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E. Chris Bush, MD
MSMS Candidate
President-Elect 2004
Endorsed by
the Wayne County Medical Society
The WCMS wholeheartedly endorses Chris Bush for President-Elect
of the Michigan State Medical Society for 2004. Dr. Bush is a
family physician with a private practice in Riverview. He has
been active in the WCMS since 1982. He was encouraged to become
a delegate to the MSMS House of Delegates and attended his first
House during his first year of practice. Dr. Bush has been on
the Board of Directors of the MSMS for the past five years and
has served on the Legislative and Third Party Payer subcommittees
of the Board. He is also a member of the Provider Liaison Committee
with Blue Cross and Blue Shield of Michgian.
“I feel my career as a family physician has prepared me well to be an advocate
for the health of all the people in the State of Michigan,” says Dr. Bush. “I
would like to focus on improving health care access to all of the citizens of
Michigan, insured, uninsured and underinsured. Our state ranks near the top of
the list for obesity, smoking, sedentary behavior and low immunization rates.
All physicians can make a difference one patient at a time with preventative
strategies that are founded on a solid scientific basis.”
DaimlerChrysler health plan shift brings questions
By JESSY SIELSKI
MSMS
DaimlerChrysler - in conjunction with the United Auto Workers -
will be moving its UAW enrollees from the Traditional plan to a Blue
Cross Blue Shield of Michigan PPO product using the Trust network. DaimlerChrysler
recently sent letters to their bargaining unit employees, retirees, Medicare
retirees, and surviving spouses, explaining the changes. What is not
contained in the letters, however, has raised some very serious questions
among health care professionals and others affected by the change.
In addition to DaimlerChrysler, General Motors and Ford Motor Company
also will be moving employees to a PPO product. The moves from Traditional
to PPO will occur throughout 2004 and/or early 2005. DaimlerChrysler
is scheduled for an April 1, 2004, switch; GM has a tentative July 1,
2004, date; and Ford is looking at Jan. 1, 2005.
For the DaimlerChrysler PPO, effective April 1, 2004, patients will pay
for the office visits until they meet a $5,000 catastrophic deductible.
DaimlerChrysler expects physicians to bill the PPO rate to patients.
Physicians may bill the member for the office visit at the time of service.
The PPO fees are available on the "Provider Communications" resources
page on web-DENIS.
During communications with BCBSM, MSMS gained insight into some of the
changes that will occur during the move from the Traditional plan to
the PPO product. Alarmed by what some of these changes might mean for
patients and physicians, MSMS is pushing hard for answers. MSMS legal
counsel is evaluating the implications of interpreting office visit coverage
subject to a $5,000 deductible (or 100 percent patient copay for office
visits) as a "covered service" and the ability to restrict
physicians to charging patients PPO rates based on this definition. MSMS
is requesting from BCBSM actuarial data on how many patients would ever
reach the $5,000 catastrophic deductible for office visit coverage. MSMS
is asking DaimlerChrysler, the UAW, and BCBSM to provide answers to the
following questions:
--Which specific codes under the PPO fee schedule are included under
office visits subject to this discount and the $5,000 catastrophic annual
deductible? And in addition to evaluation and management codes, are outpatient
consultation, medical eye codes, annual gynecological exams, health maintenance
exams and behavioral codes included in this category?
--Is the $3,000 annual catastrophic deductible for office visits per
beneficiary or per family?
--Why is the $3,000 annual catastrophic deductible for office visits
not mentioned in DaimlerChrysler communications to beneficiaries or in
BCBSM communications to physicians? If defining office visits as a covered
benefit is the rationale for expecting physicians to charge network rates,
shouldn't patients and physicians know the threshold that activates the
benefit?
--Can BCBSM provide actuarial data on how many patients would ever reach
the $5,000 catastrophic deductible for office visit coverage?
--Can BCBSM specify which CPT codes are included as covered services
under immunizations/vaccinations, screenings and the schedule for covered
well baby visits?
