Time to step up and give

Orthopaedic PAC needs better participation, more financial support.

Issue: April 2003

ByDouglas W. Jackson, MD

Douglas W. Jackson, MD [photo] --- Douglas W. Jackson, Chief Medical Editor

Over the years, political action representing the interests of orthopedic surgeons has been financially supported and the work done by a small percentage of orthopedic surgeons. In 1999, the American Academy of Orthopaedic Surgeons formed a sister 501(c)(6) organization to facilitate larger financial and open support related to political action.

This move has increased our presence in national issues and has impacted our profession and the patients we serve. It has even greater potential, however, and we have not really utilized it as we can. It is a shame that less than 10% are carrying the load for the rest of our profession.

It is not unusual in national organizations for less than 10% to really be involved when things are good. When things go wrong or a crisis occurs, there is usually more interest and criticism. We need to be proactive and have more of you step up to the plate.

As I travel around the country and talk to orthopedists, 90% do not financially support the Orthopaedic PAC.

The reasons include not understanding what it does, not caring what it does, forgetting to send the contribution, not wanting to give money to this cause, and a number of other personal reasons and excuses.

Let me try to explain what this PAC is all about and why we need to have a wider base of support among orthopedic surgeons. David Lovett, Esq., whom I have worked with for years, is the current director of the AAOS Washington office. He assisted me with the numbers, specific information, and many answers to questions raised in this column.

What is a PAC?

A political action committee is one formed by business, labor or other special interest groups to raise money and make contributions to the campaigns of political candidates whom they support.

The Orthopaedic PAC of the American Association of Orthopaedic Surgeons (AAOS) is the only national political action committee in Washington, DC, that represents before Congress the interests of the orthopedic profession and how we specifically care for our patients.

This is important because no one else will speak for us.

This PAC is entirely within the structure of the AAOS and was created by the board of directors at the February 1999 annual meeting. Under federal law, the association is able to maintain the PAC, support its administrative expenses, and integrate its activities into the agenda of the AAOS in the capitol. The PAC operates like any other committee within the AAOS.

The PAC works to advance the legislative concerns of the AAOS and other orthopedic specialty societies. The PAC has an executive committee of 11 members and a larger committee composed of regional representatives and representatives from the Council of Musculoskeletal Specialty Societies. All committee members are chosen by the AAOS Committee on Committees. While the AAOS’s Rosemont staff handles the accounting, clerical and some legal aspects of the PAC, the AAOS Washington office is primarily responsible for the PAC’s activities.

Your dues do not support the political activities of the PAC.

How many of us contribute?

Only 9.5% of orthopedists (1712 out of 18,000) contribute to the PAC. Since the time that the AAOS PAC began raising money, it has almost tripled its receipts per election cycle over its predecessor, the Committee for Quality Orthopaedic Health Care.

As of Dec. 31, 2002, in the 2001-2002 election cycle, the PAC received $583,158 from 1981 contributions ($137,525 in 2001 and $445,633 in 2002).

In addition, the PAC received $107,470 in corporate receipts from 378 contributions. Under federal law, contributions drawn from corporate accounts may not be deposited into the PAC account to be used in contributing to candidates but can be used for general association expenses. Thus, the PAC received an unprecedented $690,628 in receipts from 2359 contributions. This total is composed of many AAOS members who made multiple contributions.

As a more than half-million-dollar PAC, the Democratic and Republican leadership take notice. As of November 2002, the Orthopaedic PAC was the fourth largest physician PAC in the country. Only the American Medical Association, the Anesthesiologists, and the Ophthalmologist PAC were larger.

One of the challenges for the PAC will be to continue to educate the membership about the importance of political fundraising and its link to AAOS activities in the health policy arena.

Traditionally, nonphysician providers such as podiatrists and physical therapists raise significantly greater sums of money than the AAOS PAC. The Trial Lawyers PAC collected $7,205,585 in the 2001-2002 election cycle. This needs no discussion on their effectiveness and influence in blocking efforts to thwart the exponential increases in professional liability premiums.

Importance of coalitions?

To achieve our health policy objectives, coalition-building activities with organizations that share the AAOS viewpoint is essential. It is when we come together with other voter and financial constituencies that we become more effective. Our PAC has been instrumental in putting many of these coalitions together.

Currently the AAOS Washington office is involved in the following coalitions: Alliance of Specialty Medicine; National Quality Forum; Health Coalition of Liability and Access; National Medical Liability Reform Coalition; Medical Technology Leadership Forum; Patient Access to Specialty Care Coalition; Ad Hoc Group for Medical Research Funding; NIAMS Coalition (National Institute of Arthritis and Musculoskeletal and Skin Diseases); CDC Coalition; Coalition for Health Funding; Alliance for Aging Research; Friends of the VA; Graduate Medical Education Coalition; Trauma Care Coalition.

I think it is important to our profession and our ability to care for patients that we all contribute to the PAC.

These are two of the many issues we must address together this coming year and in years ahead: correcting the flawed Medicare physician-payment update formula, and addressing the exponential increases in professional liability premiums.

Other legislative issues are important to the AAOS as well. In response to priorities set by the board of directors and its creation of the numerous councils, committees, task forces and work groups within the academy and the association, the AAOS Washington office continues to pursue an ambitious and expansive legislative and regulatory health policy agenda.

Influence on political process?

In the 2001-2002 election cycle, the Orthopaedic PAC participated in 200 Congressional races, a record, and contributed $617,739 (36 Senate races and 164 House races). The Orthopaedic PAC had a success rate of about 90% among these races. Many contributions were made to incumbents who serve on key congressional committees with jurisdiction over health care.

Also, the PAC contributed an additional $121,500 to House, Senate and national party PACs and initiatives, equally divided between Democrats and Republicans. The PAC encourages individual orthopedic surgeons to deliver these contributions while meeting with representatives and senators in their own state. In the 2001-2002 cycle, 68 contributions were made by orthopedists in their own districts (about 34% of the total contributions made to candidates).

Take time to read a related article in this issue, which discusses the role of the PAC.

It is time for those of you on the sidelines to give. Most of you have relied too long on your colleagues’ efforts in this arena. We and our profession are in this together. No one else will do this for you.