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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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