As you might have heard by now, there's an election coming up this November. It's a pretty big one, what with the White House and control of Congress up for grabs and all. The candidates have already been making a lot of noise and so have all of those so-called special-interest groups. And it's about to get a whole lot noisier as we approach the party conventions and then plunge headlong into fall.

It never fails to crack me up when reporters and others talk about "special-interest voters," as though there might be a huge proportion of the American electorate whose interests aren't special or who maybe don't have any interests at all. Everybody's got an agenda. Everyone of us is a member of one special-interest group or another — more than one, depending on our socioeconomic status, our age, our profession, our hobbies, our relationships, our ethnicity, our religious beliefs or lack thereof, our health care status and on and on.

If you're reading this, it's reasonable to assume that one of your special interests is hospitals. And there's probably never been an election more important to people with a special interest in hospitals than the one coming right up.

As the American Hospital Association pointed out when it launched its "We Care, We Vote." initiative last month, Congress must confront a backlog of funding issues of concern to hospitals by Dec. 31 — a date known inside the Beltway as the "fiscal cliff." Among those issues: the moratorium that would prevent cuts to Medicare physician payments, the payroll tax cut and the so-called Bush tax cuts. On Jan. 3, the automatic budget cuts in last year's Budget Control Act kick in and soon thereafter, Congress will have to consider raising the debt limit again.

There's little doubt the federal deficit will be issue No. 1 for whoever wins in November. As they demonstrated in the compromises that helped lead to the Affordable Care Act, hospitals understand they'll have to shoulder some of the burden. And, as H&HN has reported in our ongoing Fiscal Fitness series, a lot of hospitals are working hard to improve the quality of what they do and to do it more efficiently, which should help bend the health care cost curve.

But further cutting payments to providers for Medicare and Medicaid could have serious consequences: reduced access to care for patients and longer wait times; fewer doctors, nurses and other caregivers; and restricted availability of new and improved treatments and technologies.

Candidates need to understand those consequences, and hospital leaders, staff, clinicians, trustees, volunteers and vendors need to help them understand. You can't afford to sit passively by and watch this campaign play out without you. Speaking up, forcefully and frequently, is imperative.

But for gosh sakes, keep calm about it. We've all had enough of special-interest groups that mistake vitriol delivered at high decibel levels for political discourse. All those people with their faces balled up, veins popping out of their temples and steam shooting out of their ears do scare me. What they never do is convince me or anybody else I know that they're right

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