--If a patient reaches the $250 individual/$500 family out-of-network
deductible, would out-of-network office visits then be covered?
--Are Medicare retirees subject to network restrictions or any benefit
changes, including the $5,000 catastrophic deductible? If not, why are
they being issued new cards? If so, are there out of network sanctions,
and if PPO fee levels are below the Medicare fee screen will Blue Cross
even pay out a benefit?
--Will the card for the new PPO clearly indicate the patients are in
the Standard Care Network so physician offices will know how to bill
correctly?
MSMS members should watch for updates on this issue in Medigram, on the
MSMS Web site (www.msms.org), in the
Monthly Top Ten, and in e-mail alerts. For additional resources, including
a sample letter that physicians may give their patients explaining the
changes in their health policy; the Blue Cross PPO Fee Screen; and letters
from Blue Cross and DaimlerChrysler, visit www.msms.org/bsyp/index.html.
For more information, contact Julie Novak at MSMS at 517-336-5768 or jnovak@msms.org.
MSMS helps physicians address ‘day-to-day’ issues
Created by the MSMS Board of Directors, the new Council
of Physician Organizations met recently for the first time to
address a number of issues that affect the day-to-day operations
of physician organizations throughout Michigan.
Prior to the meeting, physician organization leaders were surveyed to
determine the key issues concerning them. Among the topics were quality
and utilization reporting tools; chronic disease management; information
technology; physician profiling and panel size; pharmacy management;
and risk arrangement models.
During the meeting, George Kipa, MD, deputy corporate medical director,
Blue Cross Blue Shield of Michigan, previewed a pilot program that provides
financial incentives to physician groups that are monitoring performance
in persistent asthma, congestive heart failure, coronary heart disease,
and diabetes mellitus. The goal is to improve infrastructure to support
clinical improvement programs, create measurable improvements in chronic
disease care, and improve outcomes in patients with the identified conditions.
The application process is ongoing and pilot groups will be contacted
in July.
Sue Moran, director, Bureau of Medicaid Program Operations, described
the new bidding process for Medicaid HMOs. Rates will be established
using actuarial data rather than lowest bids, so plans will compete on
performance rather than price, and they must be financially solvent in
order to receive a contract. Bids are due to the state by May 14, and
bidders will be notified on June 15.
Editorial: No-Fault Medical Liability: No Longer A Dream,
Not Yet A Reality
By JOSEPH WEISS, MD
Editor
The 2003 House of Delegates sent a resolution to the Michigan State Medical
Society (MSMS) Board of Directors to develop the concept of no-fault
medical liability into a proposal to bring before the Michigan legislature.
In turn, the Board of Directors authorized The MSMS Task Force on No-Fault
Medical Malpractice.
Initially, the Task Force gathered information on how no fault works
in Europe, Australia, New Zealand, and the United States. Both Florida
and Virginia have limited areas of medical tort law that work using a
no-fault system. Task force members reviewed documents on the subject
printed in U.S. law reviews. Other materials the Task Force studied included
books by University of Michigan Professor Marilyn Rosenthal, and an article
by Dr. Susan Adelman on the Swedish Patient Compensation System. The
Task Force Committee heard from Troyan Brennan of the Harvard School
of Public Health, who has written extensively on an American approach
to no fault, and spoke to Robert Borlen from the University of Michigan
medical-legal staff on their innovative early response and settlement
to medical malpractice cases at University of Michigan Hospital.
From such information, the Task Force developed a No Fault bill containing
the following six articles:
Article 1-Need for and purpose of a patient compensation act and a series
of definitions including "medical injury."
Article 2-Coverage, basis for a claim, statute of limitations and notification.
Article 3-Creation of the Patient Compensation Commission and its duties.
Article 4-Funding and administration of the Medical Injury Compensation
Fund.
Article 5-Payment of claims including basis for determining health care
costs, lost wages, long-term disability, and death payments.
Article 6-Hearings & Appeals including a pathway for a physician
or other provider to report medical error.
The full text of the bill will be online at the MSMS Web site, and a
hard copy will be available at the MSMS House of Delegates registration
desk.
