Presidential Update: Poised to Shape the Future of Musculoskeletal Care

Last week, I interviewed orthopaedic residency candidates. I am continually struck by the passion and talent of our applicants. They are smart and committed. They want to be orthopaedic surgeons because they know it is the best job in the world. All of us should have the opportunity to listen to these valedictorians, Olympic athletes, and Eagle Scouts enthuse over the prospect of doing what we often take for granted. It reinforces that we have chosen a wonderful profession and reminds us of how grateful we should be. Like most of you, I often lose sight of this. Certainly, our profession and the way we care for our patients has evolved. The profession is barely recognizable from when I joined the field of orthopaedics in 1991. However, even with all of the changes, it remains a rewarding and fun profession. Just listen to our young members, they will tell you!

As the dust begins to settle in Washington, D.C., we are getting a clearer picture of what the new administration’s healthcare policy will look like. President Biden continues to push for the quick passage of another round of COVID-19 relief, in the form of a $1.9 trillion package through budget reconciliation. Among other things, the relief plan would provide additional stimulus checks, funding for vaccine distribution, and money for schools to reopen. Republicans oppose the cost and size of the package and articulated their concerns to the President in a bipartisan meeting last week. The alternative relief package they are proposing would cost roughly $600 billion. It would reduce the direct payments to families from $1,400 to $1,000 and does not contain emergency funding to state and local governments. While the two parties continue to disagree on both the procedure and approach to additional COVID-19 relief, President Biden has repeatedly emphasized that Congress should pass legislation before existing benefits expire in March.

The Biden administration is also busy on the regulatory front. It recently announced several temporary leadership appointments to oversee the Department of Health and Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), Food and Drug Administration (FDA), and U.S. Public Health Service (USPHS) until permanent leads are confirmed. Norris Cochran, who previously served as deputy assistant secretary for budget at HHS, will serve as acting HHS secretary while the new administration awaits Senate confirmation of Xavier Becerra. For CMS, Elizabeth Richter will serve as acting administrator and Jeff Wu will serve as acting principal deputy administrator; Chiquita Brooks-LaSure has emerged as the leading candidate to be the next CMS administrator. The Biden administration has not yet nominated a permanent commissioner for the FDA, but Janet Woodcock, MD—who brings experience from her involvement with Operation Warp Speed—has been named as interim commissioner. Lastly, Rear Admiral Susan Orsega has been named acting U.S. surgeon general until Vivek Murthy, MD, receives confirmation and assumes the role he previously held under the Obama administration.

Fortunately, the AAOS Office of Government Relations is poised to work with whomever the Biden administration chooses to lead its healthcare policy team. That is the benefit of being an organization that sets politics aside and places the advancement of musculoskeletal care before all else. Like the rest of the country, our members have different opinions and priorities; however, we share the common objective of shaping healthcare policy that allows us to provide the best possible care to our patients. That goal will remain center stage as recommendations from the AAOS Orthopaedic PAC Executive Committee regarding future contribution criteria make their way to the Advocacy Council, and then on to the Board of Directors.

Speaking of the future of musculoskeletal care, in a few short weeks, another 750 incoming orthopaedic surgery residents will receive the Match Day letter that changed our lives forever. We owe it to them and to our patients to get things right, and I’m confident that we will if we continue to embody our core values.

Stay safe and healthy,

Joseph A. Bosco III, MD, FAAOS
AAOS President