What's at Stake for Docs in Va. Election Results? Page 1 of 15 The Leg.Up Local, state and national news of interest to the physician community November 6, 2013 Mark B. Monahan, MD Virginia Urology Richard A. Szucs, MD Commonwealth Radiology Ritsu Kuno, MD Pulmonary Associates of Richmond In This Issue Vote for your 2014 Board of Trustees Vote to AFFIRM Your RAM Board! Please VOTE now to AFFIRM the proposed McAuliffe & Northam leadership of the Academy for 2014. Yes, Victories and You! it's an uncontested election, but by casting your vote of affirmation you send a strong Coming Soon: "Obama message of support for the proposed 2014 Billionaires" officers and trustees. SNL, Stewart and For 2014, we are voting on the following trustees: Congress Target Sebelius Meet Your Legislators! • Immediate Past President - Richard A. Szucs, MD • President - Peter A. Zedler, MD You Also Can't Keep Your • Vice-President - Harry D. Bear, MD Doctor • Treasurer - Ritsu Kuno, MD • Secretary - Sidney Jones III, MD Why HealthCare.gov • Trustee - Carolyn A. Burns, MD Flopped • Trustee - W. Colin Gallahan, MD • Trustee - Rhoda B. Mahoney, MD • Trustee - Harry (Chip) J. Shaia, MD https://ui.constantcontact.com/visualeditor/visual_editor_preview.jsp?agent.uid=1115496 ... 11/ 07/ 2013 What's at Stake for Docs in Va. Election Results? Page 2 of 15 Most New Coverage in • Trustee - Thomas A. Gallo Medicaid Dr. Avital to Speak at Bon Please click here to learn more Secours' Lecture about each candidate. Should Feds Oversee EMR Please click here to vote in the Errors? 2014 elections OR join us at The Devil (and the the University of Richmond's lawsuit) is in the Details Jepson Alumni Center on November 13th to vote! "Gentlemanly Cavaliers" and Dirty Money in Va. Politics Will Congress Replace What McAuliffe's and Northam's Wins Mean for Medicare's SGR? Physicians To Sleep Perchance to ... Democrat Terry McAuliffe's narrow 3 point victory over Cleanse? Republican Ken Cuccinelli - by a 48 to 45 margin, with "I no longer wanted to be Libertarian Robert Sarvis getting 7 percent of the vote - a surgeon" is sure to keep reverberating across the state and national political landscape. Struggles of Boston Amputees Mount The disastrous roll Cabbage Compound out of the Protects Healthy Tissue federal health from Radiation Damage insurance exchange Is "Scrubbing In" the helped WORST Doc Show Ever? Attorney General What's Coming Up on Cuccinelli RAM Calendar? defy pundits' predictions of a much larger win by McAuliffe's Victory Wave McAuliffe. And with the General Assembly set to take up Medicaid expansion as a first order of business in 2014, physicians will want to keep a close eye (and be part of the conversation) in the days ahead. Doctors have a new advocate in the No. 2 Virginia office, one who can cast tie-breaking votes in the state Senate: Democrat Ralph Northam, a veteran state senator and pediatric neurologist in Norfolk, handily defeated Republican E.W. Jackson by a 12 point margin (56-44) for Lieutenant Governor. In the hotly contested race for attorney general, the battle between the GOP's Mark Obenshain and Democrat Mark Herring was considered a virtual tie today and is expected to require a recount. Click here for the most https://ui.constantcontact.com/visualeditor/visual_editor_preview.jsp?agent.uid=1115496 ... 11/ 07/ 2013 What's at Stake for Docs in Va. Election Results? Page 3 of 15 recent results. "What Republicans will debate was whether Cucinelli was personally too conservative - and his party too toxic after the recent government shutdown - for what is now a classic swing state," writes political analyst Dan Balz in today's Washington Post. With the overwhelming victory of Republican Gov. Chris Christie in New Jersey - making him a leading contender for the GOP's 2016 presidential nomination - Future President Emerges? Balz writes that "the outcomes set up a battle for power between competing wings of the Republican Party. Call it the establishment vs. the tea party, or the gubernatorial wing against the congressional wing. This competition is less about ideology or policy - there is no disunity, for example, when it comes to the party's dislike of President Obama's Affordable Care Act - than about purity vs. pragmatism, tactics and strategy. Or, as Christie has put it, it is about winning an argument vs. winning elections." However that struggle for the heart and soul of the Republican Party plays out, it's pretty clear that Cuccinelli's success in improving his own vote count by attacking Obamacare is sure to "make opposition to the health-care law the first page of the playbook for 2014 races, and possibly for 2016 as well," writes Balz. Back in Virginia, Dr. Ralph Northam, 54, thanked female voters for their support, "returning to the abortion rights theme of his campaign, saying male legislators have no place telling women what to do with their bodies," reports the Virginian-Pilot. "Among the lessons he learned, he said, is that Virginians want their leaders to focus on the economy and jobs. He called for investments in transportation and education." McAuliffe's victory marks the first time since Reconstruction that a political party has held Virginia's governorship for only one term. Voters also bucked a trend going back to 1976 of electing a governor of the opposite political party the year after a president's election. https://ui.constantcontact.com/visualeditor/visual_editor_preview.jsp?agent.uid=1115496 ... 