On Jan. 20, 2009, The 44th President of the United States will inherit a country at a crossroads. The confluence of the Iraq War, sluggish unemployment and the housing crisis is expected to continue into next year, and nearly 46 million people still don’t have health insurance. But in the meantime, the 24-hour news cycle would have you believe that the future of the free world hinges on the seven houses Sen. John McCain, R-Ariz., thinks he might own or whether Sen. Barack Obama, D-Ill., has eclipsed Paris Hilton as the biggest celebrity in the world.
Patients and clinics alike are at the mercy of government decisions. And with the next president certain to push for major healthcare reform, it’s vital to push through the tall grass of partisan rhetoric to understand how the next four years could alter the healthcare landscape.
The 2008 Election and Dialysis
Dialysis has largely been a nonpartisan issue over the years garnering support from both sides of the aisle. For example, the Kidney Care Quality and Education Act of 2007 (KCQEA), which helped influence recent Medicare reform, enjoyed Democrat and Republican support after it was introduced in Congress. Specifically, the bill drew 107 Democrat and 56 Republican co-sponsors in the House. In the Senate, 10 Republicans and 18 Democrats supported the bill.
If past elections are any indication, the End-Stage Renal Disease Program is not a hot-button issue in presidential politics, so it’s difficult to gauge if either candidate even has a specific position on the ESRD Program. It also may be too early to tell how the next president might affect renal care specifically, said John Jonas, head legislative counsel for the lobbyist group Kidney Care Partners. “You’d really have to see who they appoint as administrator of [Centers for Medicare & Medicaid Services] and see who is secretary of [Health and Human Services] and see how interested those people are in preventive care, and how interested they are in managing chronic care,” Jonas added. “Those issues are very important in what happens to dialysis.”
One can surmise that Obama holds, at the very least, tacit support for ESRD reform as he was one of the Senate co-sponsors of the KCQEA last year. The Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) could be another barometer in gauging McCain’s and Obama’s stance on Medicare and dialysis. MIPPA delayed scheduled physician fee cuts, phased out payments to private Medicare Advantage plans and revised how Medicare will reimburse dialysis treatments. McCain was the only senator not present July 9 when MIPPA passed the Senate by a vote of 69-30. Obama voted in favor of the legislation. However, neither senator was present when the Senate overrode President Bush’s veto to pass the bill into law on July 15.
