AMCNO provides testimony to the House Healthcare Access and Affordability Committee

On July 30th Dr. John Bastulli, Vice President of Legislative Affairs of the AMCNO, provided testimony on behalf of the AMCNO to the House Healthcare Access and Affordability and the Senate Health, Human Services and Aging Committees. The joint hearing committee hearing was held in Cleveland and was the first in a series of statewide hearings where the committees plan to hear testimony from members of the public on various health care-related issues including current health care trends in various regions of the state, discussion on how health care needs change with age and how the health care system can adapt to these changes, and also proposals for viable health care reform.

The AMCNO testimony keyed in on specific points such as the fact that it is estimated that 1.3 million Ohioans or approximately 12.3 percent live below the federal poverty level and the fact that the 46 million Americans that are uninsured are paying only five percent of the cost of their care; and that as a nation, we are getting older, heavier and sicker.

AMCNO testimony also noted that declining health status as a result of unhealthy lifestyle choices, contributes to the escalating rise in healthcare costs and that the American Medical Association estimates that eight hundred billion dollars a year is spent on healthcare services related to five conditions: obesity, tobacco use, sexually transmitted diseases, violence and teen pregnancies. Alcohol and drug abuse is prevalent in patients that present with sexually transmitted diseases, violence and teen pregnancy. The prevalence of obesity and diabetes has doubled over the last 25 years with an increase in diabetes and obesity related heart disease. In Ohio the numbers are alarming. 25 percent of the population smokes, 10 percent are obese and 10 percent suffer from diabetes. In order to control costs, reform must address certain unhealthy lifestyle choices. Dr. Bastulli noted that other individuals participating in this debate have stated that healthcare is a basic right and should be provided for all. There is no individual right without individual responsibility.

The AMCNO testimony also noted the high costs of defensive medicine in this county – where it is estimated that the cost of defensive medicine is approximately 124 billion dollars a year, which amounts to ten percent of the total increase in annual healthcare expenditures, which are presently 8.8 percent. Higher malpractice awards and premiums are associated with higher Medicare spending. In addition, medical students that receive their education and training in Ohio are choosing not to train and/or practice here incident to our medical liability climate – which could result in a physician shortage in Ohio.

Further testimony noted that physicians have to work with inefficient health system spending that does not add any value to patient care, such as excessive costs associated with dealing with the myriad insurance companies. The medical system has become more integrated and consolidated, with many physicians now in situations of employment, and negotiating contracts with large integrated health systems and managed care companies that hold the balance of power over patient care and workplace issues. Physicians may find it difficult to negotiate terms of their contracts or obtain information from the plans to assist them in their practice. And insurance companies are implementing pay for performance and practice reward programs with increased calls for “transparency” in the healthcare system. More than likely in order to work within these systems physicians will have to implement electronic health records in their practice. All of these activities add cost to the healthcare system and should be subject to cost-effective analysis to determine whether or not they actually add value to patient care.

AMCNO suggested several options for the committees to consider such as what was recently done in California – a survey of the uninsured to ascertain their coverage needs and what they would consider adequate and affordable. AMCNO also suggested that legislators should consider a minimum benefit package – one that provides universal coverage for basic, essential services but that focuses on early intervention and prevention. AMCNO also noted that adoption of SB 59 – the mandatory arbitration legislation – would help reduce healthcare expenditures and promote patient safety and quality outcomes. We also voiced support for coverage expansion for preventive care, and the importance of reviewing the community benefit of hospitals. Last, the AMCNO pushed for funding at the state medical board level to allow the board to track specific physician demographics in order to focus on the need for physicians in the future in our state as well as calling for establishing a health insurance oversight/advisory committee made up of physicians to work under the auspices of the Ohio Department of Insurance in order to provide input on the manner in which these plans operate in and effort to monitor how these plans impact the practice of medicine from a cost perspective. Additional information on the AMCNO testimony will be in the upcoming issue of the Northern Ohio Physician magazine.