It was with great sadness that I heard of the passing of Dr. Ken Luedtke. For many of our newer doctors, the name probably doesn't mean a great deal – but for an old political hack like myself or others who lobbied in the profession during the ‘90s and earlier this century, the name is associated with doctors who were politically engaged and contributed greatly to the profession's growth.
My experience with Ken stretches back to when I was the executive director of the California Chiropractic Association. I was aware that he had been active in Wisconsin politics on the grassroots level and had served as ACA president 1987-1989. But his real efforts on the national scene were as the ACA PAC chair, a position he held during the first half of the 1990s.
Spearheading Political Action
The PAC Ken took over was in a sorry state. Its annual contributions were less than some state associations, including California. The contribution philosophy was to make small contributions, always support incumbents and never take chances – a great philosophy if you are a huge organization with a large PAC.
At that time, no one in Washington, D.C., feared the chiropractic profession or paid much, if any, notice to it. But Ken embodied a forward-thinking philosophy; working with a new governmental relations team, including Mark Gooden and Rick Miller, they changed the course of history and substantially increased the presence of the ACA and chiropractic at the Capitol. Public concern over the Clinton health care initiative, coupled with Ken's vision and dogged determination to raise the profession's flag high, helped the ACA PAC become a real force in D.C. politics, virtually overnight.
Ken was a bulldog at fund-raising. At chiropractic events, attendees would want to find out which hotel Ken was staying at to avoid his persistence for donations. No one could turn down his requests for support.
Furthermore, he organized the country into PAC regions, with each state having a representative. This wasn't simply a paper organization, but one in which the doctors were doing the job of raising local money and talking about the importance of a grassroots organization.
These efforts were quickly recognized by the Washington establishment. Prominent publications such as The Washington Post and The Hill identified the ACA as the fifth most effective health care group in Washington, D.C. In 1995, the American Society of Association Executives recognized the ACA with its highest award (best overall federal campaign) for the ACA's Grassroots Emergency Mobilization Campaign.
While the Clinton health care legislation never resulted in meaningful change, the effects of the Ken's efforts would be felt for years. In Washington politics, perception is everything, and the ACA was now perceived as an effective organization. Ken was at the forefront of making this happen.
When I started at ACA as executive vice president in 1995, the ACA was about to take advantage of this newfound recognition. Through Ken, we convinced Congressman Phil Crane, then-chairman of the powerful House Committee on Ways and Means, to present to his committee a full-scope-of-practice Medicare bill for chiropractic care that included reimbursement for all services within the doctor's scope of practice.
The bill passed out of committee with only a few dissenting votes. But like any spending bill, it had to pass by the Congressional Budget Office, whose sole purpose was to score the cost of legislation. Without a comparison model, the CBO assigned it a ridiculous cost. Since the CBO was immune to political pressure and its score was accepted by Congress, our provision died.
Soon after, Ken left the ACA PAC. It was never the same after his departure, but his influence continued. Over the next six to eight years, the ACA benefited from positive legislation and was successful in passing a number of bills regarding the VA, DoD, Medicare, and the Federal Employees Health Benefits Program.
The HHS Connection
While Ken was no longer active with the PAC, his influence continued on Capitol Hill. One of the first appointments made by President George Bush in 2001 was Tommy Thompson, governor of Wisconsin, as the new secretary of Health and Human Services (HHS). Ken's relationship with the secretary went back many years. When Thompson ran for a state senate seat, Ken was an early supporter, and continued this support through his election and re-election as governor. Their friendship grew.
During this time, Ken also became more involved in Wisconsin politics, serving as chairman of the Dane County Republican Party and becoming active in many Republican campaigns. Today, the chiropractic profession benefits form Ken's participation in politics. Some of the more significant pieces of chiropractic legislation were passed by the Wisconsin Chiropractic Association during this time, although I am sure Ken did not get the appropriate recognition. Recognition wasn't something he was seeking.
This connection continued when Thompson became HHS secretary. Ken invited me to attend a Bush inaugural party sponsored by the Wisconsin Republican Party, where, of course, the new HHS secretary and his staff were present. Ken knew everyone at the event, particularly members of the new secretary's staff. This provided the ACA with a fresh opportunity at HHS, one I don't think the association had ever experienced.
Before my involvement with the chiropractic profession,I had worked for HHS Secretary Richard Schweiker during the Reagan administration, so I have a good understanding of what access means. Many people request access to the secretary and never get it. Ken would simply walk into the secretary's office and gain immediate access. I recall one time when Secretary Thompson was speaking at an NCLC event and, from the podium, asked Ken to be sure to drop by his office later in the day, as he needed an adjustment.
Thompson's appointment came at an important time for the chiropractic profession. The previous year, we had filed a lawsuit in federal court against HHS and then-HHS Secretary Donna Shalala for a policy they adopted under the Medicare managed care law that would allow physical therapists to get reimbursed for "spinal manipulation for correcting subluxation." The suit was important not only because the section in Medicare law was a specific reference to chiropractic, but also because the new administration was placing more importance on managed care as a way to control costs. Allowing the PTs this privilege would further squeeze the profession from treating Medicare patients.
I knew HHS wasn't happy with us, as Secretary Shalala raised the issue with me when I saw her at a fund-raising event. She indicated their intent to fight the suit and that they would resist every attempt for settlement. Naturally, the American Physical Therapy Association joined the suit. Curiously, the EVP of the PT association wrote an amicus brief arguing that physical therapy "corrected subluxation." A notion that had been scorned for years was now being embraced by the PTs.
When Secretary Thompson came to office, we immediately began discussions with his staff regarding the suit. After providing them with our arguments, Ken arranged a meeting between Secretary Thompson and our attorney, George McAndrews, at the secretary's home. They hammered out a proposed statement that removed the PTs from the policy statement, as they weren't physicians – while DCs were – under Medicare.
When it became the official policy of HHS, we dropped the suit. The PTs tried to keep the suit alive, claiming the issue needed to be resolved, but without the participation of HHS, it went nowhere.
What a different atmosphere now prevailed. Those of you who haven't experienced working in Washington, D.C., will not find that action particularly significant. But it should be noted that there was no guarantee the courts would uphold our suit, particularly since we were up against a federal agency unhampered by limited resources. The secretary's actions were especially significant, as he stuck his neck out on a position that was contrary to the position of most health care organizations – notably the PTs and the bureaucrats in Medicare.
This was further complicated by pressures put upon the secretary to pursue the Bush Administration's agenda, which required the support of those same groups he was opposing on the issues involving chiropractic. Ken's actions, therefore, took on special significance – it was his connection that made this happen.
With the help of the secretary's staff, we tried to carve out some initiatives to expand on the reimbursement of various services under Medicare, but met resistance from the bureaucrats at every point. Even the HHS secretary can only make a certain amount of progress without the cooperation of bureaucrats. Sec. Thompson had burned a lot of chits on our behalf, and had to move on to other initiatives.
Surely, there were others involved in this and other successes – and a good attorney certainly helps. But it was Dr. Ken Luedtke who had the connections and relationships that made this happen. In my opinion, it was his bulldog, never-give-up determination that took us across the finish line – whether it was raising money for the PAC, confronting members of Congress, or working the trenches for political candidates. He had one goal: developing the necessary political power to help the profession grow. He never looked for headlines or applause.
Ken always walked his talk and you always knew where his heart was. He loved this profession, and although his loss is significant, both to me and the profession as a whole, he has left footprints for others to follow.
