Gasline Newsletter March 2007

Volume 8, No. 10

Health Care Reform: Let Your Voice be Heard!

Aside from the War in Iraq, Health Care Reform promises to be the single most important topic in national politics this year. It is already a major focus of the many candidates for President and is on the top of the Congressional agenda. Your Congressional Representative will be on spring recess during the first two weeks of April and likely in their district offices, maybe very near where you live or work. Make an appointment to go and speak to him or her. It's their job to represent you. A quick Google search will get you their phone number in less than a minute! Explain how the formula used by Medicare/Medicaid to calculate payments to physicians (the Sustainable Growth Rate-SGR) has resulted in declining payments despite the rising cost of medical practice (and everything else!). Explain how the "teaching rule" used by Medicare (only for anesthesiology) to cut in half payments to academic teaching programs, when faculty work with anesthesia residents, is crippling our efforts to train the next generation of anesthesiologists. Explain how Anesthesiology is treated especially unfairly compared to other specialties when Medicare rates are compared to payments determined in the medical marketplace. The CSA Web Site has everything you need to know to prepare.

If you can't meet face to face with your Representative, then make the phone call. Talk to the Staff person who assists the Member with Health Care Issues. Let our voice be heard through your action. A delegation of CSA leaders will be going to Washington, D.C., the first week of May to attend the annual ASA Legislative Leadership Conference. We will be talking to many California Members of Congress, and if you've made the contact with them locally, our message will have more strength.

CSA will also be participating in the annual CMA Legislative Conference in Sacramento, Tuesday, April 24. CSA members who are CMA members (you should all be!) are invited to attend and expenses will be paid by CSA. Many local county medical associations provide bus transportation. As you all know, Governor Schwarzenegger has made Health Care Reform in California a major priority by suggesting radical changes. This has stimulated many proposals from our State Legislature. We must make sure that we are heard in this debate. Call your local Assembymember and State Senator and let them or their staff know that anesthesiologists are important, work long and difficult hours, and deserve commensurate treatment under any reform proposal. This affects patient's access to care, and our profession's ability to retain dedicated and skilled anesthesiologists in our State.

What's Happening in Sacramento?

Although the Governor has put forth a controversial and sweeping plan to "cover every Californian," thus far no legislator has emerged willing to introduce a bill that would allow this plan to become law. It has stimulated alternative proposals from the leaders of both the State Senate and Assembly (Democrats) and from the Republican Party leadership as well. Senator Kuehl (Santa Monica) will again put forth her single payer plan. So far there is a great deal of rhetoric but little real action. Obviously, we want to be a central part of this movement as it develops, and our representation by CSA and CMA is vital to our future.

The proposals of DMHC to prohibit billing of patients by physicians not contracted with their HMO plan, which was such a hot issue in the fall, has cooled considerably while the agency prepares its response to the massive number of objections received during the public comment period.

Most recently the Governor's office has had to deal with the circus atmosphere, which surrounds the antics of his former bodybuilding buddies (now chiropractors) whom he appointed to head the State Chiropractic Board. It seems, in an effort to expand their scope of practice and legitimize the questionable practice of "manipulation under anesthesia," the board, which is supposed to protect the public, has ignored legal boundaries. There is a common theme here: agencies of the executive branch which exist to protect the public through oversight of various entities (HMO plans, CRNAs, Chiropractors, etc) have increasingly sought to promote the interests of those they should instead be regulating.

CSA District Election Results

Districts 2, 3, 5, 10, 11, 13 and 14 had delegate elections this year. The results will be available on Monday, April 2, on the CSA Web Site.

CSA/UCSD Annual Meeting and Clinical Anesthesia Update

Sign up now for this year's meeting! It will be held in San Diego at the Sheraton San Diego Hotel & Marina from May 31 through June 3, 2007. Registration fees have been reduced for CSA members. Although brochures were mailed some time ago, there is an online version of the brochure that includes the CME program, governance, hotel and other information. Saturday afternoon is free this year so attendees and their families can enjoy the San Diego area. Star Destinations, a tour company, will be available to help everyone make the most of their visit. Registration for the seminar is available online at the CSA Web Site.

CSA Survey on Payments and Stipends

The CSA survey was sent to members via e-mail several weeks ago, and more responses are needed. Each member, please contact your billing group and instruct them to complete the survey for your group. The survey will yield valuable information that will help groups in negotiating stipends and payments. Click on these links for the survey and instructions. If you would like to have an interactive Excel form of the survey, please contact the CSA office at 800-345-3691.

Mark A. Singleton, M.D.