The model legislation is under review by MSMS legal counsel. The April
House of Delegates meeting will provide an opportunity for MSMS membership
to offer further comment. The next step is to send the critiqued act
to legislative bill writers. They will put it into a form that complies
with Michigan House and Senate requirements.
This bill does not authorize replacing current tort reform legislation.
Rather, the proposed legislation asks only that the bill be given an
opportunity at one or more pilot sites. Concepts in the Act are different
than those traditionally put forward in medical malpractice law. The
premise has promise but only implementation will bring out its applicability
to the real world.
Members of the Michigan State Medical Society should feel proud. No other
state in the Union has come as far in this area as has Michigan. Likely
no other medical society has given such support for this Task Force as
has MSMS membership and its Board.
Obituary
Eugene Crawley 1918-2004
Dr. Eugene Crawley was born in Bentonville, Arkansas
August 4, 1918. He earned his undergraduate and medical degrees
at the University of Arkansas, then interned at the St. Vincent's
Infirmary in Little Rock. After a pediatric residency at Children's
Hospital in Birmingham, Alabama, he returned to Arkansas to develop
poliomyelitis vaccine programs and established a rheumatic heart
program for the children served by the Arkansas Welfare Department.
He was a fellow of the American Academy of Pediatrics and was
on the National Committee on Fetuses and Newborns.
In 1960, the pediatrician was invited to Detroit by the Michigan Department
of Health to outline a protocol for the hospital care of children and
newborns. After this job he remained in Detroit and practiced with the
Metropolitan Hospital, then the Grosse Pointe Pediatrics Group, Children's
Hospital and the eastside hospitals: St. John, Cottage and Bon Secours,
where he was Chief of Pediatrics.
He was a happy, ebullient sort and easily found his home among our physician
community in Detroit for the rest of his life. He served our community
well, caring for thousands of children for over 40 years. Judging from
his interests other than medicine, Dr. Crawley was a multifaceted person.
He and his wife, Lottie, grew herbs and made them into potpourris. He
was a gemologist and polished stones into jewelry. He was a storyteller,
studied antiques, history and the native peoples of the Americas.
My personal experience with Dr. Crawley began when we were both, for
several hears on the HIV/AIDS Committee of the Southeast Michigan Red
Cross. He brought considerable expertise to this committee with his knowledge
of intracellular viruses, their transmission, epidemiology, and the problems
of education. Together, we railed at the inability of the local Boards
of Education to cope with sex education of high school students. Fortunately,
the epidemic lessened and the focus of the committee changed to "Community
Outreach."
Sadly, Dr. Crawley died of heart trouble at the Hospice of Michigan February
9, 2004. He is survived by two sons, William and John; a daughter, Mary
Brill; a grandson, and four great-grandchildren.
Respectfully,
Ned I. Chalat, MD
AMA Position Paper:
ANTITRUST RELIEF NEEDED FOR PHYSICIANS
American Medical Association February 2004
THE PROBLEM:
In many parts of the country, a few giant health insurance companies
dominate the health care market place. When physicians attempt to
negotiate patient care issues with these health plans, they are at
a severe disadvantage.
--CONSOLIDATION AND MARKET CONCENTRATION
MEAN DOMINATION
An AMA study, Competition in Health Insurance : A Comprehensive Study
of US Markets (2003), found that 93 percent of the health insurance markets
nationwide are highly concentrated. In nearly 40 percent of these markets
a single insurer has market share in excess of 50 percent. It is virtually
impossible for individual physicians to negotiate important patient care
issues with these dominant insurers. Yet, alarmingly, insurance mergers
continue while most physicians remain in small or solo practice.
--DOMINATION MEANS UNREASONABLE
CONTRACTS FORCED ON PHYSICIANS
One-sided contracts with egregious terms are forced on physicians by
health insurers. Examples include: requiring physicians to pay for prescription
drugs for their patients if costs exceed certain thresholds; shifting
liability to physicians for the insurer's release of confidential patient
information; requiring physicians to provide the cheapest care to patients;
and forcing unfavorable terms by threatening to exclude physicians from
treating all patients covered by the health insurer ("all products" approach).
