AGA Washington Insider

A policy blog for GIs

Guest Blogger Shares Insights from Day on Capitol Hill

The timing of the AGA Trainee and Young GI Advocacy Day could not have been better. Our trip to DC coincided with 400 internists descending on the U.S. Capitol, along with numerous other representatives of health-care provider organizations, all concerned about the dysfunctional Medicare physician reimbursement system based on the flawed sustainable growth rate formula (SGR), which the final version of the health reform bill did not fix.

I walked over to the congressional office buildings from our hotel with eight other gastroenterologists. I had been to Washington before, but the site of the U.S. Capitol never stops being exciting. Inside the Russell building, it seemed as though there were hundreds of 20-somethings in dark suits, moving very fast, probably because they are busy running the country. Sometimes they would bump into each other around corners; I couldn’t hear what they were saying, but took the liberty of inserting clever lines from the West Wing and the American President.

My first meeting was with Lynn Marm, who works for my newly-elected Senator, Scott Brown, R, from Massachusetts. I shared with her that the constant fear of reimbursement cuts makes it difficult for small group practices, such as the one I work in, to plan for the future. I knew Sen. Brown to be a supporter of small businesses, so I pointed out that private physician offices were, in fact, small businesses that, nationwide, are struggling to maintain their overhead in the face of rising costs and decreasing reimbursements. She assured me that the Senator understood that the SGR had many flaws, but stated that the rising cost of health-care was an important concern. I agreed that the cost of fixing Medicare reimbursement seems daunting, but also pointed out that the cost of not repealing the SGR was probably higher in the long run. Pressures produced by the flawed Medicare payment system are leading to the closing of private physician offices and free-standing medical and surgical centers, shifting care to more expensive larger centers. She wrote down my comments and stated that she wanted to look into this issue further. She spent much more time with me than I expected, despite the fact that she had a lobby full of people waiting for her. I left her my contact information as requested, and hoped that this meeting would help build a relationship between Senator Brown’s office and the AGA.

My next meeting was with Heather Gasper in Rep. Michael Capuano’s, D-MA, office. Heather was very familiar with the SGR issue, as Rep. Capuano has always been extremely supportive of reforming the Medicare physician payment formula. He voted in favor of HR 3961 which, if it had passed in the Senate, would have repealed the SGR and transitioned physicians to a new payment system. This meeting was short as I mostly wanted to thank the Congressman for his support of health care as well as his support of NIH funding over the years. We spent some time discussing a proposal for an increase in funding for a CDC program to improve compliance with colorectal cancer screening in underserved areas, a program Massachusetts participates in and benefits from. I told Heather that, in my opinion, death from colon cancer was nearly 100 percent preventable with proper access to and compliance with health care. Finally, I conveyed my thanks for the Congressman’s local support of Cambridge Hospital, a public hospital where my husband works and one that serves so many of the Boston area’s poor and minority patients.

The last time I went to Capitol Hill to lobby, it had not been a year past 9/11 and it was difficult to draw attention to health-care issues. This was not the case this year. It seemed that even people in the elevators or stalled in security were talking about health care. The staffers I spoke with were eager for the input of practicing physicians, a group that is heard from infrequently in policy arenas. I found the experience rewarding and look forward to returning to the Hill and to following up with the district offices.

The day ended with lunch in the beautiful Senate Dining Hall with Tim Yehl of Hart Health Strategies and Dan Katz, chief of staff to Sen. Frank Lautenberg, D-NJ. Listening to Tim and Dan tell stories from their years of experience on the Hill was the highlight of the trip for this West Wing junkie!

Most importantly, I wanted to extend a heartfelt thanks to Mike Roberts, Lauren DePutter and Kathleen Teixeira of the AGA who met with us until 10 p.m. (!) the night we went to Capitol Hill, making sure we understood the issues and were prepared for our meetings. They were so energetic and enthusiastic; you really couldn’t tell they were probably sleep-deprived from just having helped run DDW weeks before. The day ran smoothly and flawlessly thanks to their hard work and impeccable attention to detail. Speaking with the other attendees, we all felt like we learned a tremendous amount in a short period of time and felt grateful for the opportunity to have an impact on the future of our profession.


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  5. Thanks so much for sharing the story… I have known Kat from the other side of the world for a long time now and it has been a few years (pre Phil) since we have seen each other or even really caught up. Your blog made me feel like I could be there for her special day.

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