HME Advocates Hopeful about Daschle’s HHS Leadership

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.