Editor's Note

United We Stand

The HME industry must stand on common ground to reform oxygen.

The sentiment “United we stand, divided we fall” traces its origins back to Aesop’s fable “The Four Oxen and the Lion,” but it is an ethic that has resonated with Americans since our beginnings. Even our seal and currency bear the latin motto “E pluribus unum” (out of many, one) to remind us that we need to stick together.

Patrick Henry used the sentiment to great effect when speaking in 1799 against the Kentucky and Virginia Resolutions, which attempted to put states’ power far above the Federal government’s, and vastly reduce the reach of Congress so that it could only exercise a few penal powers against treason. Just think what would have happened during the soon-to-transpire War of 1812, if Henry hadn’t dramatically said “United we stand, divided we fall. Let us not split into factions which must destroy that union upon which our existence hangs.”

So, I was a little surprised at the debate that ensued when the American Association for Homecare’s June 1-3 Washington, D.C. Legislative Conference when it came time to discuss the industry’s position on oxygen reform. Those at the podium were advancing the position that attendees should support New Oxygen Coalition’s reform platform to change the oxygen benefit so that HME businesses would be seen as providers, rather than suppliers of oxygen.

As part of that position, attendees were advised to forgo lobbying House Representatives during their legislative meetings to support HR 2373, the Home Oxygen Patient Protection (HOPP) Act. The HOPP Act calls for repeal of the 36-month home oxygen equipment rental cap by amending part B of title XVIII of the Social Security Act to restore home oxygen payments through the beneficiary’s period of medical need.

Essentially, the notion was posited that if providers focused on getting the HOPP Act passed, it might stymie the industry’s efforts to convince congress to incorporate the NOC’s reform platform integrated into whatever national healthcare reform legislation that is introduced into Congress.

Needless to say, many small oxygen providers were not in full agreement. More than one attendee told the panel discussing oxygen reform that they wanted “more than one bullet” in their gun. In other words, they wanted to have more than one way to kill the 36-month oxygen rental cap. And those providers made good on their word, and encouraged members of the House to support the HOPP Act in their legislative meetings. (Currently, HR 2373 had 56 cosponsors.)

This split troubles me. The nation is on the verge of dramatically reforming its healthcare landscape, and the resulting changes will impact our industry in ways we can’t even imagine. Moreover, while the HME industry only hits up lawmakers en force a few times a year, other more powerful lobbies from the healthcare industry regularly lobby congress members with legions of paid lobbyists. Make no mistake; we are the underdogs in this fight.

If we want to ensure that our voice is heard loud enough that we have an impact how health reform takes shape, we must speak with one voice. Bearing that in mind, we must find some common ground when it comes to oxygen reform and any other issue, for that matter. For oxygen, a far reaching reform is necessary, but not at the expense of the hear-and-now concerns of providers who need the immediate relief the HOPP Act offers. The industry should adopt a “repeal and reform” approach to oxygen to ensure an end to the rental cap. Nix the cap, while working on reform.

Whatever your angle on the regulatory and legislative issues facing this issue, you should be an involved participant in the process. That’s why we’ve included a legislative topic in our third annual HME Handbook. Read “How to lobby congress to help your industry” to see how you can stand together with your industry.



This article originally appeared in the July 2009 issue of HME Business.

About the Author

David Kopf is the Publisher and Executive Editor of HME Business and DME Pharmacy magazines. Follow him on LinkedIn at linkedin.com/in/dkopf/ and on Twitter at @postacutenews.

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