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President's MessageThe LegislatureN.H. Tucker, III, M.D., President |
| Before he became a legislator, an Indiana legislator from
South Bend once told me he could not grasp why our democracy did not produce the best and
brightest to represent us. His district included the University of Notre Dame and he was
well educated, eloquent and very bright. As a legislator, he later realized a simple
truth: We truly have a representative government. That farmer-legislator from rural
Indiana, whom the South Bend legislator considered slow and backward, was a very good
representative for his district. That labor leader from the outskirts of Chicago, whom he
considered narrow-minded, was a very good representative for his heavily industrialized
district. Thus the makeup of the legislature — a body of diffuse individuals, each
with his own interests and agenda and all subject to being influenced. The legislature affects or can affect the way we practice medicine. From such mundane issues as various medical taxes to the more critical issues such as medical licensure, the legislature can be involved. Such issues as the sales tax exemption on medical services, the 1.5% tax on medical facilities (the definition of which has fortunately excluded physician offices), and the tax for the injured baby fund (NICA) are all in the realm of legislative change. Also such fees and regulations as those affecting medical licensure, lab licensure, and allied and employed medical personnel licensure are all under the purview of the legislature. Managed care and insurance regulatory changes are often addressed by the legislature — one case in point is the elimination of gag clauses in managed care contracts. The entire medical tort system and medical disciplinary system can be molded and changed by legislative fiat. The legislature could pass laws requiring the reporting of every minor office or hospital incident. It is safe to say that activities of the legislature can make the practice of medicine a living nightmare, a low hassle environment, or somewhere in between. Therefore, it is in the best interest of physicians to be active in the legislative process. This involves influence. One effective way for physicians to have legislative influence is to run and be elected to office. There are presently three physicians in the Florida House, two in the Florida Senate, eight in the U.S. House of Representatives, and one in the U.S. Senate. In addition there are nine physician spouses and at least four physician relatives in the above legislatures. These physicians usually carry great weight in their respective legislatures, well beyond their individual votes. They are considered both peers and health care experts by their fellow legislators and can often effectively present medicine's position. However, most of us do not have the time, talent, or inclination to be a legislator. Therefore a more common way to gain this influence is to deal effectively with non-physician legislators. This influence can be acquired through the following ways (in ascending order of importance): financial support to legislative campaigns; sponsoring or arranging campaign fund-raising functions; helping with campaigns (such as staffing); and personal relationships or friendships. Influence does not necessarily translate into automatic support for medicine's position but it does allow for medicine's message to be heard and hopefully fairly evaluated by the legislator. As physicians, our greatest ability to collectively influence our legislature is through our medical organizations (DCMS, FMA, AMA, and specialty societies). These organizations have the political expertise and lobbying ability to make a difference — whether it is in Tallahassee or Washington. Usually every year in Florida, a few bills favorable to medicine are passed and numerous bills that would negatively impact the way we practice are defeated. Without the FMA's presence, many of these "bad" bills would be law. Al Smith, a former FMA president, once said "If you think practicing medicine is tough now, try living without the FMA to protect your interests in Tallahassee." I concur with this wholeheartedly and encourage all physicians to give of their treasure and if possible of their time to support these legislative efforts. The potential return on investment is enormous. February, 1999/ Jacksonville MedicineWhat's New
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Northeast Florida Medicine Journal ·
Know Your Physician
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Duval County Medical Society
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555 Bishopgate Lane
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Jacksonville, FL 32204 |
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