--UNREASONABLE CONTRACTS MEAN
QUALITY OF CARE IS JEOPARDIZED
Health plan domination negatively affects physician practices, which
ultimately compromises patient care. Unless physicians go along with
the demands of dominant insurers, physicians risk losing their patient
base, and both patients and physicians jeopardize losing their longstanding
relationships.
THE SOLUTION
--LEVEL THE PLAYING FIELD - Antitrust
relief is needed to enable physicians and other health professionals
to effectively deal with insurers without fear of automatically
violating antitrust laws. Physicians should be allowed to negotiate
terms that increase patient choice, improve quality of care,
and empower patients and physicians, not insurers, to make
informed decisions about their health care needs.
The AMA seeks bipartisan support
for H.R. 1120, the "Health Care Antitrust Improvements
Act of 2003," introduced by Representatives Spencer Bachus
(R-AL) and John Conyers, Jr. (D-MI). This legislation takes
a more limited approach than prior antitrust legislation (106th
Congress). If enacted, H.R. 1120 would:
--Establish a reasonable standard of review in antitrust actions so that
physicians would be permitted to "plead their case" regarding
their negotiations with insurers, instead of automatically violating
antitrust laws.
--Reduce the financial burden on physicians when defending antitrust
actions by limiting potential damages and attorney fees.
--Scrutinize the use of "all products" clauses, thereby creating
a better environment for fair dealings with insurers.
--Establish demonstration projects enabling physicians to more easily
negotiate with insurers.
AMA Position Paper:
MEDICARE PAYMENT UPDATE CRISIS
American Medical Association February 2004
THE PROBLEM:
The crisis in Medicare patients' access to health care continues. Physicians
payment cuts are again expected in 2006 due to the fundamentally
flawed Sustainable Growth Rate (SGR) formula that results in payment
cuts that dangerously jeopardize Medicare beneficiary access to medical
care. Congressional and Administration intervention to avert some
of these cuts has helped to maintain patient access, but the fundamental
need for reform remains. Additional cuts will result in:
--a decline in Medicare and TRICARE patients' access to care;
--a decline in the number of physicians who will continue to accept new
Medicare fee-for-service patients; and
--states losing millions in health care dollars.
THE FORMULA IS UNWORKABLE
Because of the formula, Medicare cut payments to physicians and other
practitioners by 5.4 percent in 2002. Another 4.4 percent cut for
2003 was replaced with a modest 1.6 percent increase only after Congress
intervened. Congress stepped in again and replaced severe cuts in
2004 and 2005 with modest 1.5 percent increases with passage of the
Medicare Prescription Drug, Improvement, and Modernization Act of
2003 (MMA); but, without additional legislation, cuts will resume
in 2006.
The SGR is Unworkable: The SGR
formula requires Medicare actuaries to predict the unpredictable,
leads to constantly changing government estimates and creates
volatile payment swings that undermine medical practice's ability
to make rational business decisions and remain financially
viable.
--MedPAC, the Congressionally created Medicare Payment Advisory Committee,
recommends replacing the SGR.
--The SGR cuts payments if growth in Medicare patients' use of services
exceeds GDP growth. This position is simply untenable. Physicians have
ethical obligations to individual patients whose medical needs do not
shrink whenever the economy slows.
The SGR I Unfair: Medicare reduces
payments to physicians and other practitioners whenever program
expenditures for their services exceed a set target, or SGR.
At the same time, however, the government induces greater use
of physician services through new coverage decisions, quality
improvement initiatives and a host of other regulatory decisions
that are good for patients but are not recognized in the SGR.
--No other Medicare provider group is subject to the SGR; yet CMS data
indicates that 2002 increases in Medicare spending for durable medical
equipment, hospitals, home health, skilled nursing facilities and hospices
exceed physician spending.
