The AAO has a communication challenge, and I applaud the Council on Communications on their efforts to improve the system. Unfortunately, some of the loudest voices of our organization tend to be of a contrarian nature. This tends to be strongest around the dues statement or any campaign to raise money for the AAO’s Political Action Committee (“AAOPAC”). The resounding rallying cry is, “What do I get for my money?” I would like to respond by saying, “Let me share with you what you didn’t get.”
Thanks to our voice in Washington, both alone and with other health care groups, the AAO was able to keep our members from “getting” many things for their money. Please remember, laws are mandates and not suggestions. The following are some brief examples of what we did not get:
Ergonomic Laws: These laws would affect how we practice. Imagine having to provide additional breaks and ergonomically correct chairs and desks.
HIPAA Laws: HIPAA laws in the Affordable Care Act would have required health services to be provided in a private setting. The majority of orthodontists practice in an open bay concept. We would have had to provide an individual room for each patient. This would have been a costly retrofit.
1099 Rule: Initially part of the Affordable Care Act, it would require a business to provide a 1099 form to any business to which we paid $600 or more. Think of all of your suppliers. Then imagine having to send a 1099 form to each one every year.
FSA Elimination: The initial Affordable Care Act eliminated the Flexible Spending Account. Nationally, almost 2/3 of orthodontic care expenses are supplemented by FSAs. Once averaging around $5000 per family, it dropped to zero. We have gotten it back to $2500, and it is now at $2600 (indexed for inflation).
Medical Device Tax: Included in the Affordable Care Act, this 2.3% excise tax imposed upon the manufacturers of medical devices includes just about everything an orthodontist uses. This tax, directly or indirectly, is passed on to us the consumers. The Medical Device Tax is currently postponed, but not repealed. We have been working to have it eliminated before it comes back into play.
These are just a few items that we did not get. We can complain about the AAOPAC contribution in our dues statement and demand to know what we get for our money. How much would it cost to provide 1099 forms to suppliers or put partitions between our chairs? How much would new patient flow decrease because some folks could not afford it? How much revenue would be consumed in excise taxes? I would postulate that we could easily be spending 10 times the amount of the AAOPAC’s suggested contribution ($500 a year) to comply with these proposed laws.
Take a moment and think about it. We really should be grateful for what we did not get for our money.
To learn more about the AAOPAC, please visit the AAOPAC website at https://www.aaoinfo.org/legal-advocacy/aaopac/
– Dr. William Crutchfield