Published 3/1/2007
Carolyn Rogers

In politics, money talks but relationships are key

Monetary contributions will always play a key role in the political process, but don’t underestimate the importance of building a personal relationship with your representatives, says former U.S. Representative Jim Nussle (R-IA), an eight-term U.S. congressman and a 2006 candidate for governor of Iowa.

Speaking at the Orthopaedic Political Action Committee’s (PAC) annual luncheon on Feb. 14 in San Diego, Nussle provided an insider’s perspective on the vital role of grassroots advocacy in the legislative process.

The political process doesn’t have to be “frustrating, distasteful and dirty,” he said. “It can also be rewarding and successful.”

Be a knowledge source
When you approach your senator or representative about any issue, what you’re really doing is establishing a relationship, Nussle said. “Writing a check is a great first step, but that check needs to be followed up with personal contact with your congressional representative and senator.”

The best way to build this relationship is to serve as a source of knowledge and key facts, he said. “To be effective, that relationship has to be built on trust and good information.”

By establishing relationships with your representatives—both in Washington, D.C., and back home—you’ll have a decision-maker you can turn to when you need to take action.

If you make a visit to Capitol Hill, call on the member in your district as well, he advised. And never underestimate the importance getting to know the legislator’s staff.

Personal stories sell your message
“Health care is personal,” Nussle said. “Like it or not, emotion is an important part of the advocacy process.”

Legislators hear from countless constituents. Including an emotional element makes your message more memorable and gives it greater impact.

“Unlike insurers and pharmaceutical companies, physicians have the ability to tell personal stories that have an emotional impact,” Nussle said. “Hearing about a little girl who was saved through medical research or a new technology gives it meaning.”

Front-burner issues
There are three front-burner issues affecting orthopaedic surgeons right now, Nussle said.

Fixing the Sustainable Growth Rate (SGR) payment formula is one. “The SGR has really put you in a box,” he said. “It makes it difficult for the reimbursement system to work and to have the necessary sustainability.”

This is also an issue of access, Nussle said. “If we want patients to have access to quality health care, then we need to have a sustainable reimbursement formula that will attract quality people to the profession.”

Unfortunately, fixing the formula would require putting every aspect of Medicare on the table for debate, which Congress doesn’t want to do. Change will probably not occur until there is some sort of collapse in the system, Nussle said. “Crisis management is often what gets Congress to act on many of these major entitlement programs.”

Fortunately, this doesn’t mean that the situation is hopeless or that the orthopaedic voice won’t matter, he stressed. “It’s exactly at that time of crisis—when they are looking for the solutions—that’s exactly the time for your solution to be at the forefront.”

Securing funding for musculoskeletal research and solving the medical liability crisis are also high-priority issues, both for orthopaedists and patients, he said.

“The most effective way to approach the medical liability problem is by emphasizing the threat to patients and to quality of care,” he said.

Speak up in early primaries!
While discussing the 2008 presidential campaign, Nussle urged orthopaedists in the early primary states (such as Iowa, Nevada, New Hampshire, South Carolina, Florida, Michigan, and New Jersey) to seize this rare opportunity to make their voices heard.

“Don’t miss the chance to raise your hand at that caucus or any other meeting with the candidates,” he said. “Be a citizen advocate and get your concerns on the front burner. You have even more of a megaphone in that setting than you get by establishing a relationship with your legislator.”