1. DO Day on the Hill Information Session Wed. April 6 th 5pm Ginsburg Auditorium

2. What is your role at DO Day on the Hill? You will be in a group of 20 physicians/students from your voting district You will be in a group of 20 physicians/students from your voting district AOA has set up appointments to meet with 2 Senators and 1 Representative (as available) AOA has set up appointments to meet with 2 Senators and 1 Representative (as available) You will be lobbying for the 3 issues that the AOA has chosen and supports You will be lobbying for the 3 issues that the AOA has chosen and supports

3. Why are you here today? To become more familiar with these 3 issues To become more familiar with these 3 issues Find out what YOU should do to prepare yourself (..who are your representatives?? How did they vote on those issues??) Find out what YOU should do to prepare yourself (..who are your representatives?? How did they vote on those issues??) To be come a more affective lobbyist To be come a more affective lobbyist

4. The 3 Major Issues 1. Medical Liability Reform (HEALTH ACT) 2. Higher Education Act 3. Medicare Physician Payments

5. I. Medical Liability Reform Top legislative priority of AOA Top legislative priority of AOA Whats the Problem? Whats the Problem? Increasing liability costs are pushing physicians out of certain specialties and geographical locations Increasing liability costs are pushing physicians out of certain specialties and geographical locations Physicians are practicing defensive medicine due to fear of lawsuits Physicians are practicing defensive medicine due to fear of lawsuits

6. Medical Liability Reform Patients are suffering too!!!! due to loss of access to essential health care services (ex. OB/GYN and Neurosurgery) Patients are suffering too!!!! due to loss of access to essential health care services (ex. OB/GYN and Neurosurgery) The HEALTH ACT (Help, Efficient, Accesible, Low Cost Timely, Health Care Act) of 2003 passed in the House of Representatives, but has failed to do so in the Senate. The HEALTH ACT (Help, Efficient, Accesible, Low Cost Timely, Health Care Act) of 2003 passed in the House of Representatives, but has failed to do so in the Senate. You can help lobby Congress to pass this important act!! You can help lobby Congress to pass this important act!!

7. Medical Liability Reform AOAs 6 Provisions: AOAs 6 Provisions: 1. Limitations on Non-Economic Damages 2. Joint and Several Liability Reforms 3. Collateral Source Reform 4. Establish Uniform Statues of Limitations 5. Periodic Repayment of Future Expenses or Losses 6. Limitations on Attorney Fees

8. II. Higher Education Act (HEA) Higher Education Act of 1965, expired in 2003, and was reinstated in 2004 with some provisions. (HEA) Higher Education Act of 1965, expired in 2003, and was reinstated in 2004 with some provisions. Goal of HEA is to make medical education more affordable for EVERYONE Goal of HEA is to make medical education more affordable for EVERYONE This includes: loans, interest rates, repayment etc. This includes: loans, interest rates, repayment etc.

9. Higher Education Act How does this affect you ? How does this affect you ? Osteopathic medical students graduate with $128,000 in debt (HIGHEST of ALL health professions!!!!) Osteopathic medical students graduate with $128,000 in debt (HIGHEST of ALL health professions!!!!) >60% become family practitioners (soul of the osteopathic profession) >60% become family practitioners (soul of the osteopathic profession) Due to financial pressures, many medical students pursue medical specialties, with a higher earning potential. Due to financial pressures, many medical students pursue medical specialties, with a higher earning potential. This is not helping the national shortage of family physicians. This is not helping the national shortage of family physicians.

10. Higher Education Act Title IV of HEA was added in Oct. 2004 Title IV of HEA was added in Oct. 2004 It included (Stafford loan increase limit from $10,000 to $12,000; allowed for moving of all loans to a variable rate, eliminating the single holder rule and reducing fees from 3% to 1% It included (Stafford loan increase limit from $10,000 to $12,000; allowed for moving of all loans to a variable rate, eliminating the single holder rule and reducing fees from 3% to 1%

11. Higher Education Act Higher Education Affordability and Equity Act (HEAEA) was passed in March 2005 Higher Education Affordability and Equity Act (HEAEA) was passed in March 2005 Current Provisions of the HEAEA Current Provisions of the HEAEA Student loan interest deduction Student loan interest deduction Higher Education Expenses Higher Education Expenses Room and Board Tax Treatment Room and Board Tax Treatment Hope Scholarship Tax Credit Hope Scholarship Tax Credit And Others….. And Others…..

