The major work of the 110th Congress is pretty much finished. Passage of legislation averting a pending reduction of physician payments under Medicare in late June marked the only opportunity to address industry grievances this session. From this point, the Congressional calendar reveals the short work weeks, frequent recesses, and early adjournment of an election year. As readers know, all 435 seats in the House and 35 seats in the Senate are up for grabs this year.

This month's Our Turn is trying its hand at handicapping what the 111th Congress will look like from an industry perspective. As always, House incumbents have a tremendous advantage going into the election but that's not true for open seats. The party in control (Democrats) has a slight advantage in open seat elections, and 24 Republicans are retiring from the House versus only four Democrats.

That being said, it's a safe bet that the Democrats will increase their lead in the House. And if Barack Obama prevails in the race for the White House, that lead could be substantial. However, the industry will undoubtedly miss the presence of one of its major supporters, retiring Rep Dave Hobson (R-Ohio). Hobson was either the sponsor, or a major cosponsor, of every piece of legislation on the industry's agenda in 2008 as he has been throughout his nine terms in Congress.

Five Republican members of the Senate have already announced their retirements. With the latest available data gathered by professional pollsters at Quinnipiac University, the University of Cincinnati, and Rasmussen Tracking, it looks like there are 12 to 14 competitive Senate races, 10 of which are currently held by Republicans in swing states. Therefore, it is highly likely that the Democrats will pick up four or five—maybe even six seats in the Senate—but it is equally unlikely they will achieve the 60-seat "super majority" their leaders so desperately long for.

The race for the White House could prove to be interesting. No matter what happens on November 4, the next president will make history either as the first African American, or the oldest person ever elected to the highest office in the land. At this point, polls show Senator Obama leading Senator McCain by a margin of three to seven percentage points in the popular vote. However, all polling data points to another nail biter on election night with the final outcome dependent on the battleground states of California, Texas, Florida, New York, Michigan, Illinois, and, of course, Ohio.

Look forward to a lively campaign that, if the candidates stick to their promises, will be about issues rather than personal attacks. Between now and November, Americans will have the opportunity to closely examine both candidates to see where they stand on hot button issues. This will also be true for industry advocates.

The next president will inherit an immense national debt, an unpopular war, and a Medicare program significantly challenged by the coming onslaught of Baby Boomers. The country is eager for change and hungry for decisive leadership. It will be difficult to get the administration to focus on industry issues. It would be nice if these issues had a friend in the White House, but the crushing demands of the Medicare and Medicaid programs are left to the bureaucracy—and that means legislative relief is often the only avenue for redress against bad policies (competitive bidding), much less proactive initiatives that favor home-based health care options.

So who's the best bet for filling Hobson's role as "the industry champion"? There were others such as Reps Mike Ross (D-Ark), Jim Langevin (D-RI), and John Tanner (D-Tenn). Maybe one of them or someone in a leadership position will step up to fill Hobson's role as the "go-to guy"—but there is an unspoken quid pro quo, and it's more than a small fund-raiser or a chance to address a legislative conference.

It's an old rant but a timely one. The best way to get politicians to pay attention to your issues is to be there for them now when they need you more than ever. There are few uncontested races for Congress, and no matter what the polls say today, any candidate can win in November. As a campaign volunteer, you literally get to help put the person in office and, with the exception of presidential campaigns, winning candidates get to know each one of their campaign workers before November 4.

Volunteer for the health care policy staff of a candidate for Congress. You might be subordinate to a 20-something fresh out of college, but when you let the right people know who you are, and your field of expertise, you might just get a chance to help draft a position paper on the subject and include industry issues. That is how advocates for industry issues are made, and only you have the power to create them.

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