October 5, 2009

IN THIS ISSUE

Physician Tax Still On Table: Contact Your Legislator
Editor's Column: Arise And Sing
Responses To Editor's Column
HFHS, Wayne State University SOM Enter Partnership Talks
Senate Finance Committee Reform Vote Delayed
Michigan Income Slide Leaves 11.5 Percent Without Health Insurance
Do You Like Community Service?
2009 Children's Holiday Party Contributors

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Physician Tax Still On Table: Contact Your Legislator

By PAUL NATINSKY
The Michigan state budget is still in limbo and the 3 percent physician tax is still on the table as a partial solution.

MSMS is strongly opposed to the physician tax. Colin Ford, MSMS Director of State and Federal Government Relations visited WCMSSM offices Oct. 5 to brief the Committee on Medical and Public Health Issues on the state budget and national health care reform issues.

Ford told attendees that the tax is being considered as part of a solution to a $160 million gap in the state Department of Community Health budget for fiscal 2009-2010.

Supporters of the tax , including Gov. Jennifer Granholm and House Speaker Andy Dillon view the tax as a mechanism to draw down federal matching dollars and claim that physicians will get the money back as Medicaid reaches farther and brings more Medicaid-covered patients into physician offices.

The reality, as reported by MSMS, is that the rate paid to physicians for Medicaid patients is inadequate and that the tax and increased Medicaid volume at present low rates will drive physicians away from Michigan and create further health care access problems.

Tax supporters position the tax as a “Quality Assurance Assessment” program and contend that hospitals and Medicaid managed care plans already pay a similar tax. However, said Ford, those organizations are non-profit and do not pay personal income tax or the state’s single business tax, which is paid by most physician practices. This adds a further problem for the state in its desperate hunt for revenue dollars: doctors leaving the state will take their portion of the personal income and business tax bases with them.

MSMS and WCMSSM urge physicians to contact their legislators and oppose the tax.

Ford said the Department of Community Health budget bill likely will be taken up again by the state Senate next week.

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Editor's Column: Arise And Sing

Isaiah 26:19

By JOSEPH WEISS, MD
The AMA (American Medical Association), the ACP (American College of Physicians), AAFP (American Academy of Family Practice), the ACS (American College of Surgeons) and other medical organizations continue to address Washington on our behalf. The results of such advocacy is that the public and its legislators know that the medical profession advocates coverage for all Americans, repeal of the present Medicare physician payment formula and changes in the medical liability environment as the pillars of health care reform.

That our perspective comes out of experience helps support the data coming from census reports and Kaiser Health Foundation polls. Probably most readers of this column can name at least one patient who has asked to pay a deductible of $40 in increments over months. Likely, most WCMSSM community physicians have told the office manager to wipe off a particular patient’s debt because there was no way that the office could stop seeing the patient and there was no way the patient could pay for the services received. In turn, recounting these experiences to people outside the profession brings urgency and weight to our advocacy.

Physicians have responded to those hostile to change. We have pointed out that inadequate reform means more patients uninsured, more cuts in Medicare reimbursements, fewer primary care physicians available to render basic care, and possibly bankruptcy of Medicare itself.

Finally, the profession has reminded the public that health care reform is not a redistribution of the costs and profits of care. Rather, reform represents a campaign for justice for every American.

After reaching this degree of agreement and understanding, it appears that no two doctors can come together on how to achieve that justice or the permissible cost to gain such ground. For physicians, the great debate coming in health care is not with outsiders but among ourselves.

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Responses To Editor's Column

H. Michael Marsh, MBBS, comments:

This is very thoughtful and thought-provoking. When and where can we begin that all-important dialogue. Perhaps even now with an agreement amongst Physicians about beginning design of the future workforce and educating future Doctors in how to build and manage the teams that will almost certainly be necessary to deal with our patient populations in face of new constraints?

ALLAN DOBZYNIAK, MD, comments:

The author certainly has raised some interesting points. An indictment of the physician community for not supporting uniformly a set of changes to increase the access of all Americans to the very best clinical medicine is not fair. The very nature of even what constitutes health care has not been defined. How much of what and at what cost is difficult to conclude if an understanding of what is to be provided under the umbrella of health care is not defined. Like any other heterogeneous group, a myriad of market-driven and government solutions will be supported by physicians. That physicians should diminish their economic value and give of themselves to altruistic self sacrifice is a choice. To be an entrepreneur and have the ability to participate in the American dream is also a choice. To make a value judgment that confers a higher level of morality to one group over the other is not appropriate. These philosophical positions do not confer medical excellence and care of equal quality can result from either position.