From 1991-2004, payment rates for physicians and health professionals
fell 15 percent behind practice cost inflation as measured by Medicare's
own conservative estimates. Even the 1.5 percent increases for 2004 and
2005 were only about half the 3 percent rise in practice cost inflation
estimated by CMS.
--Medicare SGR cuts also affect 8.3 million uniformed services beneficiaries
because TRICARE rates are directly tied to Medicare, as are Medicaid
rates in some states.
THE SOLUTION
The SGR Must Be Replaced.
Multiple studies have shown that physician acceptance of new Medicare
patients is declining and that this trend will accelerate if payments
are again cut. The time has come to adopt MedPAC's recommendation to
replace the SGR with an annual update system which, like those of other
providers, reflects actual increases in physicians' costs.
The
Wayne County Medical Society Foundation
Cordially invites you to attend the
Inaugural Gala
in honor of
Richard E. Smith, MD
Celebrating his installation
as
The 121st President of the Wayne County Medical Society
Saturday, the 15th of May
2004
The Detroit Institute of Arts, Woodward Avenue, Detroit
Reception 6:30pm Kresge Court, Dinner 7:30pm Diego Rivera Court
Dancing 9:00 to 11:00 pm, Music by The Scales
Valet parking Woodward Avenue
Entrance
Black tie optional
$150 per person - Reply by
May 10, 2004
Membership
Mohamad F. Al-Rabbat, MD
Anesthesiology
Medical School: U of Damascus, Facility of Medicine, Syria 1991
Residencies: Loyola University Medical Center
Office: 18181 Oakwood Blvd., Suite 208, Dearborn, MI 48124-5031
Tele: 313-593-1573, Fax: 313-593-1389
Feda E. Almallouhi, MD
Anesthesiology
Medical School: U of Damascus, Facility of Medicine, Syria 1986
Residency: St. Luke's Medical Center
Office: 18181 Oakwood Blvd., Suite 208, Dearborn, MI 48124-5031
Tele: 313-593-1573, Fax: 313-593-312
Email: malouhi@netzero.net
Mohammed A. Arman, MD
Gastroenterology
Medical School: College Baghdad, Iraq 1985
Residency: Henry Ford Hospital 1994
Office: 2012 Monroe, #102, Dearborn, MI 48124
Tele: 313-724-9170, Fax 313-724-9175
Email: aarman@comcast.net
Chenicheri Balakrishnan, MD
General Surgery
Medical School: Medical College, Calicut U Kerala, India 1979
Residencies: Ennis General Hospital 1980-1983
Regional Hospital, Waterford, Ireland 1984
Pinderfields Gov. Hospital, Wakefield 1986-1987, 1987-1988
Royal Victoria Infirmary, U.K. 1988-1992
Detroit Receiving Hospital 1992-1993
Office: 4201 St. Antoine St. Rm. 3V-26, Detroit MI 48201
Tele: 313-745-4770, Fax: 313-745-4770
Asim F. Durrani, MD
Anesthesiology
Medical School: King Edward Med Coll. U of Punjab, Lahore, Pakistan 1981
Yale New Haven Hospital - 24 months
Indiana U School of Medicine - 12 months
Office: 18181 Oakwood Blvd., Suite 208, Dearborn, MI 48124-5031
Tele: 313-593-1573, Fax: 313-593-1389
Randy L. Gehring, MD
Neurosurgery
Medical School: Indiana U School of Medicine 1981
Residencies: University of Cincinnati Medical Center 1981-1982
Henry Ford Hospital 1982-1987
Office: 22201 Moross Road, Suite 352, Detroit, MI 48236
Tele: 313-343-7900, Fax: 313-343-7001
Robert J. Gordon, DO
Family/Occupational Medicine
Medical School: MSU College of Osteopathic Medicine
Residency: Riverside Osteopathic Hospital, Trenton MI 1982-1983
Office: 965 South Main, Plymouth, MI 48170
Tele: 734-455-2970, Fax: 734-455-3405
Hussein A. Huraibi, III, MD
Anesthesiology
Medical School: WSU School of Medicine 1995