12. III. Medicare Physician Payments Enacted in 1965, with the goal to ensure health care services to millions of Americans Enacted in 1965, with the goal to ensure health care services to millions of Americans 40 million Americans currently depend on the system, but as the population ages, the system has become STRAINED 40 million Americans currently depend on the system, but as the population ages, the system has become STRAINED

13. Medicare Physician Payments How are physicians affected? How are physicians affected? Reimbursements for physicians have continuously decreased over the years (in 2002 decreased by 5.4%) Reimbursements for physicians have continuously decreased over the years (in 2002 decreased by 5.4%) Looking to the future? Looking to the future? According to the Medicare Trustee Report we face reductions of at least 5%/yr from 2006 through 2012. According to the Medicare Trustee Report we face reductions of at least 5%/yr from 2006 through 2012.

14. Medicare Physician Payments Although Congress in 2004 and 2005, with the MMA (Medicare, Prescription Drug Improvement and Modernization Act) slightly increased physician payment rates, MORE reform is needed. Although Congress in 2004 and 2005, with the MMA (Medicare, Prescription Drug Improvement and Modernization Act) slightly increased physician payment rates, MORE reform is needed. As more medicare services (ex. Preventative medicine) are being provided, physicians are being financially penalized by the system. As more medicare services (ex. Preventative medicine) are being provided, physicians are being financially penalized by the system. This needs to STOP!!! This needs to STOP!!!

15. What should you do before the Day? Find out who are your representatives and senators? Find out who are your representatives and senators? www.capwiz.com/aoa-aoia www.capwiz.com/aoa-aoia www.capwiz.com/aoa-aoia ***MAKE SURE YOU GO ON THIS*** ***MAKE SURE YOU GO ON THIS*** Tells you how they voted on our issues Tells you how they voted on our issues Do your own research on these topics!!! Do your own research on these topics!!! read agenda e-mailed to you last week…lots of great links to learn more about the issues and your representatives.

16. What should you do before the Day? Check to see if your member of Congress is on one of these 4 Committees: Check to see if your member of Congress is on one of these 4 Committees: Senate Health, Education, Labor and Pensions Committee Jurisdiction Senate Health, Education, Labor and Pensions Committee Jurisdiction Senate Finance Committee Jurisdiction Senate Finance Committee Jurisdiction House Committee on Energy and Commerce Jurisdiction House Committee on Energy and Commerce Jurisdiction House Committee on Ways and Means Jurisdiction House Committee on Ways and Means Jurisdiction http://www.gpoaccess.gov/cprints/ (check this or other similar links to find out) http://www.gpoaccess.gov/cprints/ (check this or other similar links to find out) http://www.gpoaccess.gov/cprints/

17. What should you do before the day? Learn about the Process. Learn about the Process. How a law is made: http://thomas.loc.gov/home/lawsmade.t oc.html How a law is made: http://thomas.loc.gov/home/lawsmade.t oc.html http://thomas.loc.gov/home/lawsmade.t oc.html http://thomas.loc.gov/home/lawsmade.t oc.html Enactment of a law: Enactment of a law: http://thomas.loc.gov/home/enactment/e http://thomas.loc.gov/home/enactment/e nactlawtoc.html http://thomas.loc.gov/home/enactment/e

18. The Dos and Donts of Meeting with a Member of Congress/Staff Dos Dos Be polite and personable Be polite and personable Stay focused Stay focused Be ready to answer questions on your issue Be ready to answer questions on your issue Use anecdotal situations to support your issue Use anecdotal situations to support your issue Leave packet with every office Leave packet with every office

