Much has been said and written about the significant economic effect the Deficit Reduction Act of 2005 (DRA) will have on the imaging industry. For many, imaging expansion plans have been stopped, development or equipment sales departments have been downsized, and equipment purchases and upgrades have been placed on hold or cancelled.
Considerable human and economic resources have been expended to publicize what, quite literally, happened in the dark of night in Washington, DC. Activities are underway to analyze the DRA’s full effect while seeking ways to change it—or, at least to lessen its damaging effects.
From a business perspective, the imaging industry seems to have divided itself into three camps.
The It-Can’t-be-That-Bad camp is comprised of organizations that have chosen a wait-and-see position related to the DRA and specifically to its impact on their business. These campers include some physicians, imaging centers, and developers of software, equipment, or pharmaceutical agents. This camp appears unconcerned about the looming vulnerability the imaging industry faces with a possible additional DRA proposal in 2006. Additional cuts are currently being contemplated in Washington, DC, as a fix is sought for mitigating the upcoming, scheduled -5.1 percent adjustment to the physician fee schedule. The previous “SGR fix” is what led to the imaging cuts included in the DRA of 2005.
The Woe-Is-Me camp complains about the federal government and the manner in which decisions are made, with little belief in their own or their organization’s ability to advocate for (or influence) change. It is my opinion that the public servants in the nation’s capitol are better able to serve/vote if they are given information from the real world.
The Let’s-Roll-Up-Our-Sleeves-and-Work-Together camp is an exciting place for those who like close-to-impossible odds. Working with the National Coalition for Quality Diagnostic Imaging Services (NCQDIS), the equipment manufacturers, several medical specialty societies, and various other groups, we have done what we were advised was impossible to do: introduced bills in both the Senate (S.3795) and the House (H.R.5704) placing a moratorium on the DRA imaging cuts. Last January, we were advised by many Washington insiders that no Republicans would sign on to such a bill because the administration and Congressional leadership would pressure them to leave it alone. We were also told that, in this election year, Democrats and Republicans would not go on the same bill with each other. That we have proven the pundits wrong is a testament to our elected officials’ willingness to listen and the hard work of the Roll-Up-Our-Sleeves camp.
During the first week in September, we topped 90 House co-authors. There is a detailed story to be told about how each one of these co-authors was persuaded to sign on the bill. Always, it includes contact with a constituent(s) who will be directly affected by the DRA.
Although none of us expect the DRA moratorium bill to pass as a separate bill, we are working to see that the language of it is included in any Medicare or health appropriations bill that comes up between now and the end of the year. This is a daunting goal, but well worth the attempt because of the ramifications if we are not successful.
Speaking of ramifications, everyone in the imaging industry should also be a member of the most important group: the What-About-Our-Patients camp. All of us in the imaging industry should be blowing our horns, banging pots and pans, and generally making a big ruckus of righteous indignation related to how the DRA legislation will impact our patients. Whether your company manufactures a contrast agent, develops PACS software, builds faster or higher strength machines, or is an IDTF or physician practice, the ultimate recipients of our services are those who will be most affected.
For example, our patients at CDI include the grandfather who noticed a motor-skills delay when placing nickels in a slot machine at a Minnesota casino. Stroke was suspected, but the MRI with and without contrast indicated metastasized cancer. The DRA cuts that procedure by 49 percent. What would a two- or three-week delay in diagnosis have meant to this patient and his family, considering he began treatment within 24 hours of his MRI? Why would we want a public policy that potentially delays this type of care for our elderly patients through the elimination of quality providers?