CMA Policymaking: Your SFMS Delegates at Work

Joshua H. Rassen, MD, Brian J. Lewis, MD, and Steve Heilig, MPH

The 133rd annual session of the CMA House of Delegates took place in March-in Sacramento this year, where the CMA headquarters now resides. The arduous but sometimes fun sessions all took place within sight of the Capitol building, which served as a constant reminder of where the "outcome" of CMA policy often resides.

Resolutions to reform health care financing, encourage universal immunizations for children, and protect the doctor-patient relationship were among the resolutions passed by the House. As usual, the relatively small SFMS delegation was disproportionately highly visible in terms of speaking to issues, proposing resolutions, and serving on key CMA bodies. Complete description of new actions and policies is available on the CMA website: www.cmanet.org.

Here are a few highlights from our perspective, with SFMS authors listed where relevant:

Ratings for Films with Tobacco Use: (Lucy Crain, MD) calls on CMA to encourage the motion picture industry to apply an R rating to all new films depicting cigarette smoking and other tobacco use.

Herbal Products and Drug Interactions: (Joshua Rassen, MD and Steve Follansbee, MD) calls for labels on herbal and nutritional products to prominently list any known adverse interactions with prescription and nonprescription medications and warn that unknown interactions may occur.

Fingernails and Infection Control: (Rita Melkonian, MD) CMA shall support a statewide infection control policy that prohibits artificial fingernails or natural fingernails beyond a certain length for health care workers who engage in direct hands-on patient care in ICUs, operating rooms, perioperative settings, inpatient or outpatient wound care, and other high-risk settings.

Tax Credits for Healthcare Costs: (Steve Walsh, MD) States that health care expenditures should be a tax-credited expense. A related new policy (also by Walsh) urges that Health Savings Accounts be made available to those over 65 years of age.

Elder Abuse Allegations: (James Davis, MD) Urges that education of legislators and appropriate legislation be pursued to address the problem of improper charges of elder abuse in long-term-care settings.

Medical Records Privacy: (Steve Walsh, MD) Urges that the consent requirements for release of records that have been lost in recent years due to "reform" be restored.

"Mad Cow" Disease (BSE): (Robert Lull, MD) Urges study and appropriate action, including increased testing, of animals consumed by humans for prior diseases, including BSE.

Pharmaceuticals from Canada: (Andrew Calman, MD) Urges that the FDA develop special quality and safety guidelines for drugs imported from Canada.

Asthma Inhalers in School: The delegates passed Resolution 113-04 (Tom Addison, MD), which says that CMA shall support legislative efforts to authorize the possession and self-administration of inhaled asthma medications in all public schools by children with asthma, provided there is written authorization from the child's parent or guardian and a written authorization from the health care provider documenting that the child has the skills necessary to self-administer the medication.

Physician Well-Being: (Linda Hawes Clever, MD) Directs CMA to work with physicians, medical students and others to develop effective efforts to improve the health and satisfaction of physicians.

The Doctor-Patient Relationship: The delegates passed Resolution 119-04, which calls on CMA to take a strong public stand against legislation banning late-term abortion and continue to educate the public and Congress about the strong need to protect the physician-patient relationship.

Greenhouse Gas Vehicle Emissions: (Tom Addison, MD) calls on CMA to urge the California Air Resources Board (CARB) to expeditiously and without delay adopt and implement the strongest possible regulations to reduce greenhouse gas emission levels from motor vehicles under the Clean Cars Law.

Universal Immunizations: CMA supports an adequately-funded universal immunization program for all children in the United States. The resolution also emphasized that insurers should be required to cover all childhood immunizations recommended by the CDC's Advisory Committee on Immunization Practices and American Academy of Pediatrics, without asking for the usual deductible.

Health Care Financing Reform: The delegates adopted a health care financing reform policy (Report B-1-04) that supports mandates to assure universal health care coverage; encourages a health care benefit design that includes technology and medical advancements that are evidence-based and have proven value; and incorporates appropriate individual responsibility for health care costs.

THE SFMS DELEGATION, 2004 includes:
Joshua H. Rassen, MD, Chair
Brian J. Lewis, MD, Vice-Chair
Dexter Louie, MD Robert J. Margolin, MD
Judith L. Mates, MD
Rita Melkonian, MD
Stuart Rosenberg, MD
George P. Susens, MD
Edward A. Chow, MD
William H. Goodson, III, MD
E. Ann Myers, MD
H. Hugh Vincent, MD
Lucy Crain, MD
Peter W. Sullivan, MD
Stephen J. Walsh, MD
James A. Davis, MD
Mei-Ling E. Fong, MD
Alan Greenwald, MD
Russell E. Leong, MD
Randall Low, MD
Robert J. Lull, MD