It now appears that Congress will be unable to achieve consensus on the Medicare prescription drug legislation that includes competitive bidding in the House version, and a 7-year price freeze in the Senate version.

Trust us, competitive bidding versus a price freeze is not the seminal issue that could condemn this bill to history’s trash heap. The fact is that the two bodies have adopted radically different approaches to providing seniors with a prescription drug benefit.

And so, the HME industry may have dodged the bullet of nationwide competitive bidding again. Using an old analogy, one could say that the glass containing the political assets of the industry should be considered “half full.” Another reason for optimism is the fact that a growing number of companies are investing time and money into influencing the legislative process. It was not that long ago when one or two people were doing all the heavy lifting for the industry.

On the other hand, some will look at the same glass and suggest that it is half empty. First, some very influential members of Congress are convinced that all HME providers are dishonest. Until they can be convinced otherwise, they will continue to churn out proposals like nationwide competitive bidding. At the same time, you don’t need all 10 fingers to count the members of the House and Senate who truly understand the HME industry and its issues and who can be counted on to support our position on a regular basis.

Second, now that the pressure is off for this year, most of the grassroots efforts to educate Congress on the benefits of home health care will grind to a halt. More than 8,000 bills are introduced every 2 years. Absent a sustained and meaningful effort to educate members and staff on the issues important to the industry, HME issues will always be an afterthought at best.

Third, while the number of companies participating in lobbying activities is growing, it is still a small minority of the people and businesses affected by proposals like competitive bidding. Heck, our national trade association still has less than 1,000 member companies out of a potential membership of well over 10,000. Too many companies are willing to sit back and let a few of their competitors do all the work.

Finally, and perhaps most important, our industry remains adrift with no vision and no long-term agenda. The only time Capitol Hill hears from most HME representatives is when they are facing a crisis like competitive bidding. And then, many providers whimper to their legislators about being treated like commodity brokers rather than health care providers yet question the need for, or cost of, accreditation or professional certification. The industry knows that a small number of providers engage in fraudulent activities but waits for the government to deal with the problem rather than proposing ways to reduce or eliminate fraud.

The political glass of the HME industry will remain half-empty until and unless its leaders develop a proactive, long-term agenda that addresses these issues. The industry needs to get serious about working with Congress to help control health care costs. If the industry does not propose solutions to the challenges facing Medicare, the bureaucracy will, and you can bet you won’t like them.

The industry must make a concerted effort to build and maintain strong relationships with as many members of Congress as possible, as well as develop a strategic vision of its place in the continuum of care and develop a long-range plan for getting there. The central focus of the message must be on how the HME industry plays a significant role in providing quality products and services that reduce costs and result in acceptable outcomes for Medicare beneficiaries.

Ask yourself the following questions: Are you doing everything you can to fill the political glass of the HME industry? Does the industry have the political capital to deal with its next challenge? Does the industry have a plan that protects good providers and gets rid of the bad apples? Can the industry articulate a vision of the role it can play as the health care system is forced to address the financial challenge of serving the Baby Boomers?

The HME industry’s ability to respond to the next challenge it will face requires that the answers to these questions be “yes!”

Cara C. Bachenheimer, JD, is a partner at the law firm Epstein, Becker & Green in Washington, DC. David T. Williams is director of government relations for Invacare, Elyria, Ohio.