MMS Physicians Visit Beacon Hill Legislators, Universal Access Tops the Agenda

by Tom Walsh

On Wednesday, Nov. 2 -- “Doctors’ Day” -- approximately 200 MMS physicians from around the state converged on the Massachusetts State House to inform lawmakers what they believe needs to be done to improve the state’s health care system for physicians and patients.

Photos by Fayfoto Senate President Robert Travaglini acknowledges the significance of Doctors’ Day at the State House, November 2, 2005. Senate Majority Leader Frederick Berry listens to the concerns of Massachusetts physicians during Doctors’ Day. Senate President Robert Travaglini and MMS Executive Vice President Corinne Broderick Sen. Susan Fargo, chair of the Legislature’s Public Health Committee, and Kenneth Peelle, M.D., MMS ­president-elect, confer during Doctors’ Day at the State House on Nov. 2.

At one point during that day, six high-ranking MMS leaders listened closely to Rep. Ronald Mariano (D-Quincy) as the influential chair of the Joint Committee on Financial Services offered a State House insider’s perspective on prospects for health care reform. “We’re excited,” he said. “We think we have a package that can work.”

Mario Motta, M.D., chair of the MMS Legislative Committee, smiled as Rep. Mariano spoke. The night before he’d read what was then the latest version of a House bill to extend health insurance coverage to the state’s uninsured population. “I’m impressed,” Dr. Motta told Rep. Mariano. “You’ve put something together that we can support.”

Although the business community has reservations about some aspects of universal access legislation, the mood at the State House on Doctors’ Day was cautiously optimistic. Rep. Mariano was well-versed on issues important to Massachusetts doctors. However, he cautioned, “The thing that has become clear is that there are no easy solutions.” The MMS delegation nodded as one.

Wide-Ranging Agenda
While the universal coverage issue topped the agenda, it was not the only topic on physicians’ minds. They also came prepared to discuss adequate physician reimbursement for treating Medicaid patients, professional liability reform, proposed regulations on physician ownership of technology such as MRI services, legislation that would expand the ability of nonphysicians to practice medicine, public health issues, and physician administrative hassles (see related article).

“We are here this morning because we care deeply about the future of our health care system,” MMS President Alan M. Harvey, M.D., M.B.A., told his colleagues as they gathered in the Great Hall before splitting up into small group meetings with legislators. Dr. Harvey emphasized how timely the appearance of MMS doctors was. “The MMS House of Delegates made it clear last spring that there must be universal coverage,” he declared. “The Legislature is meeting this week to deliberate on these proposals. We are extremely hopeful that the results of this process will be a system that is true to our cherished principles -- a system that provides high-quality care that is continuous, affordable, and sustainable.”

Meeting a Challenge
Six months ago in a Vital Signs interview, Senate President Robert E. Travaglini challenged the state’s doctors to play a more active role in State House deliberations. “We accept that challenge,” Dr. Harvey said on Doctors’ Day.

And not a moment too soon, Sen. Travaglini told the Doctors’ Day gathering, “We’ve thrown ourselves into the crux of the debate around health care reform,” he said. “There are a whole host of issues that you know a lot more about than I do. But, along with the governor and the [House] speaker, I’m the one making the final decisions, and you’re going to have to live with them. So it’s important that you’re here today.”

Medical Citizenship
Physicians in attendance needed no convincing about the significance of Doctors’ Day. “This shows that doctors actually do care about what the Legislature is doing,” said Bruce G. Karlin, M.D., who practices internal medicine in Worcester and sits on the MMS Committee on Communications. “But this will have to continue every year. It’s a part of our medical citizenship.”

Armed with summaries of relevant health care bills and a list of advocacy “dos and don’ts” provided by staff, physicians disbursed into small groups for pre-arranged meetings with local lawmakers and legislative leaders.

Meanwhile, the MMS leadership team was sitting down with Rep. Mariano. In addition to Dr. Motta, Rep. Mariano was joined by Dr. Harvey; Kenneth Peelle, M.D., MMS president-elect; James Kenealy, M.D., vice chair of the Committee on Legislation; Dale Magee, M.D., MMS vice president; and Corinne Broderick, MMS executive vice president.

No Quick Fixes
The MMS delegation was determined to help lawmakers understand how various aspects of universal access impact physicians. For example, Rep. Mariano heard how expanding Medicaid eligibility might not significantly expand access to care unless Medicaid reimbursement to physicians is increased. “There are doctors who just don’t take Medicaid patients anymore,” Dr. Kenealy said. Added Dr. Motta, “If 20 percent of your patients are free care or Medicaid, you can’t make a living.”

Rep. Mariano listened intently, but he pointed out that not all of the problems plaguing the health care system can be fixed quickly.

In another small group meeting, Rep. Robert A. DeLeo, chair of the House Ways and Means Committee, took copious notes as MMS physicians offered their views on universal access. As the conversation swung to the need for uniform credentialing to eliminate long, costly hours of administrative paperwork for physicians, the lawmaker conceded he was not familiar with the issue. The doctors filled in Rep. DeLeo about the “hassle factors” in today’s practice of medicine, after which Dr. Motta advised, “Give us the tools, and we’ll be happy to help you get a better handle on health care costs.”

Rep. DeLeo then asked Anna Wheeler, M.D., a pediatric resident at Massachusetts General Hospital, which issues she faces as a young doctor. “As a pediatrician,” she replied, “I’m concerned about what we are doing for children.” Along those lines, Dr. Wheeler expressed concern regarding how doctors are reimbursed for advising their patients about preventive care. “If I’m concerned about an overweight child and I spend half an hour talking with the family about it, I need to know that I will get reimbursed for it,” Dr. Wheeler said.

Based on feedback from lawmakers and physicians, MMS President Dr. Harvey concluded that Doctors’ Day was “both timely and important.”