19. The Dos and Donts of Meeting with a Member of Congress/Staff Donts Donts Dont misinform. Dont be afraid to say I dont know. If you are asked a question and you are unsure, take note of the question and give the info to an AOA staff member Dont misinform. Dont be afraid to say I dont know. If you are asked a question and you are unsure, take note of the question and give the info to an AOA staff member Dont argue or antagonize Dont argue or antagonize Dont steer away from the issues Dont steer away from the issues Dont be offended by inconvenience Dont be offended by inconvenience

20. Words of Advice: Issues: Issues: Be brief. Dont let the representative or staffer side-track the meeting. Be brief. Dont let the representative or staffer side-track the meeting. Be prepared when you arrive. Know what you are going to say. Be prepared when you arrive. Know what you are going to say. Present your opinion, bolstered by facts, figures and a PERSONAL STORY. Present your opinion, bolstered by facts, figures and a PERSONAL STORY. Know and understand opposing arguments. Be prepared to discuss them Know and understand opposing arguments. Be prepared to discuss them Gently remind your representative that youre a constituent and that you always vote. All politics is local. Gently remind your representative that youre a constituent and that you always vote. All politics is local. Be passionate (not emotional), and never leave in anger. Be passionate (not emotional), and never leave in anger.

21. Words of Advice: Closing Closing Leave when your time is up. Leave when your time is up. Ask for a commitment from the member to support your position-but do not apply pressure or be threatening. Ask for a commitment from the member to support your position-but do not apply pressure or be threatening. After every contact with a legislator, be sure to say the magic words -- THANK YOU. After every contact with a legislator, be sure to say the magic words -- THANK YOU.

22. Words of Advice Choose a leader! This person is responsible for facilitating the meeting and will introduce the group. Choose a leader! This person is responsible for facilitating the meeting and will introduce the group. Its important to establish a relationship between the 3 parties: the staff member (lets call him John), the leader, and the group. Its important to establish a relationship between the 3 parties: the staff member (lets call him John), the leader, and the group. Dont be afraid to step up and take the leader position. Dont be afraid to step up and take the leader position.

23. Step 1: Introduction Thank the staff member (John) for his time! Thank the staff member (John) for his time! Who we are? Who we are? Who are you? Who are you? Can we introduce ourselves? Can we introduce ourselves? –Home, school, political activity.. What is Johns reaction? What is Johns reaction?

24. Step 2: Hopes for the Session The Leader must establish with John what he or she hopes to receive from session. The Leader must establish with John what he or she hopes to receive from session. How much time do we have? How much time do we have? John, how much do you know about these issues? John, how much do you know about these issues? John, What are your goals from this session? John, What are your goals from this session?

25. Step 2: Hopes for the Session John…These are our HOPES for this session.. John…These are our HOPES for this session.. 1.offer prospective from med school student, future physician, on these issues 1.offer prospective from med school student, future physician, on these issues 2.tell you our concerns 2.tell you our concerns 3.tell you why these issues are important to us and to the voting constituency back in our home states. 3.tell you why these issues are important to us and to the voting constituency back in our home states.

26. Step 3: Discuss the Issues Is John ready to listen? Is John ready to listen? Ask John, Is it OK if I start here? Ask John, Is it OK if I start here? Clarify the situation and continuously CONTRACT with John what you as a group will be discussing. Clarify the situation and continuously CONTRACT with John what you as a group will be discussing. Ask John, if the Senator would like or is available to meet with us, as we are discussing these issues. Ask John, if the Senator would like or is available to meet with us, as we are discussing these issues.

27. Step 4: Closing At 5 Minutes to the end, the Leader must inform John that our meeting ends in 5 minutes, but we can continue our conversation if you would like. At 5 Minutes to the end, the Leader must inform John that our meeting ends in 5 minutes, but we can continue our conversation if you would like. At the end: Remember to always THANK John and dont forget to leave the Hill Packet with him. At the end: Remember to always THANK John and dont forget to leave the Hill Packet with him. Consider leaving a small gift with the office Consider leaving a small gift with the office

28. Thanks for your time!!!! Look for an e-mail with a complete list of links of the web-sites mentioned. Look for an e-mail with a complete list of links of the web-sites mentioned. E-mail me if you have any problems finding the necessary information on these topics. E-mail me if you have any problems finding the necessary information on these topics.