11/ 07/ 2013 What's at Stake for Docs in Va. Election Results? Page 4 of 15 With voter backlash against Obamacare helping Cuccinelli improve his odds at the ballot box, and the uncertainty about expanding Medicaid, RAM members will have plenty to chew on before next year's White Coats on Call visits to the General Assembly! You can get a head start on chatting with YOUR legislators by joining in on our "Legislator Meet & Greets" later this month (please see item below!) Click here to read this analysis by veteran political writer David Ress in The Daily Press. "McAuliffe's precedent shattering election leaves Virginia with an even more divided state government," he writes. "The GOP remains in firm control of the House of Delegates. There now will be a Democratic lieutenant governor to break tie votes in the evenly divided state Senate, a role that Republican Lt. Gov. Bill Bolling used to help make GOP-backed voter ID and education reforms law. And McAuliffe seems likely to be working with a Republican attorney general." While the latter statement is questionable -- the recount may go the Democrats' way -- Ress and other pundits are seeing possibly polarizing times ahead. Though McAuliffe thanked "historic numbers of Republicans who crossed party lines to support me," and, according to this report in The New York Times "invoked a tradition of bipartisanship in Richmond" (lauding outgoing Republican governor Bob McDonnell), others see hard times ahead in Virginia's capital. "It will be just like Congress - just an ugly, ugly mess," one veteran Richmond lobbyist told the Times-Dispatch. "Look what the Republicans did to Mark Warner and Tim Kaine. I can't see how they're going to let (McAuliffe) have a free ride." So when it comes to Democratic proposals to expand Medicaid, McAuliffe will have his "hands full, " Schapiro said today on WCVE/NPR. Coming Soon: "Obamacare Billionaires" From the "if you can't beat 'em, join 'em" department: While many Republicans still oppose Obamacare, other members of the GOP on Wall Street have seen its profit potential, priming the pump for the first wave of "Obamacare billionaires," Adam Davidson writes in The New York Times Magazine. https://ui.constantcontact.com/visualeditor/visual_editor_preview.jsp?agent.uid=1115496 ... 11/ 07/ 2013 What's at Stake for Docs in Va. Election Results? Page 5 of 15 While the prevailing narrative among Republicans has been a "government takeover" of medicine, Tom Scully, former CMS director under President George W. Bush in 2001, and a longtime Republican-turned- entrepreneur, told a crowd at New York's posh "21" Club: "It's not a government takeover of medicine. It's the privatization of health care," Scully said. Obamacare "was largely based on past Tom Scully Republican initiatives. If you took George H.W. Bush's health plan and removed the label, you'd think it was Obamacare." Scully, who helped design and execute Medicare Part D while at CMS, has been telling interested investors, the Times reports, that "no matter what investors thought about Obamacare politically ... the law was going to make some people very rich." The ACA, Davidson writes, "wasn't simply a law that mandated insurance for the uninsured. Instead, it would fundamentally transform the basic business model of medicine. With the right understanding of the industry, private-sector markets and bureaucratic rules, savvy investors could help underwrite innovative companies specifically designed to profit from the law. Billions could flow from Washington to Wall Street, indeed." And that's why this Republican health care advisor turned investor has taken a different tack: "During the past three years, as other Republicans have tried to overturn Obamacare, Scully searched for a way to make a killing from it." He co-founded a company based in Nashville, naviHealth, "designed to streamline an enormous but often overlooked corner of the health care market that, many studies conclude, is the most financially wasteful: post-acute care." Though the idea appears sound, the current competition for market dominance reminds Davidson of the early days of Google (which beat out Yahoo) and Amazon (which beat out many other online retail stores, such as Pets.com).