Residency: Oakwood Hospital - 12 months
Mary Hitchcock Memorial Hospital - 12 months
Office: 18181 Oakwood Blvd. Suite 208, Dearborn, MI 48124-5031
Tele: 313-593-1573, Fax: 313-593-1389
Lubna C. Khan, MD
Anesthesiology
Medical School: Dow Medical College, U of Karachi, Pakistan
Residency: Strong Memorial Hospital U of Rochester - 36 months
U Health Center of Pittsburgh - 13 months
Office: 18181 Oakwood Blvd., Suite 208, Dearborn, MI 48124-5031
Tele: 313-593-1573, Fax: 313-593-1389
Merajuddin M. Khan, MD
Anesthesiology
Medical School: Grant Medical College U of Mumbai, Maharashtra, India
1994
Residencies: Washington U/B-JH/SLCH CONC. - 48 months
Washington U/B-JH/SLCH CONC. - 18 months
Office: 18181 Oakwood Blvd., Suite 208, Dearborn, MI 48124-5031
Tele: 313-593-1573, Fax: 313-593-1389
Rita S. Khandwala, MD
Anesthesiology
Medical School: Topiwala Nat'l Med College, U of Mumbai, Maharashtra,
India 1983
Residency: U of Maryland School of Medicine - 36 months
Office: 18181 Oakwood Blvd., Suite 208, Dearborn, MI 48124-5031
Tele: 313-593-1573, Fax: 313-593-1389
William J. Kupsky, MD
Neuropathology/Anatomic/Clinical Pathology
Medical School: Harvard Medical School, Boston MA 1978
Residencies: NY & Presbyterian HP Columbia Campus - 12 months
NY & Presbyterian HP Columbia Campus - 36 months
Office: 3990 John R, Detroit, MI 48201
Tele: 313-745-2504
Email: wkupsky@dmc.org
Charles F. McKolay, DO
Anesthesiology
Medical School: MSU, College of Osteopathic Medicine 1995
Office: 18181 Oakwood Blvd., Suite 208, Dearborn, MI 48124-5031
Tele: 313-593-1573, Fax: 313-593-1389
Matthew McManus, MD
Anesthesiology
Medical School: U of M Medical School, Ann Arbor 1995
Residencies: U of Chicago Hospitals - 12 months
U of Chicago Hospitals - 36 months
Office: 18181 Oakwood Blvd., Suite 208, Dearborn, MI 48124-5031
Tele: 313-593-1573, Fax: 313-593-1389
Robert E. Meehan, MD
Orthopedic Surgery
Medical School: U of Nebraska College of Medicine, Omaha, NE 1993
Residencies: WSU/Detroit Receiving Hospital 1997-2002
U of California-San Diego 2002-2003
Office: 4201 St. Antoine, UHC-7C, Detroit, MI 48201
Tele: 313-745-3415, Fax: 313-745-7483
Email: rmeehan@dmc.org
Martin B. Van Dort, MD
Internal Medicine 2001
Medical School: North Colombo Private Medical College, Ragama, Sri Lanka
1993
Residency: Coney Island Hospital - 37 months
Office: 2022 Dix Road, Lincoln Park, MI 48146
Tele: 313-381-5674, Fax: 313-381-7224
Email: martinvan-dort@hotmail.com
Transfers from Macomb County Medical
Society
David G. Fry, MD
Diagnostic Radiology
Medical School: WSU School of Medicine 1988
Residencies: U of Illinois College of Medicine
St John Hospital & Medical Center
Office: 11800 E. 12 Mile Road, Warren, MI 48093
Tele: 586-573-5060
George L. Figacz, MD
Diagnostic Radiology
Medical School: Ludwig-Maximilians-U, Fak Medicine, Munchen, Germany
1981
Residency: WSU Detroit Medical Center
Office: 11800 E. 12 Mile Road, Warren, MI 48093
Tele: 586-573-5060
Reinstatements
Sophia E. Grias-Radwanski, MD
Physical Medicine & Rehabilitation
Medical School: WSU School of Medicine 1998
Residency: Wm. Beaumont Hospital, Royal Oak, MI - 48 months
Office: Wm. Beaumont Hospital, 3601 W. 13 Mile Road, Royal Oak, MI 48073-6769
Tele: 734-453-1952
Rosamma O. Mathew, MD
Anesthesiology
Medical School: Med Coll. U of Kerala, Trivandrum, Kerala, India 1990
Residency: Sinai Grace Hospital, Detroit - 36 months
Office: 18181 Oakwood Blvd., Suite 208, Dearborn, MI 48124-5031
