April 1997 Bulletin

State society officers attend strategy session

Ninety state orthopaedic society officers and staff participated in the Academy's second State Legislative Strategies meeting, designed to help them prepare for the challenges of the 1997-1998 state legislative sessions.

The meeting in Rosemont, Ill., Jan. 17-19, provided an overview of the current political climate in which state legislatures operate, focused on expected legislation and reviewed the importance of developing effective relationships with elected officials. State orthopaedic societies that have already taken a proactive approach to legislative initiatives or currently play a lead role in patient access coalitions shared their successes and frustrations with the audience. Other speakers provided insights on legislative issues and state orthopaedic society development.

During the past two years, orthopaedic surgeons have been leaders in several state coalitions modeled on the national Patient Access to Specialty Care Coalition. These coalitions promote a variety of patient and physician protections through the state legislative process. The protections have included bans on "gag clauses" in managed care contracts, due process for deselection, disclosure of policies and requirements for an optional point-of-service feature.

Four states with orthopaedic-led coalitions participated in a panel discussion of their efforts: the Illinois Coalition for Patient Access and Choice; Indiana Patient/Family Access to Specialty Care Coalition; Iowa Alliance for Access to Specialty Care; and North Carolina Orthopaedic Society. It was clear that while each of the coalitions was pursuing virtually the same goals, they followed different paths, attracted different participants and met with varying degrees of success.

Michael Naylor, a Washington, D.C. lobbyist who chairs the Corporate Health Care Coalition, an organization that represents 22 of this nation's largest companies which provide $8 billion in health care coverage for 4 million lives, said the coalition was formed in response to President Clinton's first-term health care reform proposals. The coalition members believed they had been successful in stopping the escalating health care costs and did not want government interference.

Naylor, who is corporate director, public policy and government relations, Allied Signal, Inc., said coalition members are interested in providing quality coverage at the lowest price. Several of the orthopaedic surgeons in the audience questioned his definitions and standards.

Thomas Dowd, Dowd & Associates, public affairs consultants, a former member of the Connecticut State Legislature and a former lobbyist, told the audience of the importance of building relationships with elected officials and their staffs. Dowd stressed that legislators want to do the right thing, but often do not have in-depth knowledge about many of the issues they face. They must rely on staff, constituents and professionals affected by the legislation to educate them.

Dowd said orthopaedic surgeons can play an important role in health care legislation by providing legislators with important and effective information that can influence their vote. This can be very effective if patients partner with physicians in this process, Dowd said.

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