This week, over 30 CSA delegates and many more CSA members are in Washington DC for the ASA Annual meeting. As usual, the educational and governance sessions are in full swing and thousands of anesthesiologists can be found engaging in a range of opportunities at the DC convention center. They say that all politics is local, but we are meeting in DC during an election year, and it would seem that national politics is on everyone’s mind.
The ASA opening session reflected this, as the keynote speakers were James Carville and Mary Matalin. In a question and answer format moderated by ASA First Vice President Jane Fitch, MD, the two were alternately serious, witty and combative, playing to the crowd as expected. Many of Dr. Fitch’s questions were about the national political scene and Carville and Matalin’s opinions and predictions about the upcoming election—which they both believe is currently too close to call and will come down to the performance and communication abilities of the candidates and their campaigns in the final stretch. Dr. Fitch also reflected the concerns of ASA members on the issues of Health Care Reform (HCR) and the Affordable Care ACT (ACA). It was at this point in the proceedings that the conversation became particularly heated, with Carville and Matalin interrupting one another and barely looking at each other.
Carville and Matalin’s differing points of view on the ACA reflected the chasm in the Republican and Democratic points of view. Matalin believes that the majority of Americans favor repealing the ACA, that senior citizens don’t like it because they understand the impact on their own lives, and that for seniors it has become an economic as well as a health care issue. Carville stated that the framework of the ACA is a good one, insofar as it puts the healthy population in the same pool as the sick one so that the resources were available to take care of all. He believes that any problems with the ACA could be handled with ongoing tweaks and adjustments. Matalin stated that not having insurances is not the same as not having access to health care, and that people are smart enough to figure out what to do without having the government tell them. Carville questioned who would pay for care without the government mandate…. It is certain that this argument/discussion will continue on a local and national level for a long time to come. The outcome of the presidential and congressional elections will have a major impact on how this process and discussion moves forward legislatively.
At the governance level of the ASA, the first meeting of the ASA House of Delegates (HOD) took place on Sunday, October 14. The candidates for ASA officer positions addressed the HOD. Of note were the speeches of ASA President-elect John Zerwas, MD and First Vice President Jane Fitch MD. Dr. Zerwas described the theme of his upcoming presidency, driven by the strategic plan of the ASA. He emphasized the financial security of the ASA, the need to bring exceptional staff talent (“we are on a path to bring the best and the brightest to the ASA”), and improving lifelong continuing education resources for members as a primary focus for the upcoming year. The new ASA Committee on Future Models of Anesthesia Practice was described as a means to explore the peri-operative surgical home concept and an “opportunity to define the future of health care and be defined by it.”
Dr. Fitch elaborated on the theme of this year’s Annual Meeting: Transforming Patient Safety Through Education and Advocacy. She deftly continued with the theme of safety by describing it as a “safety net for our patients through physician supervision.” Along this line, she emphasized the need for a physician-led health care team, the elimination of drug shortages, and a peri-operative surgical home model that must be physician led. Dr. Fitch stated, “never before has the need for eternal vigilance been clearer…or the stakes higher.”
I think we can be confident that our elected ASA officers have the interests of the stakeholder members in what Dr. Fitch described as a “bottom up member driven organization” clearly in mind. At least here in DC, one can find anesthesiologists who know and understand their constituents. Whether that is true on the national political scale and in the context of the national election remains to be determined in November.