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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.
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