Medicaid Budget; 2/16/04

 

Prognosis looks good for Medicaid budget

Despite a huge state budget deficit, the Medicaid program is in line to receive some much-needed increases during the next fiscal year. Gov. Jennifer Granholm's proposed health care budget protects 200,000 or more Michigan children who stand to lose health care services if additional cuts are made, and also protects thousands of Michigan jobs, the Partnership for Michigan's Health said.

MSMS, a founding member of the Partnership, praised the budget. "The governor's budget is good news for a lot of vulnerable Michigan children to help ensure access to basic health care," said MSMS President Hassan Amirikia, MD. "Funding health care is a sensible investment in Michigan's future."

MSMS physician leaders and other Partnership members spent the afternoon meeting with the following state lawmakers to secure their support of Medicaid relief before they vote on the governor's proposed budget: Sens. Shirley Johnson and Tony Stamas, Reps. David Farhat, Mickey Mortimer, and Gary Newell.

HIGHLIGHTS
While most other departments did not see increases, more than $400 million in state funds have been added to the fiscal year 2005 Medicaid budget, with most of the funds coming from cigarette tax increase
Boosting the state cigarette tax from $1.25 to $2.00 would generate $295 million in new revenue ($30 million would go into the Healthy Michigan Fund for smoking cessation and chronic disease prevention programs, $265 million would be deposited into the Medicaid Benefits Trust Fund to provide direct, ongoing support to the Medicaid program)
Continuing to tax large estates also will generate more revenues ($94 million in fiscal year 2005, and $130 million on a full-year basis) that would also be deposited into the Medicaid Benefits Trust Fund
Funds would also help to reduce Michigan's near nation-leading rate of smoking, protect thousands of health care jobs, and help Michigan improve its status as a "donor state." (For every $1 Michigan spends on health care, the federal government sends Michigan $1.24)
The MSMS Board of Directors will take up the cigarette tax issue during its next meeting in March.
For more information about the Governor's proposed budget, contact Colin Ford at MSMS at (517) 336-5737 or cford@msms.org.

Conference examines patient saftey
The Michigan Health and Safety Coalition has announced its 2004 safety conference, Improving Patient Safety Through Innovation and Action. The conference offers information and dialogue on today’s key patient safety issues.

National experts will explore how to balance accountability with the need to learn from mistakes; how workforce issues affect the quality of care; tools, designs and principles that create a safer environment; and the role of patients and families in patient safety. Concurrent sessions led by Michigan health professionals will focus on innovative ways to improve patient safety in all settings.

The conference is scheduled for April 14-15 at the Ford Motor Company Conference and Event Center, Dearborn. Continuing medical, nursing and pharmaceutical education is being offered for both days and a poster display will spotlight patient safety projects and outcomes by a number of Michigan hospitals and health systems.
The brochure and registration materials are available on the Michigan Health & Safety Coalition’s Web site at www.mihealthandsafety.org.

Editorial: Moving Ahead Or In Circles?
By JOSEPH WEISS, MD
Editor
To date, we have championed the cause of the Detroit/Wayne County Public Health Authority. We, as well as others, see the DMC connection with the Health Authority as the link whereby the promise of health care for the uninsured will become provision.

Recent information gives pause in such faith. Greatly troubling was the Dec. 31 announcement of the sale of five DMC clinics. At that time, the DMC administration stated that this move was a business decision: these facilities were losing $23 million per year. After critics questioned that financial assertion, the DMC administration made another announcement, stating it had made an error: the real financial loss was $3 million per year. Critics of the sale also noted that the facilities being sold provided 50,000 uninsured people with ongoing and good quality medical care.

In response, DMC Chief Operating Officer, Gwen Mackenzie stated that the clinics will not close or stop seeing patients during the transition from the DMC to new owners.

The same newspaper article that quoted Ms. Mackenzie also noted that the clinics were not sold as of Dec. 31, as the DMC administration had implied. Rather, there was a month of due diligence involved for the would-be owners. A close reading of the article brought to light that Ms. Mackenzie did not comment on what would happen to the uninsured when the transition was complete.

However, this time period gave an opportunity for further discussion on the impending, but not completed, sale. Both MaryAnn Mahaffey, President of Detroit's City Council, and Ms. Jewel Ware, Chair of the Wayne County Board of Commissioners, pointed out that sale of the clinics as planned would shut out the poor and uninsured from needed medical care.

However, the most forceful and telling damnation of the DMC action came from the Detroit Medical News. This was in a Jan. 19 article authored by Dr. Herbert Smitherman and 11 fellow doctors who manned the clinics being sold. Their report laid out clearly the fate of the clinics, and confirmed predictions that purchase by the group making the bid will end care for the uninsured. Dr. Smitherman et al also pointed out that sale of these clinics would further aggravate the overload in the DMC's emergency rooms as the uninsured turned away had no other resort in time of their need.

Then there is the question of the role of DMC Chief Executive Officer Michael Duggan. On Jan. 22, he went before the Detroit City Council declaring that the 5 clinics must be sold immediately because these facilities were costing the DMC $ 7 million a year. There was no explanation why the previously accepted $3 million per year was no longer valid. His actions raise a question about his intent. Does he plan to save a hospital with a unique mission and a dedicated staff, or is he the spokesman for a Board of Directors that has lost sense and direction.

At this time it may be appropriate to pause in support for health care reform for Detroit's residents as now presented. It may be better to allow the DMC to self-destruct. Possibly, once freed from the burden the DMC brings, the medical community and the Public Health Authority can surge forward in providing, sustaining, and improving health care for the uninsured.


Wayne County Medical Society
of Southeast Michigan.
All Rights Reserved.