CMA: Managed Care Tops Agenda At Annual Legislative Day
The California Medical Association held its annual legislative day last Wednesday in Sacramento to discuss issues important to California physicians. The Chico Enterprise-Record reports that major issues included treatment denials by HMOs, "absorbing losses incurred by caring for the poor on Medi-Cal," the medical use of marijuana and physician-assisted suicide. "CMA leaders talked about the latest legislation, gubernatorial candidates Dan Lungren and Al Checchi made campaign speeches, top lawmakers talked about their priorities and later the doctors fanned out to pitch bills to members of the Senate and Assembly," the Enterprise-Record reports.
One of the major issues doctors discussed at the meeting was HMO reforms to guarantee "that the doctor and patient have the final say in care -- not a health plan reviewer under pressure to reduce costs." Dr. Tom Wilkinson, a Chico neurosurgeon, said, "The patient has to trust the doctor is taking care of him and that care and advice is not being based on his (fee)." Another big issue was childhood vaccinations, because "[s]ome health plans are refusing to pay the higher costs of newly discovered vaccines, particularly for hepatitis B and chicken pox." Office visit reimbursements are also a concern since "MediCal has frozen for numerous years the general $16 reimbursement for a basic office visit, while general overhead is now up to about $25 per patient." Physician-assisted suicide was also debated. The CMA is "opposed to doctors helping people kill themselves" and is "pushing legislation that would make it easier for physicians to prescribe a new breed of potent pain killers for the terminally ill." Dr. Richard Gray, a family physician and president of the Butte-Glenn Medical Society, said, "The role of the physician is to help patients, to cure them and improve their condition." The issue of medicinal use of marijuana was another topic discussed, and doctors backed "proposed state legislation calling for a definitive study of whether marijuana is truly effective." Dr. Chester Ward, the retired public health officer for Butte County, said, "I have not seen any good scientific evidence" that marijuana is effective for the chronically ill (Gardner, 4/27).