February 4, 2008

IN THIS ISSUE

Editor's Column: Change And What Will Not Change
Blues Defend Tax Break At Senate Hearing
Keep Heat On Senate For Anti-Smoking Bills
MSMS Supports Tanning Facility Regs
Learn How 'VEBA Is Shifting Michigan's Gears'
HHS Secretary Seeks To Expand EHR

Click Here To Contact Us


 

Editor's Column: Change And What Will Not Change

By JOSEPH WEISS, MD
The call for single-payer national health insurance has become loud enough to reach the ear of every voter. Do those who advocate single-payer know what they will get, and what will not change, though it should?

What will we get?

1) Cutthroat strife between doctors. Each specialty from family practice to retinal surgery will fight to keep its share of the dollar pie. Allegiance to one’s specialty society will intensify as each society becomes the vehicle for advocacy vital to survival. 

Specialty societies will spend millions for lobbyists, as reimbursements worth tens of millions of dollars will ride on the placement of a comma on page 624 of a rider attached to an energy bill. Since the total dollars available for health care services will hardly expand from year to year; what one physician specialty gains will come at another specialty’s loss.

The AMA will suffer. As physicians’ loyalties transfer to their specialty, and as the cost of dues for that specialty society increase to pay lobbying costs, interest in the AMA will wane. This attitude will be self defeating, as the AMA provides the best way to develop compromise among conflicting physician claims. Only the AMA can bring to Congress a comprehensive alternative for individual specialty squabbling and demands for increased reimbursement.  

(2) Decreased choice and increased rules. Presently, conditions in Southeast Michigan aside, if a physician does not care for a health plan, that physician can leave the health insurer. If there is only one plan, there is no chance to walk away from it and still practice medicine. Not only must you work for one boss, you must follow all the rules that the administration lays down as conditions of employment. Thus, pay-for-performance becomes not an option but a rule. 

(3) rationing of care- At present what a patient can pay for health care determines how much care that patient will receive. Under single-payer, what medical care patients receive becomes a government decision.  Once more, intense lobbying will ensue as advocates for each disease head to Capitol Hill to ensure their group, such as scleroderma, kidney transplant, myasthenia gravis, etc., receives attention for drugs, surgery, physical therapy and laboratory testing. Limiting the money spent combined with a single decision maker will make possible decisions on what age to no longer fund procedures such as kidney dialysis, coronary stenting and hip replacement among other end-of-life procedures.

(4) Mindless decisions. We will see more of the arbitrary decisions government can make with its power of the final word. Recent examples include the Veterans Administration refusing to give its cancer statistics to the National Cancer Registry and the Medicare order to Sinai-Grace to stop the ICU checklist that proved effective in stopping intensive care related catheter infections.

What will continue?

Delay in making decisions on health care policies. Months of lobbying will lead to months or years of congressional hearings which, in turn, will yield further delays as rules are subject to comment, debate, and changes in financing.

What is unknown?

How single-payer national health insurance will change the distribution of doctors between urban and rural and between medical specialties. Will we all be made into family practitioners with the numbers among us in specialties determined by quotas or lotteries?

You may want to remain in medical practice just to find out what will happen and feel, first hand, its effect.

Share Your Thoughts on this Article

  Back to top

Blues Defend Tax Break At Senate Hearing

By PAUL NATINSKY
LANSING - The Senate Health Policy Committee under Chairman Tom George, MD, listened Jan. 30 to Blue Cross and Blue Shield of Michigan describe a new study it commissioned that the insurer said shows it spends more than $300 million per year on its “social mission.”

Blues Vice President Mark Cook said BCBS’ social mission spending included discounted services to hospitals, partially subsidizing Michigan’s MIChild program for poor children and direct charitable contributions.

The new study comes after a study commissioned by a consortium of insurers provided an estimate that the Blues receive a tax break of more than $120 million, about $40 million more than the Blues estimated.

The Blues’ tax-exempt status is partly determined by a requirement that the insurer provide insurance to all who request it. BCBS rates must be approved by the state, unlike rates for commercial carriers, which are essentially just filed with the Office of Financial and Insurance Services.

House Bill 5282 would allow BCBS to retain its tax break, while shifting its sickest and most expensive subscribers to a high-risk pool subsidized by a surcharge to all insurers based on their market share. The Blues estimated their market share at 61 percent.

Other bills in the package would allow the Blues to expand the types of insurance it is able to sell through its subsidiary, the Accident Fund.

Other insurers in the marketplace oppose the bills as anti-competitive and likely to raises rates. Representatives from the Michigan Association of Health Plans, which represents HMOs and other managed care plans in the state testified in opposition to the bills as did a the representative of a coalition of insurers in the market. Others opposed to the bills include AARP of Michigan, the Consumers Union and Michigan Attorney General Mike Cox. Cox is scheduled to testify Wednesday and has been the most outspoken critic of the package, accusing the Blues of placing profits ahead of its mission.

