State Of The Union Resounds
With Familiar Themes

By PAUL NATINSKY
Health care issues were hardly front-and-center in President Bush's State of the Union address. When he took time to address such issues, the president made a strong pitch for regulations friendly to Health Savings Accounts (HSA), in which patients save tax free dollars to pay for routine medical expenses while purchasing high-deductible insurance policies to pay for more expensive care. He also pushed federal medical liability reform, expanded use of electronic medical records and more money for AIDs/HIV care and research.

The American Medical Association is reacted positively to most of the president's proposals, but policy analysts and Democratic critics pointed out shortcomings in several of the proposed initiatives.

"Consumer-driven health care encourages patients to take a greater interest in their health care and how they spend their health care dollars, by putting patients in the driver's seat," said AMA President J. Edward Hill, MD. "The AMA believes that HSAs empower patients to have greater control over their health care decision-making, and are an important choice in the health insurance mix. Coverage choices such as HSAs provide flexibility and portability for patients, allowing them to change jobs without worry."

Veteran Democratic Congressman Pete Stark of California told the New York Times: "The president's proposals for HSAs are tilted toward the rich. They give disproportionate benefits to wealthy people and do almost nothing for low-income people."

The AMA is also generally supportive of advances in health information technology and strongly advocates national medical liability reforms.

Some critics have referred to the HSA rhetoric as a "perennial proposal" that has yet to make it through Congress. On the medical records side, physician, particularly those practicing in small groups have lamented the prohibitive cost of implementing new technology. In what is perhaps a red flag, Congress has provided less money than the White House has sought for such programs in past years. Finally, there are concerns in Michigan that some elements of federal medical liability reform initiatives might weaken this state's strong tort reforms enacted in 1994.

The president did not mention the recent difficulties encountered by those enrolling in the new Medicare prescription drug plan.

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Governor Aims To Reduce Number Of Uninsured
 

By PAUL NATINSKY
In her State of the State address Jan. 25, Gov. Jennifer Granholm unveiled the Michigan First Health Care Plan that would provide health care coverage to 550,000 uninsured citizens through a variety of private carriers, including Blue Cross and Blue Shield of Michigan. The plan would cover such basic health services as preventive and primary care coverage, emergency room services, hospitalization, mental health care and prescription drugs. The plan would be partially subsidized by contributions from beneficiaries.

The governor also announced plans to further the implementation of electronic medical records technology "among state and health care entities."

The nagging question, of course, is where the money will come from as the state continues to face Medicaid shortfalls and physicians continue to struggle with the high cost of health information technology.
What are your thoughts on the governor's proposals? Let us know at info@wcmssm.org

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Editor's Column:
By Doing Nothing, Congress Acts
 

By JOSEPH WEISS, MD
The Congress waited and dallied and at year’s end the absurd went into effect. The government docked our Medicare reimbursements by 4.4 percent. The medical community had acted responsibly. The AMA and every specialty and state medical society brought to Congress’s attention the urgency to pass a resolution that, at the least, would continue the status quo in medical reimbursements.

By doing nothing Congress showed its contempt for us. That body said, in effect, that we are overpaid, that it is our fault why health care is expensive, that we deserve rebuke, and here it is.

Do not be deceived by your Congressman’s declaration of support for our request for a modest 1 percent increase in payment. Remember that Congress deliberately delayed in a simple vote that had an enormous effect on the whole medical community.

Eventually, we will return to our zero reimbursement position. Then, once more we need to petition Congress to grant us a 1 percent increase in reimbursement. Again, we will have to explain that the 1 percent does not go into our pockets, but is the only way we have to offset our increasing costs for employee salary and benefits, the expense of malpractice, and the cost of new technology. We know that the request for 1 percent will bring the counter response of Congressional mandates such as pay-for-performance. We know already the mandates, like pay-for-performance will have twists and turns like a 2 percent reimbursement takeaway.
 
However, we have already felt the worse: the humiliation of Congress’s contempt. We must work harder to bring out the truth. We are not driving the cost of medical care, we are not enriching ourselves by ordering unnecessary tests, we are not the lackeys of the pharmaceutical companies, nor do we spend our days ignoring our patients’ needs or pain.

The cost of care rises because of technology, longevity, patients' expectations, and the living habits of the public, including its politicians.
We must not allow ourselves to remain scapegoats. We know if we receive reasonable support, we'll return a yeoman's effort.

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This publication brought to you by Natinsky Publishing Network.

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