Washington Scene: STS Advocacy Efforts Address Coronavirus, Tobacco Use, Reimbursement Cuts

STS News, Spring 2020 — The Society is working closely with federal legislators, regulatory agencies, and grassroots advocates on a number of issues that impact cardiothoracic surgeons and their patients. These efforts include ensuring access to extracorporeal membrane oxygenation (ECMO) during the coronavirus pandemic, reducing tobacco use, and reversing cuts to Medicare reimbursement for the specialty.

ECMO and COVID-19

STS proactively weighed in with the Administration’s coronavirus task force, various federal agencies, and members of Congress to highlight the importance of ECMO programs to the US pandemic response. Representatives from STS and the Extracorporeal Life Support Organization have been working to elevate concerns about patient access to ECMO, geographic distribution of centers, supply chain demands, and the need to quickly and accurately share information across all sites.

In addition, the Society is advocating for legislation and administrative action that protects the health and safety of front line physicians, eliminates Medicare reimbursement cuts scheduled for next year, and provides financial relief for physician practices that lose revenue as a result of canceling or delaying elective cases, among other issues.

STS will continue fighting to ensure that cardiothoracic surgeons on the front lines have the resources needed to treat patients during this global crisis.

Anti-Tobacco Efforts

A key STS advocacy priority was achieved in December with the passage of the fiscal year 2020 appropriations bill. The legislation included a provision raising the age for purchasing tobacco from 18 to 21, which will help protect kids and young adults from the harmful effects of smoking. 

To build on this success, STS recently endorsed several bills aimed at reducing tobacco use, including the Protecting American Lungs and Reversing the Youth Tobacco Epidemic Act of 2020, which passed the House of Representatives on February 28. The legislation would prohibit any kind of flavoring (including menthol) in tobacco products, impose a tax on nicotine, and ensure that the Food and Drug Administration promptly implements graphic health warnings on cigarette packaging and advertising materials. At press time, the bill was under consideration by the Senate Committee on Finance.

Additional legislative and regulatory actions supported by STS would ban e-cigarettes in schools and child care facilities that receive federal funding, charge a fee to manufacturers and importers of electronic nicotine delivery systems, and set stricter standards for premarket tobacco product applications.

For more information on the Society’s commitment to combating tobacco use, a new policy paper is available at sts.org/tobaccopaper. The Board of Directors approved the paper—which serves as a guide for related advocacy efforts—for inclusion in the STS Health Policy Compendium in January.

Cuts to Medicare Reimbursement

The Society also is continuing to work closely with a group of surgical specialty societies to fight back against substantial cuts to Medicare reimbursement for cardiothoracic surgeons. Cuts of up to 7% for both cardiac and thoracic surgery are scheduled to be implemented in January 2021 and could have a significant impact on patient care. Additional drops in reimbursement are likely to be proposed this summer.

The Surgical Coalition is planning a comprehensive strategy consisting of legislative and regulatory advocacy, a public relations campaign, research and data collection on the impact of the cuts, and legal action. More information is available at sts.org/globals.

Key Contact of the Year Says ‘Medical Advocacy is a Team Sport’

The Society’s Key Contact of the Year Award recognizes those STS members who have gone above and beyond to advocate for the specialty. 2019 recipient Seth Wolf, a medical student at the University of Vermont (UVM) Larner College of Medicine in Burlington, shared his thoughts on the importance of grassroots advocacy, his experience working with legislators, and why he believes his fellow STS members must become involved in advocating for the specialty.

Q: Why are you involved in STS advocacy? Why is it so important?
A: Before attending Morehouse College in Atlanta, I lived in Stockholm, Sweden. Going from socialized medicine to inner-city Atlanta and now the sparsely populated, relatively rural community of Vermont has allowed me to experience an array of vastly different political and medical systems. My diverse encounters with health care is what piqued my interest in advocacy. As medical students, we represent the future workforce of physicians, which comes with the responsibility of fighting for the rights of tomorrow’s patients. It is with privilege and enthusiasm that I choose to carry this torch.

Q: What was your experience at the most recent STS Legislative Fly-In?
A: The 2019 Legislative Fly-In truly was a memorable experience. It was an amazing opportunity to gain insight into what is required for advocacy on a national scale. Networking and learning from individuals such as Drs. John Calhoon, Dawn Hui, Stephen Lahey, Robert Higgins, and many others who dedicated their valuable time was an exceptional experience.

Q: How have you engaged with your lawmakers at home?
A: In the past year, I arranged and led local meetings in Vermont with the offices of Senator Patrick Leahy and Congressman Peter Welch. These meetings were effective, in part, due to achieving buy-in from UVM cardiothoracic surgery faculty such as Drs. Bruce Leavitt and Fuyuki Hirashima, who accompanied me to meetings. These efforts resulted in co-sponsorship of bills including the Resident Physician Shortage Reduction Act.

Q: What would you say to your fellow STS members to encourage them to become involved?
A: Medical advocacy is a team sport, and maximum results require maximum effort. Everyone has a role to play, whether you are a medical student, resident, or attending. With an ever-evolving specialty and a fluctuating political scene, medical advocacy is imperative for continued growth and the ability to provide outstanding patient care. Having the opportunity to become involved with advocacy early in my career has ignited my passion, and I am determined to turn this into a lifelong commitment of advocating for the field of cardiothoracic surgery and the patients we serve.