Since there is no clearly defined correct or optimal approach to solving the issue of how to provide value-driven health care, the opportunity to get it wrong is a risk. Reform is best; change can result in negative outcomes. Incremental reform studied carefully as to outcome, evolving over sufficient time, value-driven and understood and advocated by American citizens is better than precipitous change whose consequences are poorly reasoned.

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HFHS, Wayne State University SOM Enter Partnership Talks

Henry Ford Health System and Wayne State University have entered into discussions aimed at creating a partnership in education, research and clinical services, according to reports on both organizations’ websites.

Henry Ford and Wayne State have signed a letter of intent to conduct extensive and formal discussions that would bring Wayne State's School of Medicine into a closer, more comprehensive relationship than currently exists with Henry Ford.

If, in the next 90 days, talks conclude with an agreement to proceed, the two institutions will work toward a goal of a formal agreement that would be implemented by mid-2010.

Both organizations bring substantial resources to the table. Henry Ford Hospital with its 1,000-member Henry Ford Medical Group is the nation's 7th largest provider of graduate medical education, with seven hospitals, 27 medical centers, an established, integrated health system and more than $70 million in annual research expenditures.  The Wayne State School of Medicine is the nation's largest single-campus medical school, with more than 1,200 medical students and 400 additional students in doctorate and master's programs.  In 2008, the School of Medicine received more than $115 million in research funding and grants.

Discussions are expected to be wide-ranging and comprehensive. Potential topics include:

• Increasing the number of Wayne State medical students training at Henry Ford;
• Combining research efforts with an emphasis on translational research;
• The potential for a new research center in or near TechTown; andProviding the next generation of physicians with a more comprehensive education in integrated health systems and best clinical practices.

The two organizations already collaborate on a number of projects in research and medical education. Henry Ford has been a core academic affiliate of the Wayne State School of Medicine since 2002. In 2008, Henry Ford was the pilot site for the School of Medicine's clinical campus model, hosting 62 third-year medical students at Henry Ford's Detroit campus; through that agreement, Henry Ford physicians and researchers who teach WSU students receive academic appointments as Wayne State faculty.

More than 260 Wayne State School of Medicine alumni work at Henry Ford. The two organizations also have collaborated on a planning grant submitted for a National Institutes of Health Clinical Translational Science Award, while Henry Ford's cytogenetic diagnosis, DNA and drug discovery labs are located in the TechOne building at TechTown, the university's research and technology park.

"This partnership clearly would mean a major enhancement to the research and education programs of our School of Medicine," said Jay Noren, MD, president of Wayne State University. "Training our students at a national top 10 integrated health system such as Henry Ford would give them the diverse experiences and highly skilled technical knowledge required for the next generation of medical practice. I look forward to working with leadership of Henry Ford toward our common goals of exceptional medical education, extraordinary research and excellent medical care."

"Not only does this potential partnership strengthen our academic and research missions," said Nancy Schlichting, president and CEO of Henry Ford Health System. "It also strengthens Detroit's reputation as a go-to city for training, research and clinical services and could be a strong, economic boost for the city."

"These talks are a natural progression of our long-term relationship with Henry Ford," said Valerie Parisi, MD, MPH, MBA, interim dean of the Wayne State University School of Medicine. "This is a really exciting opportunity for our medical students, exposing them to an integrated health system recognized nationally for its clinical excellence, patient safety and e-technology."

"Henry Ford Medical Group has a long history of leadership in, and commitment to, academic medicine," said Mark Kelley, M.D., CEO of the Henry Ford Medical Group. "Together with Wayne State's School of Medicine, we will be one of the country's premier organizations dedicated to conducting innovative research and will strengthen our academic mission of providing outstanding future health care providers."

Henry Ford is comprised of seven hospitals, including its flagship, Henry Ford Hospital, and the 1,000-member Henry Ford Medical Group, modeled after the Mayo Clinic employed group practice. Henry Ford recorded $3.6 billion in revenues in 2008 while providing more than $164 million in uncompensated medical care. Every year, 23,000 Henry Ford Health System employees provide care during more than 3.1 million patient contacts. Henry Ford health care providers perform 78,000 ambulatory surgery procedures each year. More than 81,500 patients are admitted to Henry Ford hospitals annually.

Founded in 1868, the Wayne State University School of Medicine is the nation's largest single-campus medical school with more than 1,200 medical students. In addition to undergraduate medical education, the school offers master's degree, PhD and MD-PhD programs in 14 areas of basic science to about 400 students annually. More than one-half of the School of Medicine's alumni remain in Michigan to practice medicine after graduation.