A large portion of testimony focused on the 34 states that employ a high risk pool. Joe Aoun, a Northville attorney speaking for the Coalition for Access and Affordability in Michigan, representing commercial insurers, said that states with high-risk pools all require their Blue Cross plans to pay state taxes.

Sen. George repeatedly asked whether prohibiting what he called “re-underwriting,” meaning raising rates upon renewal for those who become sick while insured. Responses were hesitant, qualified and varied, although most, when pinned down agreed it would.

   Share Your Thoughts on this Article

  Back to top

Keep Heat On Senate For Anti-Smoking Bill

House Bill 4163, which aims to ban smoking in nearly all public workplaces—including bars and restaurants—faces a tough road to move out of the remote Senate Government Operations & Reform Committee. Senate Majority Leader Mike Bishop (R-Rochester), who also chairs the Committee, previously has said that he favors leaving the decision to go smoke-free up to business owners. This is why grassroots action in the Senate is so important now.

KEEP THE HEAT ON THE SENATE - Use the MSMS Action Center (www.msms.org/action) to send an electronic message to your state senator and the Senate Majority Leader to support a healthier Michigan by passing the workplace smoking ban.

If the bill were to pass the Senate and be signed into law, Michigan would join 31 other states that already have adopted some form of workplace smoking ban. Also, it would give Michigan one of the strongest smoke-free laws in the country.

MSMS, the Campaign for Smokefree Air (CSA), and the American Cancer Society support HB 4163, introduced by Rep. Brenda Clack (D-Flint). Through its Future of Medicine Wellness Work Group, MSMS is a member of the CSA, along with the American Cancer Society and 240 other organizations. For more information or to join the CSA, visit www.makemiairsmokefree.org.

Share Your Thoughts on this Article

Back to top

MSMS Supports Tanning Facility Regs

As part of the 2008 MSMS Legislative Agenda (www.msms.org/legagenda) and the Future of Medicine goals of wellness and prevention, MSMS is supporting House Bill 4146, which addresses the risks of indoor tanning in Michigan. The bill, introduced by Rep. Frank Accavitti (D-Eastpointe), specifically would require parental consent for anyone under 18, larger warning signs in tanning facilities listing potential health consequences, a signed informed consent form for all customers, and licensing by the state. For more information, visit www.msms.org/advocacy, or contact Joshua Richmond at 517-336-5788 or jrichmond@msms.org.

Share Your Thoughts on this Article

 Back to top

Learn How 'VEBA Is Shifting Michigan's Gears'

MSMS will be one of the first organizations in the state to host a multi-stakeholder event to discuss the new Voluntary Employee Beneficiary Association (VEBA), the health reimbursement arrangement created in the UAW agreements that will place the UAW in charge of purchasing health insurance for its members. On Thursday, April 3, from 1:00 to 4:00 p.m., MSMS will welcome physicians, administrators, and other health care professionals to the Rock Financial Showplace in Novi for a close look at VEBA. Speakers will include Darcy Hitesman, Esq., Hitesman & Associates, PA; Mark Gaffney, Michigan State AFL-CIO; Thomas Simmer, MD, BCBSM; and others. To register, visit www.msms.org/eo or call 517-336-5784.

 Share Your Thoughts on this Article

Back to top

HHS Secretary Seeks To Expand EHR

US Health and Human Services Secretary Mike Leavitt proposed a $150 million incentives plan Jan. 31 to push doctors toward adopting electronic medical records in their practices.

Leavitt told a crowd of 80 at Des Moines University that “electronic records are key to improving patient care, cutting medical costs and reducing errors,” according to a report in the Chicago Tribune. The newspaper reported that he said, only 15 percent of physicians at small practices have access to electronic medical records.

Leavitt said he envisions a system that eventually allows patients to go online and research a physician's track record and costs.

Leavitt’s speech was part of a 40-city tour to outline a five-year inititative that would pay incentives to doctors in smaller practices who begin filing patients' health history electronically. He said those who do so would get more Medicare money, though he did not specify how much.

A dozen communities nationwide can apply to be in the pilot program. Physicians would have to buy their own technology, with upfront costs for implementing computer systems ranging from $20,000 to $40,000. Leavitt said creating incentives for doctors to implement the technology would help cover the cost of the investment.

   Share Your Thoughts on this Article

 Back to top

This publication brought to you by Natinsky Publishing Network.

Problems seeing this email? You may view it online at http://www.wcmssm.org
To subscribe or unsubscribe to this newsletter contact info@wcmssm.org