March 9, 2003

 
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Maine Medical Association Joins in Cover the Uninsured Week - This Week!
Over 130,000 Maine people do not have health insurance, and the number is growing. MMA joins many other organizations during the week of March 10-16 for an unprecedented weeklong series of events focusing attention on the problems of the uninsured.
More than 41 million Americans, including more than 130,000 Maine people, do not have health insurance, and the number is growing.  During this week of March 10-16, several Maine organizations are joining their national counterparts in focusing attention on the problems of the uninsured.   On Wednesday, March 12, a Health Fair and Enrollment Day will be held at 54 sites across Maine.  At these sites, officials will be availabe to enroll eligible persons in public programs providing coverage.

For a complete listing of events in your area, call 207-761-0101 or visit www.CoverThe UninsuredWeek.org.

U.S. House to Vote on Medical Liability Reform This Week
As expected, the House Committees on Energy and Commerce and the Judiciary passed H.R. 5 this past week.  The legislation now advances to the House floor and a vote is expected this week, most likely on Wednesday, March 12th or Thursday, March 13th.

H.R. 5, the bi-partisan HEALTH (Help Efficient Accessible, Low-cost, Timely Health Care) Act was introduced by Rep. James Greenwood (R-PA) and is cosponsored by 120 House Members.  The Act safeguards patients' access through the following reforms:

                 Allowing patients to recover for economic damages such as future medical expenses and loss of future earnings while establishing a cap on non-economic damages, such as pain and suffering, of $250,000.

                   Allocating damages fairly, in proportion to a party's degree of fault.

                    Limiting the number of years a plaintiff has to file a healthcare liability action to ensure that claims are brought on a timely basis.

While Maine's statute of limitations is, from a physician perspective, superior to that proposed in H.R. 5, the other provisions of the bill, and particularly the cap on non-economic damages, would be very helpful in keeping professional liability premiums at a reasonable rate.  Maine physicians should contact Representatives Allen and Michaud and urge them to vote for H.R. 5 when it reaches the House floor.  Calls can be made through the AMA Grassroots Hotline at 1-800-833-6354 which will connect you to the Congressman's office.

For more information on the medical liability reform issue, visit the AMA in Washington web site at www.ama-assn.org/grassroots.

                  

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"Eggs & Issues" Breakfast Features Harvard Professor Who Calls on Consumers to Take Control
Nancy Kane of the Harvard School of Public Health spoke at an 'Eggs & Issues' breakfast, sponsored by the Portland Community Chamber of Commerce, on March 5th and urged Maine consumers to take a greater role in choosing health insurance plans and in  managing their own health care.  Professor Kane cited a number of cost drivers in the current system, including the demand for high-quality intensive care, technological advances, prescription drugs and hospital costs.  She noted that Maine hospitals, on average, provide care at a higher cost and are more profitable than the average hospital in the Northeast and nationally.

Ms. Kane also noted that most of the costs benefit a small number of patients, citing that 1 percent of patients account for 25 percent of the healthcare spending in the country.  By contrast, 50% of the population accounts for just 5 percent of the total cost.

Stating that a consumer driven health care system makes sense, Kane added that consumers would need the bargaining power of a large group to keep insurance and health costs at a reasonable level.  She also stated that a consumer-driven system would require a state agency to regulate and negotiate for lower costs.  There also would be a need for a process that would give consumers the information they need to make choices. [return to top]

Aetna Back on Track Financially
After struggling for years to get back on track financially, Aetna, Inc., reported a gain in profits for every quarter in 2002, after losing money in every quarter in 2001.  The company's financial turnaround is attributed to severe layoffs, hefty premium hikes and dropping of unwanted subscribers from its rolls.

The Hartford Courant reported on March 4th that Aetna reported $450 million of operating profits in 2002,after posting a $63 million loss in 2001.

As a reward, CEO John Rowe, M.D. was paid nearly $9 million and received options on 350,000 shares of Aetna stock with a potential estimated value of $5.44 million.  No information was reported relative to Aetna's reimbursement to Maine's physicians. [return to top]

MaineHealth Sponsors Course on Asthma and COPD at Sugarloaf on March 29th
Maine Health is sponsoring a one-half day course on asthma and COPD at Sugarloaf on March 29th.  Speakers include Jon Musmand, M.D.  and Joseph Zibrak, M.D.  Dr. Musmand is with Asthma and Allergy Associates in Portland and Dr. Zibrak is from Beth Israel Deaconess Medical Center in Boston, Division of Pulmonary and Critical Care Medicine.  There is no charge for the course but space is limited.  To register, contact Marianne Miro at 207-775-7001 or e-mail mirom@mmc.org.  Discounted lift tickets are available to participants.  The program is funded by an unrestricted educational grant from GlaxoSmithKline.  CME will be offered. [return to top]

Dr. Charlotte Yeh named Regional Administrator for CMS
The federal Department of Health and Human Services has announced the appointment of Charlotte Yeh, M.D. as the new Regional Administrator for the Centers for Medicare and Medicaid Services, Boston Regional Office.  Dr. Yeh, who is well known to Maine physicians, comes to her new position with over 20 years of experience as an emergency physician providing direct medical and administrative services.  She has run both community and academic emergency departments as Chair, and established the first academic Department of Emergency Medicine at Tufts University Medical School.  She has been an active member of the Massachusetts Medical Society and currently chairs its Communications Committee.

