There is more than one proposition on the California ballot this November that threatens health care providers and patients. The same groups pushing to change the Medical Injury Compensation Reform Act (MICRA) – “Consumer Watchdog” and their trial lawyer allies – are also pushing Proposition 45 that would give the state Insurance Commissioner sweeping new power over health care benefits, rates, and co-payments for individuals and small groups.
SFMS is part of a broad coalition opposed to Proposition 45, including the California Medical Association, California Hospital Association, specialty societies, hospitals, health plans, labor, and small businesses.
Prop 45 threatens physicians’ ability to provide the care that patients need by giving a single elected politician – the Insurance Commissioner – vast new power over health care benefits and rates. With recent cuts to the Medi-Cal program, we are already seeing the devastating impact it can have on patient access to care when politicians cut reimbursement rates below the cost of providing care. Additional cuts would result in an even more difficult time for patients that need care the most.
Prop 45 also has a hidden agenda – allowing trial lawyers and the sponsors to file costly new health care lawsuits. They buried a provision in the fine print that allows them to “intervene” in the regulatory process created under the Initiative and file lawsuits if they don’t like the results. In doing so, they can pocket millions of dollars in so-called “intervenor fees” – as much as $675/hour. In fact, the proponents have already received more than $11.5 million from a similar provision used in auto and home insurance regulation.
Prop 45 establishes new and conflicting rules that could interfere with California’s implementation of the Affordable Care Act. It provides more uncertainty, delays, and confusion at a time when California providers and patients are already dealing with massive changes to our health care system.
Join SFMS and CMA to oppose Prop 45. For more information, visit www.stophighercosts.org.
The new California POLST form goes into effect on October 1, 2014, and health care professionals must take note of key changes to the form.
POLST (Physician Orders for Life-Sustaining Treatment) is a physician order signed by both a doctor and patient that specifies the types of medical treatment a patient wishes to receive toward the end of life. POLST is a tool that encourages conversation between providers and patients about their end-of-life treatment options, and helps patients make more informed decisions and communicate their wishes clearly. As a result, POLST can prevent unwanted or medically ineffective treatment, reduce patient and family suffering, and help ensure that patient wishes are followed.
The new version of the POLST form includes goal statements for each potential treatment option so patients can better understand their choices. The treatment options are also listed more consistently (from most aggressive to least aggressive), so patients can better understand what is involved in their choices.
The new version of the POLST form, printed on bright pink paper, will be effective October 1, 2014. Beginning October 1, physicians should only use the new version of the POLST form, though previous versions will continue to be honored.
Click on the links below to download the 2014 POLST form:
5 things you need to know about DEA’s final rule reclassifying hydrocodone as Schedule II. The changes will go into effective on October 6, 2014.
References cited in Our Bodies’ Best Buddies by Elisabeth M. Bik
References cited in The "Second Genome" and Women's Health by Linda C. Giudice, MD, PhD
References cited in Pre- and Probiotic Foods for a Healthy Gut by Jo Ann T. Hattner, MPH RDN and Susan Anderes, MLIS
References cited in The NIH Human Microbiome Project by Erica Goode, MD
References cited in Why the Microbiome Matters: One Primary Care Physician's Journey toward Understanding Its Significance by Payal Bhandari, MD
Originally published on SFgate.com on September 12, 2014
By Michael H. Rokeach, MD
As an emergency-room doctor in San Francisco for more than 30 years, I see some of the city’s most critical patients — people suffering heart attacks, life-threatening infections, gunshot wounds and more. Proposition 46, which seeks to increase the limit on the amount of medical malpractice lawsuit awards, is a critical threat to the health care of all Californians. The thoughtful response is to oppose it.
The initiative is a complicated, costly measure — written and funded by trial attorneys — which makes sweeping changes to California’s health system without any input from health care experts or medical practitioners.
It’s also deceptive. It uses alcohol and drug testing of doctors (whether they are on or off duty — unprecedented in the U.S.) to disguise the real intent, which is to lift the cap on the medical malpractice lawsuit awards to $1.1 million from $250,000, thereby raising attorney fees, while increasing costs for everybody else.
But, worst of all, it’s bad for health care and health access for low-income communities. It will cost the state and local governments hundreds of millions of dollars and it will make it harder for community clinics such as Planned Parenthood to provide specialty services.
With millions of newly insured patients looking for quality care under the Affordable Care Act, I can’t think of a worse possible time to increase cost and decrease access to trusted health providers. Vote NO on Prop. 46.
Michael H. Rokeach is an emergency-room physician and past president of the San Francisco Medical Society.