MMA Opposes Baldacci Health Care Reform Proposal
Following an analysis of the 72 page Plan and 45 page legislation, the MMA Legislative Committee last week voted to oppose the proposal expressing grave concern about the short timeframe for consideration of the bill and its impact on physician recruitment and retention.
The two bills comprising the Governor's package were printed and available to the public on Monday, May 12th. On May 13th, members of the Association's Legislative and Executive Committees spent three hours reviewing and discussing the provisions of both bills before concluding that the MMA had to oppose the proposal in its current form. The Committees came to a strong consensus that the very concrete threats to physicians and patients outweighed the speculative benefit of covering currently uninsured patients with some form of insurance. The bill opposed is L.D. 1611, An Act to Provide Affordable Health Insurance to Small Businesses and Individuals and to Control Health Care Costs.
Members did agree to strongly support the second bill, L.D. 1612, RESOLUTION, Proposing an Amendment to the Constitution of Maine to Preserve the Fund for a Healthy Maine. This bill proposes a constitutional amendment to ensure that Maine's share of the national tobacco settlement funds continues to be used exclusively for healthcare purposes.
On May 14th, Maroulla Gleaton, M.D., President-elect of the Association, Andrew MacLean, General Counsel and Gordon Smith, EVP, met with Trish Riley and Ellen Schneiter of the Governor's Office of Health Policy and Finance to discuss the results of the Tuesday evening meeting. We were joined at the meeting by Kellie Miller, Executive Director of the Maine Osteopathic Association which shares our concerns. Ms. Riley is the primary architect of L.D. 1611. The following issues were identified as the most significant problems in the legislation for Maine physicians and their patients.
1. The expansion of eligibility of MaineCare (formerly called Medicaid) without increasing reimbursement fees to at least the level of Medicare.
2. The concept of setting global budgets for Maine's hospitals and establishing a 3% 'voluntary' spending cap (for physicians, as well) without impacting positively on the cost drivers in the system, except for the possible impact on bad debt and charity costs.
3. The expansion of Certificate of Need to the private physician's office.
4. The onerous provisions regarding the collection of 'quality' data from the physician's office, through rule-making by the Maine Health Data Organization (MHDO). The bill would greatly expand the authority of the MHDO.
5. A mandate for all physicians to bill electronically by 2005.
6. Disclosure of pricing information, to be 'posted' in the physician office.
Proposed amendments were discussed and the administration seemed genuinely interested in working with the Association on some new langauage on some of the above points.
On Thursday afternoon, May 15th, EVP Gordon Smith presented MMA's testimony in opposition to L.D. 1611 at a public hearing before the Legislature's Joint Select Committee on Health Care Reform. Other physicians attending and in some cases testifying were Lawrence Mutty, M.D., Chairman of the MMA Executive Committee; Jo Linder, M.D., Chairman of the Maine Coalition on Smoking or Health; H. Burtt Richardson, M.D., a Winthrop Pediatrician; Wayne Moody, M.D. of Central Maine Orthopeadics, Craig Young, M.D., a former President of MMA and an ophthalmologist currently practicing in Presque Isle and Bangor; and Paul Klainer, M.D., of Owl's Head who operates a free clinic in Rockland. Representatives also attended from Orthopedic Associates in Portland.
Other opponents of the bill included Anthem General Manager Jim Parker, Maine Hospital Association President Stephen Michaud and Maine Osteopathic Association Executive Director Kellie Miller. Proponents included largely uninsured individuals, some small business representatives and advocates for low-income and uninsured individuals.
Work sessions on the bill will be held this week on Tuesday, Wednesday and Thursday afternoons. There is still considerable pressure from the administration to vote the bill out of committee this month. As discussed in Mr. MacLean's 'Political Pulse', which you can access through the following link, MMA encourages all physicians to carefully consider L.D. 1611 and L.D. 1612 and to discuss the issues with your legislators. L.D. 1611 will have a significant impact upon your practice, regardless of specialty or setting. The following link will also give you access to MMA's testimony, contact information for the Joint Select Committee and talking points. http://newsmanager.commpartners.com/mmpp/issues/2003-05-15.html