you do and be sure to vote in the 2012 general election.