Get out the vote: Make a difference on issues of critical concern to surgery

Legislative and regulatory policies can directly affect surgeons and patients. Fellows who take action and leverage their voices through political advocacy help to demonstrate the profession of surgery’s position and allow the American College of Surgeons (ACS) to serve as a valuable resource to policymakers while helping to effect real change in health policy.

The 2015–2016 election cycle is proving to be one of the most unpredictable, yet critical, U.S. elections in recent years, which is why it’s so important to get out the vote. Candidate platforms include proposals pertaining to Medicaid and Medicare, health information technology, research, funding, and many more health care-related issues that have the potential to affect the future of surgery and the surgical patient. Both inside the halls of Congress and locally back home, it is crucial that the College’s surgeon advocates engage with their representatives, educate them about issues affecting their patients and practice, and provide feedback to the ACS Division of Advocacy and Health Policy’s federal legislative team.

Make your voice heard

The ACS and the ACS Professional Association (ACSPA) work to ensure that issues of concern to surgery remain top priorities on Capitol Hill. To uphold the College’s stance on promoting and protecting the future of surgical practice, members are encouraged to register to vote prior to Election Day.

According to the National Conference of State Legislatures (NCSL), more than two-thirds of the states (37), plus the District of Columbia, offer some form of early voting. Many proponents argue that early voting makes the process easier, and, as a result, increases turnout, which may be significant come November. Additionally, the Pew Research Center’s July and August 2016 studies examining this year’s presidential election suggest that while many voters appear conflicted about this election process—with respondents’ views ranging from more interested in politics than they were four years ago to completely turned off by this year’s campaigns—it appears that turnout can be relatively high even when voter satisfaction with the candidates is low, and vice versa.¹

Before you cast your vote, visit SurgeonsVoice.org, the College’s nationwide, interactive advocacy program, to get up to speed with the lawmakers in your state and district. SurgeonsVoice has several resources to assist you, including an interactive map and toolkit. The interactive map allows you to learn about the key players from your state on Capitol Hill and important legislation in your state legislature.

The SurgeonsVoice toolkit is the College’s most comprehensive pre-election education resource.  Issue briefs, talking points, and PowerPoint presentations are available to assist you in evaluating where your candidates stand in terms of the ACS legislative priorities.

For an insider’s perspective on races within your congressional district, contact the ACS Washington office staff at ahp@facs.org or 202-337-2701.

Surgery’s success starts with ACSPA-SurgeonsPAC

Although the ACSPA’s political action committee (ACSPA-SurgeonsPAC) does not participate in presidential elections, gauging how it and other health care PACs disburse contributions to candidates can be helpful in benchmarking which members of Congress are advocating for the future of health care.

Standing together as surgeons allows surgeons to make a difference when it comes to the issues they care about most. ACSPA-SurgeonsPAC, in conjunction with the College’s federal legislative team and surgeon advocates, works to establish relationships with surgical champions on Capitol Hill. The more champions we have in Congress, the greater success we will have leveraging our issues and establishing surgeons as leaders and partners in finding legislative solutions to complex issues. The following guidelines shape the ACSPA-SurgeonsPAC disbursement strategy for candidates:

• Leadership position. Candidates who serve as ranking members of their parties have a greater ability to move legislation forward and influence his or her party’s position on the issues.
• Committee assignment. Candidates who serve on key committees are better positioned to advance health policy legislation in support of surgeons and the surgical patient.
• Record on issues. ACSPA-SurgeonsPAC evaluates candidates’ service as champions for surgery and the surgical patient.
• Medical professional. Candidates with medical degrees, especially surgeons who are Fellows of the ACS, are recognized leaders in health policy.
• Political viability. The candidate should have an organized campaign with demonstrated potential to win.

Candidates and incumbents supported by ACSPA-SurgeonsPAC

To enhance the probability of electing and re-electing candidates who are sympathetic to the concerns of surgeons and their patients, the ACSPA-SurgeonsPAC has contributed more than $900,000 to key U.S. House and Senate races across the country. In addition to supporting 14 physician incumbents, ACSPA-SurgeonsPAC has contributed to seven physician and dentist candidates’ campaigns, including two Fellows of the College. The following are a few examples of candidates and incumbents whose races ACSPA-SurgeonsPAC has supported to date:

