To recapture federal dollars, healthcare lobbyists must do more than reveal the pain that providers say they are feeling from the Balanced Budget Act of 1997.
Not a day goes by that some healthcare mouthpiece isn't whimpering about shrinking Medicare margins and other budget-law-induced spending slashes.
But that has not produced any serious work on Capitol Hill to undo the act. Hospitals and their lobbyists should stop carping and start courting the American Association of Retired Persons and other influential patient advocacy groups.
Congress may yet decide to revisit the budget law if providers can successfully convince these groups that the cuts will affect patient access and quality. Pleas from the examination room and the waiting room will prove much more effective than cries from the boardroom of the health system.
While the industry's cry-wolf approach is clear and consistent, skeptics think providers vastly overstate the problem. Certainly that has happened before, although this latest "crisis" appears to be much more serious to the long-term health of hospitals. For example, the American Hospital Association recently released a study showing that seven of 10 hospitals will be losing money on Medicare in 2002.
The AHA is seeking at least $25 billion in relief from the lower payments imposed by the budget law. The act is expected to reduce Medicare hospital payments by $71 billion over five years-one-third more than projected when the law was enacted.
Healthcare was the tool used to balance the budget, and insiders anticipated the cuts would steamroll hospitals that had used fat inpatient Medicare payments as a cushion to offer attractive deals to managed-care plans.
While the days of cost shifting are over, healthcare providers ought to receive some help from the budget surplus piling up in Washington. Moreover, there's mounting evidence that Medicare spending already is under control.
To get relief, providers should identify how they are dealing with financial pressures and explain how cutbacks will disrupt patient care.
Those messages will get results.