As we watch Congress and the Administration tussle with the current Medicare reform legislation, we must begin to categorize the congressional members so as to avoid wasting time and money on people we have no chance of influencing.

The first category is our foes; those members who can be counted on to label every HME provider as a crook or opportunist who is threatening the solvency of the Medicare trust fund. House Ways and Means Chairman Bill Thomas (R-Calif) and Representative Joe Barton (R-Tex) are classic examples of foes of the industry.

The HME services industry has made some progress this year in developing more friends on Capitol Hill. A political friend is someone who will listen to you, offer to run interference, and give voice to the issues or causes you represent. But friends are often reluctant to make solid commitments to which they can be held accountable. You will often hear friends end a conversation with statements such as: “I understand where you are coming from and you have raised a legitimate concern. But I will have to wait to see what direction leadership takes on this issue.”

The problem with friends is that you never really know how they are going to vote until the final tally is in. Moreover, friends are the most likely to trade support for your issue in exchange for votes in favor of their own agenda. Senator Charles Grassley (R-Iowa) understands the HME industry and acknowledges the problems associated with competitive bidding. But he has demonstrated his willingness to trade his vote against competitive bidding for support of his rural health initiatives.

After years of hard work, the industry now has a small cadre of “true believers”—people who understand the role of the industry in the continuum of care and are willing to fight to the death for our issues. Representative Dave Hobson (R-Ohio) and Senator George Voinovich (R-Ohio) are two “true believers” in the HME services industry. Hobson recently told the House leadership that he would vote against any Medicare bill that included nationwide competitive bidding. This is a courageous stance and it will cost him some goodwill with the leadership, but he understands our industry and is willing to spend his own political capital on our behalf. Needless to say, the industry needs more true believers.

That being said, it’s time for the industry to begin a campaign to convert some of our friends into true believers.

The industry should stop wasting time and resources trying to get through to foes like Thomas and Barton. They will never change and we should not reward their bad behavior by throwing cash at them in the hope that they will see the light. Our efforts must be directed at our friends and at the true believers who are our voice on Capitol Hill.

The industry must show its appreciation for people like Hobson and Voinovich by actively supporting their reelection campaigns with money and volunteer labor. HME providers serving the constituents of true believers should make every effort to let their customers know that they are being well represented in Washington, DC. The industry should seek out opportunities to recognize these legislators for their courage and tenacity.

At the same time, the industry should evaluate its list of friends and see which ones may be good candidates to become true believers. These legislators should also be the beneficiaries of financial support as well as active participation in their campaigns. The best way to convert a friend into a true believer is to build a strong personal relationship. Don’t just go to the legislator when a crucial issue is up for a vote but stop in to see them on a regular basis. Invite them to visit your business and see just what you do for patients every day. If the opportunity arises, invite them to speak to a local or regional group of providers and acknowledge their efforts on behalf of the industry.

The Medicare prescription drug bill and Operation Wheeler Dealer are not the only challenges facing our industry. If the industry is to survive and grow to its full potential, we need more “true believers” to stand up for us in the same way Hobson and Voinovich are doing.

Cara C. Bachenheimer, JD, is vice president of government relations for Invacare Corp, Elyria, Ohio. David T. Williams is a consultant for political and legislative strategy.