• Rep. Ami Bera, MD (D-CA). Representative Bera is one of the few Democratic incumbents facing a tougher race than expected this year. Since being elected to California’s Seventh Congressional District in 2012, he has worked his way up the ladder, gaining respect and support from key Democratic leadership and is one of the few Democratic liability reform champions in Congress. Representative Bera’s first political event was held in the ACS Washington, DC, Office board room, and he has championed many efforts important to members of the College.
• Neal Dunn, MD, FACS (R-FL). Dr. Dunn is on the National Republican Congressional Committee (NRCC) “young guns” list, which means he is running for one of the most competitive congressional seats in the 2016 election cycle. Dr. Dunn is a urologist and Fellow of the College who is running in Florida’s Second Congressional District. This is an open seat vacated by Rep. Gwen Graham (D-FL). Dr. Dunn has support from former Florida House Speaker Allan Bense (R), the Florida Medical Association, and several physician groups in Washington, DC.
• Drew Ferguson, DMD (R-GA). Dr. Ferguson is a dentist running for Rep. Lynn Westmoreland’s (R) seat in Georgia’s Third Congressional District. In Georgia, the winner of the primary (held this year on May 24) must take 50 percent plus one. If this goal is not accomplished, the top two candidates—in this case, Dr. Ferguson and state Sen. Mike Crane (R)—enter a runoff, which Dr. Ferguson won July 26 with 54 percent of the vote. Dr. Ferguson is strongly favored to win the general election in this heavily Republican district.
• Raja Krishnamoorthi (D-IL). Mr. Krishnamoorthi, considered to be one of the Democratic Party’s emerging leaders, is running in Illinois’ Eighth Congressional District as Representative Tammy Duckworth (D-IL) vies for the Senate seat. Mr. Krishnamoorthi is still the clear frontrunner, receiving critical endorsements from President Barack Obama, Representative Duckworth, and more than 20 other members of Congress, including Sen. Dick Durbin (D-IL), House Democratic Leader Nancy Pelosi (D-CA), and Rep. Jan Schakowsky (D-IL).
• Roger Marshall, MD (R-KS). Dr. Marshall, an obstetrician-gynecologist from Great Bend, won the August 2 Kansas First Congressional District Republican primary with 57 percent of the vote against incumbent Rep. Tim Huelskamp. This win is significant, as Representative Huelskamp is the first House Republican in this election cycle to lose a primary for reasons unrelated to redistricting. Whereas this district is solidly Republican, Dr. Marshall is the projected winner for the general election.
• Rep. Tom Price, MD, FACS (R-GA). Representative Price is an ACS Fellow who has risen through the congressional ranks. Serving on the advisory group to House Speaker Paul Ryan (R-WI), Rep. Price is typically in the room when key decisions are made. He played a critical role in inserting the global codes provision in the sustainable growth rate formula, as well as advocating that future payment models should be physician-centric.

To view a complete list of candidates supported by ACSPA-SurgeonsPAC in your state, visit SurgeonsVoice.org. To learn more about ACSPA-SurgeonsPAC’s disbursement process, contact ACSPA-SurgeonsPAC staff at surgeonspac@facs.org or 202-672-1520.

Election update

Many of this year’s congressional races have proven competitive, and the November election results may change the political climate of the U.S.

Approximately one-third (34) of U.S. senators are up for re-election in November. Members of Congress within both parties are concerned that the current political climate may cause a shift in power. At present, the Senate is composed of 44 Democrats, 54 Republicans, and two Independents. According to recent polls and race ratings, including The Cook Political Report, a nonpartisan online analysis of electoral politics, the U.S. Senate has several vulnerable “toss-up” seats; two are held by Democrats and seven by Republicans.^2,3 (See sidebar.)

At present, Republicans have a 54–46 majority in the Senate. To gain a majority in the Senate, Democrats would need a net gain of five seats. Sources such as The Rothenberg and Gonzales Political Report indicate that Democrats are likely to gain 3–6 seats.⁴

In terms of the House, although Republicans have a 247–188 majority, recent polling analyses predict Democrats are likely to pick up at least 10 seats, but larger numbers are conceivable.⁵ The possibility of Democrats gaining control of the House also continues to grow as Democrats only need to win 15 races to obtain majority status. Some of the most contested House races nationwide include three Democratic and 16 Republican seats. Toss up seats in the House appear in the sidebar.

To influence election outcomes, many political groups have recently increased their presence in some of these contentious races, including the National Republican Senatorial Committee and the Democratic Senatorial Campaign Committee, both of which are investing staff, time, and money in Arizona, Colorado, Florida, Illinois, Iowa, Maryland, Missouri, Nevada, New Hampshire, North Carolina, Ohio, Pennsylvania, and Wisconsin. Similarly, the Democratic Congressional Campaign Committee and the NRCC are promoting their respective “emerging races,” “red-to-blue” candidates, and “young guns” to increase contributions. From investing in ads in battleground states to adopting the use of Snapchat to expand their demographic reach via custom filters and videos, party committee tactics are proving to be almost as competitive as some of the races themselves.

ACS continues to fight for surgery

In this unpredictable election year, one fact is certain: the ACS continues to have strong working relationships with both Democrat and Republican members of Congress and will continue to successfully advocate on behalf of all of surgery during the remainder of the 114th Congress and beyond.

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References

1. The Pew Research Center. 2016 campaign: Strong interest, widespread dissatisfaction for July 7, 2016. Available at www.people-press.org/2016/07/07/2016-campaign-strong-interest-widespread-dissatisfaction/. Accessed August 25, 2016.
2. The Cook Political Report. 2016 Senate race ratings for August 19, 2016. Available at: www.cookpolitical.com/senate/charts/race-ratings. Accessed August 25, 2016.
3. The Pew Research Center. U.S. voter turnout trails most developed countries for August 2, 2016. Available at: www.pewresearch.org/fact-tank/2016/08/02/u-s-voter-turnout-trails-most-developed-countries/. Accessed August 25, 2016.
4. The Rothenberg and Gonzales Report. Senate ratings. Available at rothenberggonzales.com/ratings/senate. Accessed August 25, 2016.
5. The Rothenberg and Gonzales Report. House ratings. Available at rothenberggonzales.com/ratings/house. Accessed August 25, 2016.