Tele: 313-593-1573, Fax: 313-593-1389
Lisa R. Rogers, DO
Neurology
Medical School: Kirksville College of Osteopathic Medicine, Kirksville
MO 1976
Residency: Cleveland Clinic, Cleveland Ohio - 36 months
Sloan-Kettering Cancer Center - 24 months
Office: Henry Ford Hospital, 2799 W. Grand Blvd, Dept of Neurology, Detroit
MI 48202
Yevgeniyu Stefadu, MD
Internal Medicine
Medical School: Moscow Med. Stomatologic Inst., Moscow, Russia 1981
Residency: Raritan Bay Medical Center - 36 months
Office: 28200 Franklin Road, Southfield, MI 48034
Andrew Tartaglione, DO
Anesthesiology
Medical School: Kirksville College of Osteo Med., Kirksville, MO 1992
Residency: Advocate Illinois Masonic Medical Center - 36 months
Office: 18181 Oakwood Blvd, Suite 208, Dearborn, MI 48124-5031
Tele: 313-593-1573, Fax: 313-593-1389
Medical Student
Shree R. Venkat 2007
WCMS Resolutions for MSMS House of Delegates
Increasing State
Tobacco Taxes
Submitted by Ron Davis, MD
Whereas, Governor Granholm has proposed a 75-cent per pack increase
in the state cigarette excise tax to support health care services, dedicating
the first $30 million in new revenue to disease prevention and health
promotion and $265 million to preserve the Medicaid safety net that provides
access to services for the most vulnerable populations-children, the
elderly, and the disabled; and
Whereas, this cigarette tax increase would prevent 30,000 kids from dying
prematurely from smoking-caused illnesses and 94,000 youth from becoming
addicted to tobacco, and would lead to 56,000 fewer adult smokers, and
would result in 13,400 fewer smoking-affected births over the next five
years, saving over $15.3 million in health care costs; and
Whereas, Michigan ranks among the worst states for prevalence of risk
factors such as smoking, obesity, and physical inactivity, which result
in 70 percent of all deaths as well as nearly 75 percent of all health
care costs; and
Whereas, revenue from the proposed cigarette tax increase would be invested
in helping communities control diabetes, hypertension, smoking, obesity,
cancer, heart, lung and other chronic diseases; and
Whereas, revenue from the cigarette tax increase would also be invested
in programs and services that promote maternal and child health; and
Whereas, some of the new revenue would be used to serve 1.3 million Michigan
citizens through Medicaid health care services; and
Whereas, the Medicaid program has experienced severe under-funding of
$505 million while the number of eligible citizens has increased by 19
percent, seriously threatening the health care safety net for millions
of Michigan children and families; and
Whereas, the MSMS Board of Directors has endorsed the Governor's recommended
75 cents per pack increase in the cigarette excise tax, now therefore
be it
Resolved, that the Michigan State Medical Society strongly support an
increase of 75 cents per pack in Michigan's cigarette excise tax (and
comparable increases in taxes on other tobacco products); and be it further
Resolved, that MSMS support the Governor's proposal to allocate all of
the revenue generated from this tax increase to health care and public
health programs, with the first $30 million being dedicated to public
health programs including tobacco prevention and cessation, chronic disease
prevention and control, and maternal and child health, and with $265
million being dedicated to Medicaid services.
