If not you, who? If not now, when?

Q. I've held site visits with my congressman and participated in other industry lobbying events--but the Medicare reimbursement cuts keep coming. Why should I continue to fight what seems like a lost cause? A. The Talmud says, "If not you, who? If not now, when?" The simple answer is--if you don't fight, who will? I can understand why providers are frustrated and may want to throw in the towel. The past decade and, most notably, the past few years have been extremely challenging. Last fall, it was bad enough that we knew about the cap on DME in the Deficit Reduction Act (DRA) and were trying to fight that. The addition of the 36-month oxygen cap in the 11th hour was enough to push anyone over the edge. Now we are working on legislation that will repeal the cap, while simultaneously commenting on the proposed regulations for competitive bidding. If you are feeling burnt out, you are not alone. We're always hoping for the "win" but sometimes the "win" isn't getting exactly what you asked for. Sometimes it's getting close to what you want. For example, when Rep. Bill Thomas, R-Calif., tried to sneak in an 18-month cap for oxygen equipment into the DRA, the industry was able to get the cap raised to 36 months. It's still a cap, you might say. Yes, it is. Is this a "win"? I would say yes because it gives the industry some time to work on legislation to repeal it. We must remain diligent in our lobbying efforts because the president's budget calls for a 13-month cap. More cuts to Medicare could come in the lame duck session at the end of this year. Don't quit! We need to continue to lobby for H.R. 3559, 5513 and 4994. These pieces of legislation will protect small providers and patients. If not you, who? If not now, when? --- Karyn Estrella is executive director of the New England Medical Equipment Dealers (NEMED) association. Reach her at 508-993-0700 or karyn@nemed.org.