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Senate Finance Committee Reform Vote Delayed

From the AMA:

According to press reports that have been confirmed by AMA staff, the Congressional Budget Office did not complete its preliminary cost estimates of the Senate Finance Committee’s health system reform package over the weekend, which will delay the committee’s planned vote tomorrow on final approval of the package. The committee vote could be delayed until next week, which will likely affect the schedule for Senate floor consideration of a combined Finance/ Health, Education, Labor, and Pension Committee package. More information will be provided as it becomes available. 

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Michigan Income Slide Leaves 11.5 Percent Without Health Insurance

Michigan’s median income continued to slip below the national average in 2008, with $48,591 per household compared with $52,029 nationally, according to the US Census Bureau.

Michigan is one of only five states where median income in 2008 fell below that of 2007.

The American Community Survey also reported that 11.5 percent of those in Michigan lack health insurance.

It’s a statewide problem. In Detroit, nearly one of every five residents (18.9 percent) lacked insurance. In Flint, 11.5 percent went without insurance, while in Grand Rapids, it was 15.5 percent. In Lansing, 13.7 percent lacked insurance, while in the Upper Peninsula, 9.8 percent of Marquette County residents did not have health insurance.

The numbers show the need for Congress to pass a comprehensive health reform bill as soon as possible.

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Do You Like Community Service?

Do you want to meet Wayne State Medical Students that have a commitment to Community Service?

Would you like to collaborate with the Future, Past and Present Representatives of Medicine?

Aesculapians is proud to announce our first social event. Aesculapians is an honorary service organization that is devoted to the city of Detroit and the WSU School of Medicine. Our organization consists of approximately 50 members from all four classes.  Keeping in mind the Aesculapians credo of commitment to community service, we are pleased to announce that we will be inviting medical students and doctors that have made a commitment to serving the community around them.  If you are interested in continuing your community service, then this is the place to meet those with similar passions.

Location

Andiamo's Detroit Riverfront

http://www.andiamoitalia.com/detroit/index.html

Date & Time

October 6th, 6:30pm to 8:30pm

RSVP

jomiller@med.wayne.edu

Purpose

To meet Doctors and fellow students with a passion for community service

Hope to see you there!!!

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2009 Children's Holiday Party Contributors

The following is a list of contributors to the WCMS Foundation’s 24^th Annual Holiday Party for underprivileged children. This year’s event is Dec. 5 at the New Detroit Science Center. For more information, or to contribute, call (313) 874-1360 or visit www.wcmssm.org

S.V. Mahadevan, MD

Indu & Bala Pai

Chris and Janet Bush

Eve M. VanEgmond, MD

Taufiek Alhadi, DO

Gwendolyn H. Parker, MD

Dr. Ray and Mrs. Marcia Littleton

Drs. Daniel & Margarita Morris

Dr. & Mrs. Laurence E. Stawick

Dr. & Mrs. John Calwell

S. Rao Talla, MD

Ghaus M. Malik, MD

Eastlake Pediatrics PC

Vernon F. Strand, MD and Jane P. Strand

Robert Brent, MD

William Knapp, MD

Nancy Goll

Elizabeth Edmond, MD

Martin Daitch, MD

Benjamin Ramos, MD

Peter Cracchiolo

Robert Borchak, MD

Julian Alvarez, MD

Beth Ann Brooks, MD

Dr. & Mrs. Sajal Choudhury

William L. and Betty G. Knapp

Drs. Safwan Halabi & Razan Asbahi

Joe Weiss & Marilyn Shapiro

Dr. & Mrs. George C. Hill

Neela Sripathi

Homer M. Smathers, MD

Sidney Baskin, MD

John C. Somogyi, MD

Charla Blacker, MD

Todd R. Williams, MD

Iris and Fred Whitehouse

Joseph M. Beals, MD

Stephanie Flom, MD

Dr. & Mrs. Mark F. Pezda

Eudoro Coello, MD

Christopher W. Hughes, MD & Debra J. Hughes

Claus Petermann, MD

Richard D. Cieslak, MD

Daniel S. Moore

Drs. Peter & Alice Watson

Drs. Rachel and Brian Silver

Kathleen Yaremchuk, MD

Anne-Mare' Ice, MD

John M. Malone, MD

Anne Nachazel, MD

Eastside Surgical Specialists

Paul Mazzara, MD

Dr. Richard Pollard

Michael G. Taylor, MD, FACS

Drs. Kenneth & Deborah Granke

Aaron Lupovitch, MD

Keith P. Bartold, MD

Rev. William and Dr. Mary Logan

Scott Monson, MD

Arthur J. Frazier, MD

M. Natacha Umlauf, MD

Phyllis A. Vallee, MD

Michael Schaldenbrand, MD

Heidi R. Gunderson, DO

Paul J. Sullivan, MD

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