Fees for Copies of Records
Submitted by Narinder K. Sherma, MD
Whereas there have been increasing demands on physicians
to provide copies of records to many organizations; and
Whereas the cost of doing so has escalated, even in times of decreasing
reimbursement; and
Whereas there is no clear Michigan statute allowing physicians to charge
for these services; and
Whereas some of our neighboring states like Illinois have clear statutes
setting fees for copies of records (735 ILCS 5/8-2003 and 2006); now,
therefore be it
Resolved that our MSMS seek clear legislation allowing physicians to
charge for copies of medical records and materials and that these fees
be annually adjusted for inflation.
Targeting Obesity
Submitted by Federico G. Mariona, MD, FACOG, FACS
Whereas, the prevalence of obesity has doubled in the U.S
in the last four decades and reaches approximately 66 percent
of the adult population and
Whereas this situation increases the individual risk of diabetes, cardiovascular
disease and other co-morbidities and
Whereas studies have shown that sedentary adults consume 500 to 800 calories
per day above true need and
Whereas population studies, clinical interventions and understanding
the mechanisms to prevent obesity provide clinical improvement and enhance
quality of life,
Resolved: That MSMS join other medical organizations to aggressively
promote effective interventions to deal with overweight and obesity as
an increasing and pervasive public health concern and
Resolved: That MSMS promote preventive health preservation educational
programs based on
a. making better dietary choices,
b. increased physical activity,
c. informing the medical practitioners on practical and effective ways
to counsel patients on the dangers of excessive body mass
d. informing the public on ways and means to help themselves to become
thinner and healthier.
fiscal note: Not significant
Physician Representation
on Hospitals Board of Trustees
Submitted by Narinder K. Sherma, MD
Whereas Hospital Boards of Trustees have the ultimate fiduciary
responsibility for hospitals; and
Whereas physicians have the unique responsibility to assure the quality
of care patients receive; and
Whereas some decisions are made at Boards of Trustees with inadequate
physician representation and without regard to physician input; and
Whereas there have been increasing conflicts between physician medical
staffs and administrations in several states; and
Whereas precedence exists in state legislating constitution of non- profit
corporation boards therefore be it
Resolved that our MSMS seek legislation to mandate an adequate number
of actively practicing physicians (elected by medical staffs) on Hospital
Boards of trustees.
Reappointment To
Medical Staff
Submitted by N.K. Sherma, MD
Whereas: The Joint Commission (JCAHO) requires hospitals
to reappoint and renew privileges of physicians at least every
two years (standard MS 4.20) and
Whereas: most other licensing authorities have changed the frequency
of renewals from yearly to three to four years (i.e. DEA, State licensing
etc) and
Whereas: there is always an ongoing performance quality review within
departments of hospitals
Whereas: this process has become very time and resource consuming for
physicians, medical staffs and hospitals.
Resolved: that MSMS request our AMA to pursue with JCAHO changing of
the requirement for reappointments to medical staff from every two years
to every four years.
State Audit of Mental
and Physical Health Funds to Counties
Submitted by Edward Jankowski, MD
Whereas, the State of Michigan is faced with a budget deficit
that impacts on state services delivery and
Whereas, the services provided by or funded by the Department of Community
Health may be severely restricted or eliminated in the next fiscal year
because of the budget deficit, and
Whereas, the Medicaid Program is particularly vulnerable to cuts in previously
eligible participants, reductions in payments to physicians and other
providers and elimination of health programs, and
Whereas, the public has the right to know how tax dollars are expended
for state services; and
Whereas, physicians have questioned the expenditure of state funds for
mental and physical health services in their counties; and
Whereas, many physicians are concerned that administrative expenses consume
more state funds than necessary for the efficient delivery of these mental
and physical health services; therefore be it
Resolved that the Michigan State Medical Society urge the legislature
to enact legislation requiring an annual independent state audit, reported
by county, of Medicaid and other state and federal funds, provided through
the state, for mental and physical health services; and be it further
Resolved, that this audit report be made widely available to all citizens
of Michigan.
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