12-17-08
Health Care Reform Is Your Future: AOTA Is the Voice for Your Future
After 2 years of campaigning, November 4 has come and gone, and Inauguration Day is nearly upon us. On the campaign trail, president-elect Barack Obama made many promises, particularly in the area of health care reform. Which ones are likely to become a reality, and how will the changes impact you as an occupational therapy practitioner?
Regardless of your political persuasion, advocating for good public policy on Capitol Hill is important to advancing occupational therapy as a profession—and getting clients the care they need and deserve.
Likely Obama Administration Changes and Their Impact on Practitioners
Health care reform is a top priority for Congress and the Obama administration next year, second only to an economic stimulus and relief package. As such, Congress has been aggressively planning and developing a framework for reform that will provide parameters for the upcoming debate.
According to Christina A. Metzler, AOTA’s chief public affairs officer, “This health care reform debate may be even larger and have more impact than the debate in the Clinton years. Occupational therapy needs a voice to protect its future and AOTA is that voice. This effort could try to turn the tables of the existing system, or it could simply make incremental changes. Either way, occupational therapy will be affected.”
Metzler notes that president-elect Obama has already begun making changes. “With the appointment of Senator Tom Daschle as head of the Department of Health and Human Services and head of the White House Office of Health Care Reform, president-elect Obama already has begun impacting his future administration. Coordinating the Executive Branch activity under the guidance of an experienced legislator with connections and savvy about Capitol Hill will really transform the flow of ideas from legislative proposals to actual implementation strategies.”
“Health care reform as a top priority is both a boon and a threat to occupational therapy at the same time,” says Metzler. “We are talking about significant changes to service delivery and payment. But we are also talking about creating opportunities for many more people to have access to occupational therapy services. Whether there are incremental reforms or a wholesale upheaval in the system, this profession will not be immune to the consequences and changes. Health care reform is the future of occupational therapy. AOTA is the voice that can make sure that future is prosperous for occupational therapy—and for the people who need occupational therapy services.”
Tim Nanof, federal affairs manager at AOTA, adds, “There is a lot of talk about the concept of creating a ‘medical home’ for individuals to move toward a coordinated, integrated system of care that is patient-centered and responsive to the range of medical and social needs of patients. For instance, many people think a child’s medical home should be associated with schools, where children ‘are.’ If children’s health service delivery is focused more on schools, occupational therapy is already there, working with children in special education, and will be positioned to play a critical role in bridging services from the community to schools.”
A challenge by the disability community regarding the provision of services to people with disabilities in nursing facilities, rather than the community, is also likely. Metzler says this creates another opportunity.
“On the other hand, there will be new challenges,” she continues. “Many other providers will try to step up and say they can provide services too—and maybe at a lesser cost than occupational therapy. We have to be sure that if people are promised occupational therapy, they receive authentic occupational therapy from a qualified therapist or assistant. All the licensure protections we have built up in states over the years—and that AOTA is still building—must continue to govern who provides what services. AOTA will be watching to see if provider qualifications come up in the debate.”
Quality and the type of interventions is also an issue. Senator Max Baucus (D-MT), chair of the Senate Finance Committee, which has jurisdiction over Medicare and Medicaid, is proposing a “comparative effectiveness” agency to evaluate not just drugs and devices but also treatment. “AOTA has been getting ready for this challenge with our evidence-based projects over the past several years,” said Metzler. “But we’ll need more and more research to show in hard, scientific terms what we can accomplish and what it means to society.”
Importance of Advocacy
Enacting meaningful reform requires a bipartisan approach with the vision and commitment to invest in a system of health care—even if it may cost more now to deliver efficient, quality care in order to achieve greater future savings. Any health care reform must more equally and equitably distribute the costs and benefits of quality health care to all who need it, for the benefit of individuals and society.
“Health care reform discussions will provide an opportunity to put occupational therapy’s philosophy forward as a key component of evaluating the health care system—that people should be considered in their full context, with all their social, medical, emotional, and physical needs as part of the equation. Reforming the system, even if it is piece by piece, provides the chance for this message to get to policymakers. And AOTA can convey that message on behalf of the profession,” said Metzler.
AOTA Advocates for Health Care Reform
Last April, the Representative Assembly held discussions on what key elements were important in health care reform. AOTA’s staff are using that information, the results of the health reform survey, and the results of the open forum on health care held on December 18 with members and nonmembers from across the country.
AOTA is engaging key influencers on Capitol Hill independently and in coalition with others from the health care advocacy community, including the Consortium for Citizens with Disabilities (CCD), where AOTA Federal Affairs staff serve as a co-chair of the Health Taskforce.
“A leadership role in the CCD task force helps AOTA better support the interests of people with disabilities—along with the interests of occupational therapy—in the health care debate,” noted Nanof, who will be a co-chair.
But grassroots advocacy will be critical. “It is clear that the Obama administration has a preference for getting ‘real people’ involved in decision-making,” said Nanof. “So, occupational therapy practitioners will have to work with AOTA to take responsibility for voicing what they want in their future.”
Watch the Legislative Action Center for more updates.