Most recently, Dr. Yeh served as Medical DIrector  for National Heritage Insurance Company, the Medicare Part B fiscal intermediary for Maine, New Hampshire, Vermont and Massachusetts. [return to top]

Revisions Being Prepared to Medical Staff Chapter of Hospital Licensing Regulations
The Hospital Licensing Review Board is currently discussing proposed revisions to Chapter lX, The Medical and Professional Staff, of the state hospital licensing regulations.  Two additional meetings of the Board have been scheduled for May 2nd and May 16th to further consider the proposed changes.  Both Sandra Parker, attorney for the Maine Hospital Association and Gordon Smith, Esq., of MMA have been invited to participate in the redrafting process and physician and hospital interests are well represented on the Board, which is chaired by Lee Miles of St. Mary's Regional Medical Center.  Dennis Sullivan, M.D., President of the Medical Staff at Mercy Hospital and a consultant to the DHS Division of Licensing and Certification also is involved in the effort. 

Copies of the draft amendments to the Medical Staff chapter can be obtained from Mr. Smith via gsmith@mainemed.com. [return to top]

Governor's Health Action Team Hits the Ground Running
Governor Baldacci's Health Action Team (HAT) meets on Friday March 14th to continue its work in developing the Governor's comprehensive Health Care Reform proposal.  The HAT is working under an extremely constrained time frame in order to meet the Governor's goal of having a legislative proposal submitted to the Legislature by April.

All HAT meetings are public proceedings, including the many subcommittee meetings, but some of the subcommittee meetings are being conducted via teleconferencing which certainly limits public involvement.   Partly in recognition of this constraint, a half-hour portion of each full HAT meeting is set aside for public comment.

The five Subcommittees include Public Purchasing, Benefits, Quality and Accountability, Financing Low Income Access and Cost Containment/State Health Planning & Regulation.  The subcommittees include a number of individuals not on the 26-member HAT.   Each HAT member this past week was asked to respond to the following two questions;

        1.  What 2 or 3 specific things must be included in the health reform package (eg: what are your key ideas to make health reform work for Maine?)

          2.  Are there 2 or 3 things that health reform should not do- activities that should not be included in the proposal?

         In responding to these questions, MMA HAT representative Maroulla Gleaton, M.D. responded that the proposal should offer coverage to all persons and should require participants to bear some of the cost, except for the very poor.  She also noted that there should be incentives for good quality, using appropriate technology where possible to reduce administrative expense.

       All MMA members are invited to provide input to Dr. Gleaton ih her role as the sole representative of participating physicians on the HAT (although we are pleased to see some additional physicians on the subcommittees including, among others, Dan Onion, M.D., and Donald Smith, M.D.)  Dr. Gleaton can be reached through atleegleaton@earthlink.net.  Comments can also be provided to Gordon Smith at gsmith@mainemed.com.

The Governor's effort is ambitious and may well set in motion a number of initiatives that would effect Maine physicians for years to come.  Proposals in the areas of Certificate of Need, Quality/Accountability, Rate Setting, and Universal Coverage are all expected, along with the proposal to establish a state financed, non-profit health insurance company.

The HAT will meet every other Friday,  with subcommittees generally meeting in the morning and the full HAT meeting beginning at noon.  The meetings are held at various locations around Augusta. [return to top]

Smallpox Vaccination Update
No serious reactions have occurred as a result of the more than 4,000 smallpox vaccines administered to civilians in February, the CDC announced on Feb. 20th.  As  of that date, 4,213 persons had been vaccinated and none had experienced reactions considered 'potentially life-threatening, severe or moderate', although seven persons had experienced symptoms including fever, rash, malaise, itching, hypertension and inflammation of the pharynx.  In addition, five serious reactions occurred among the more than 100,000 military personnel who received the vaccine; two developed encephalitis, one developed a heart infection, one developed a rash known as 'generalized vaccinia' and one may have developed ocular vaccinia, which migrates to the eye.

Based on past data, experts anticipate between 15 and 50 'life-threatening' reactions out of every million people vaccinated, including one or two fatalities. [return to top]

For more information or to contact us directly, please visit www.mainemed.com l ©2003, Maine Medical Association