From the Editor: Black Knights

Thursday, June 30, 2005

There was no end of interest in competitive bidding at the AAHomecare Conference last month. Tom Scully told attendees they could fine-tune it or slow it down but not stop it. Congressman Mike Ross called it a dumb idea. HME suppliers on visits to legislative offices railed against it.
During an AAHomecare panel at the conference, several voices sounded off on the issue. One attendee called for a comprehensive legal analysis or assessment of the issue so the industry might consider its options. Another man complained that PAOC was inadvertently putting a stamp of approval on the issue by offering advice to CMS about how to handle the issue. Others talked about fighting competitive bidding as if the issue had reared its head yesterday. It didn't.
This is the thing about competitive bidding: It's with us now. Congress wrote the legislation. The president signed it into law. CMS is writing a notice of proposed rulemaking. Many of the options that people want the industry to pursue in its fight against competitive bidding are good but moot.
Some of the intra-industry protesting reminds me of the Black Knight in Monty Python and the Holy Grail. Remember that guy? In a sword fight against King Arthur, he lost one limb after another until he was armless and legless but still threatening his armed opponent. "I'll bite your legs off!" he yelled as Arthur clopped away.
If you've read this far and decided that this position is one of resignation and submission, you've missed the point. The point is that you can't fight the good fight now the way you were fighting it before the MMA chopped your arms off. It'd be foolish to boycott PAOC or dedicate resources toward a legal assessment of competitive bidding.
It won't be foolish to support Rep. Dave Hobson's efforts to introduce legislation that would mitigate competitive bidding. Or, as Ross, suggests, to build bridges toward seniors who are likely to be disgruntled by their prescription drug benefit after the law kicks into gear Jan. 1.
Unless of course you're a black knight, who believes his current pains are but a "flesh wound."