Congressional power shift: MDs will feel impact on many fronts

The impact will be felt on several fronts, including Medicare and how physicians are paid for their services. Democrats have already signaled that they want to negotiate prescription drug prices directly with pharmaceutical companies, a move that has not been met with glee in that industry.

All over Washington, lobbyists are scurrying to strengthen their relationships with Democrats. The comment by one long-time health industry lobbyist summed it up.

The new 110th Congress will welcome 60 new members: 54 in the House and six in the Senate, which will shift from 55 Republicans, 44 Democrats, and one Independent to 49 Republicans, 49 Democrats, and two Independents, both of whom will caucus with the Democrats, giving them a narrow 51 to 49 majority. In the House, the margin switches from 232 to 203 with a Republican majority to a 231 to 202 Democratic edge. (Two races, at press time, were still undecided.)

With victory comes the spoils, and in Congress, that means Democrats are now in charge of all congressional committees. Not only do they chair the committees, they get the most members and more staff than the Republicans do. It's a reversal of what has been a Republican advantage for the past 12 years.

In the Senate, Sen. Edward M. Kennedy (D-MA) now runs the Senate Health, Education and Pensions (HELP) Committee, where he immediately declared removal of barriers to stem cell research a major priority. That, no doubt, will set up what could be an emotional confrontation with President Bush.

"We will be back again and again [in 2007] until we succeed in overturning the restrictions on stem cell research that hinder the search for new cures and delay the day when the hope of a better future becomes a reality for patients across America," Kennedy said in a post-election statement outlining his priorities for the new Congress.

In the House, led by new Speaker Nancy Pelosi (D-CA), the chairman of the House Energy and Commerce Committee is Rep. John Dingell (D-MI), who has also laid down some markers. In late November, Dingell promised that he and other Democrats would carry out several investigations, including at least one involving Medicare. Dingell has been a critic of the Medicare prescription drug program, and will push for direct governmental negotiation with pharmaceutical companies on drug prices, which he says could save seniors as much as 25% on their prescription drug costs.

A strong Dingell ally is Rep. Henry Waxman (D-CA), the new chairman of the House Energy and Commerce Subcommittee on Health. Last year, Waxman and some other leading Democrats introduced the "Medicare for All Act," which would make health care coverage available to every American by expanding the Medicare program to those under age 65. Under the proposal, citizens could choose health insurance coverage through Medicare or through any plan available to members of Congress, the president, or other federal employees.

Just before adjournment last month, Congress approved a catch-all bill extending some popular tax cuts and including key trade provisions, and rolling back an average 5% Medicare physician pay cut that was slated to take place Jan. 1. The bill also promised a bonus payment of 1.5% for the last 6 months of 2007 for those doctors who participate in new reporting requirements to help Medicare collect quality-of-treatment data.