Massachusetts Medical Society Testifies In Opposition To Parts of House Bill 4490

Contact: Richard Gulla
rgulla@mms.org
(781) 434-7101

Waltham/Boston -- March 10, 2010 -- The Massachusetts Medical Society, the statewide organization of physicians with more than 22,000 members, today testified before the Legislature's Joint Committee on Health Care Financing in opposition to selected sections of House Bill 4490, An Act Providing for Job Creation by Small Business.

The legislation was filed by Governor Patrick in part to ease the burden of health care costs on small business as well as encourage business growth in the Commonwealth through several measures. The Medical Society testified in opposition to sections 24-32 of the bill, provisions related to regulating the health insurance market.

Jack Evjy, M.D., senior medical advisor for the Society, said that physicians recognize that more and more individuals and small businesses are confronting the problem of affordability of health insurance, including members of the Medical Society. He said the organization has heard directly from members who are small businesses and know the difficulty of sustaining a small business.

"However," Dr. Evjy testified, "artificially containing the cost that payers may pay to practices gives us serious concern. Not the least of which is the message that rate regulation makes Massachusetts an unattractive place to practice" for physicians.

Dr. Evjy noted that the state is experiencing shortages of physicians in a number of specialties, among them, primary care, dermatology, neurology, urology and vascular surgery.  "We are concerned," he said, that attempts to regulate contractual relationships send a negative message about coming to Massachusetts. This in turn results in access problems for patients."

He said the Society believes that a great deal of groundwork has been accomplished in attempts to contain costs and made specific reference to the final report of the Massachusetts Health Care Quality and Cost Council (HCQCC), created by Chapter 58, the state's landmark health care law.

HCQCC's final report, said Dr. Evjy, if implemented strategically, "will allow the Commonwealth to meet its goal of sustainability and containing cost growth in health care."

The HCQCC's report included a number of cost containment measures, such as comprehensive payment reform, support of system-wide redesign efforts, widespread adoption and use of health information technology, implementation of evidenced-based health insurance coverage informed by comparative effectiveness research, implementation of additional health insurance plan design innovations to promote high-value care, development of health resource planning capabilities, enactment of malpractice reforms and peer review statutes, implementation of administrative simplification measures, consumer engagement efforts, emphasis on the prevention of illness and the promotion of good health, and increased transparency.

Noting that the Council recognized the immediacy of the cost challenge and that it recommended short-term solutions, Dr. Evjy said "We would strongly encourage the Legislature and Governor to take the necessary steps to make these savings a reality." Among those proposals are administrative simplification, consumer engagement efforts, and evidence-based regulatory interventions and public health campaigns.
 Dr. Evjy concluded his testimony by addressing the topic of utilization of services and the practice of defensive medicine.

"We believe that services are being delivered in a defensive reaction to the pervasive liability climate in which doctors' practice," Dr. Evjy said. He cited a Massachusetts Medical Society 2008 study of defensive medicine in the Commonwealth, which conservatively estimated the cost of these practices -- tests, procedures, referrals, hospitalizations, or prescriptions ordered by physicians out of the fear of being sued - to be nearly $1.4 billion. 

"Legislation has been proposed in this session that we believe lays the groundwork for mitigating the need for defensive medicine," Dr. Evjy said. "We urge you to pass House Bill 1332 or Senate 574. The savings will be real, and they will translate to savings for our patients and their employers." 

House 1332, An Act Improving Patients Access to Timely Compensation, and Senate 574, An Act Relative to Malpractice Reform, are identical pieces of legislation and would encourage the early disclosure of medical errors and appropriate apology, and provide the fair and prompt non-judicial resolution of claims for damages resulting from those errors. 

The Society's complete testimony is available at www.massmed.org/testimony

The Massachusetts Medical Society is dedicated to educating and advocating for the patients and physicians of Massachusetts. The Society publishes the New England Journal of Medicine, a leading global medical journal and web site, and Journal Watch alerts and newsletters covering 13 specialties. The Society is also a leader in continuing medical education for health care professionals throughout Massachusetts, conducting a variety of medical education programs for physicians and health care professionals. Founded in 1781, MMS is the oldest continuously operating medical society in the country. For more information please visit www.massmed.org, www.nejm.org, or www.jwatch.org.   

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