MMA News
House to Consider MMA's Sick-Tax Strategy
Minnesota physicians have submitted approximately 60 resolutions for the MMA House of Delegates to consider at this year’s annual meeting September 14 and 15 in Minneapolis.
Reference committees will hear testimony on the resolutions on Thursday, September 14. The next day, the House will vote on each resolution, deciding whether to adopt, not adopt, amend, refer, or adopt a substitute for it.
This year’s resolutions touch on a wide range of topics, from pay for performance to safe driving.
One hot topic will be a resolution from the MMA’s executive committee calling for the MMA to create an oversight committee to advise the Legislature on the use of the Health Care Access Fund (HCAF). The goal is to ensure that the revenue from the HCAF is used to increase access to health care and improve the health of all Minnesotans.
The resolution came out of efforts of the 10-member Provider-Tax Work Group formed earlier this year.
The work group discussed whether the MMA should shift its lobbying focus from eliminating the tax to ensuring that the money is spent correctly. The MMA has fought the tax since it was passed in 1992 as a way to fund MinnesotaCare, the state’s subsidized health insurance program.
The work group conducted a nonscientific survey of members and found that the membership was somewhat divided on the question.
“The survey reaffirms the difficulty the association has had because membership doesn’t like the tax but values the MinnesotaCare program,” says Dave Renner, MMA director of state and federal legislation.
For example, 47 percent of surveyed members agreed that eliminating the tax should be the MMA’s top legislative priority, but 42 percent disagreed with that statement.
“One thing that was clear in the survey was that members didn’t think the program should be scrapped to get rid of the tax,” Renner says. Only 22 percent of members polled said they would support the elimination of MinnesotaCare to rid the state of the tax.
Another question the group asked was whether physicians had received any benefit from the tax. Research showed that in 2005, physicians paid about $87 million of the approximately $357 million collected from providers. That same year, MinnesotaCare spent an estimated $125 million on ambulatory services.
“These numbers show at least there are some benefits that come back to physicians from the tax,” Renner says.
In the end, the work group reaffirmed that the sick tax is misguided and that safety-net programs shouldn’t be funded on the backs of the sick. But it also recommended a shift in focus from repeal to how the money is used.
In response, the Executive Committee drafted R318, calling for the creation of an oversight committee of physicians, consumers, and others to advise the Legislature on HCAF expenditures.
Whether or not the resolution passes, the MMA will remain steadfast in opposition to the sick tax and seize any realistic opportunity to repeal it.
Potential Medicare Payment Cuts Deepen
Medicare released a proposed rule on August 8 that would result in a 5.1 percent payment cut to physicians starting January 2007. The federal government previously proposed a 4.7 percent reduction.
Medicare is proposing deeper cuts in physician payment rates to offset the cost of greater utilization of physician services by Medicare beneficiaries.
Medicare expenses for physician services in 2005 increased 10 percent more than expected because beneficiaries made more frequent and intensive visits to doctors’ offices, doctors ordered more diagnostic images, and because of higher costs related to physicians administering drugs, according to a press release from the Centers for Medicare and Medicaid Services.
In the Medicare system, if costs exceed a pre-set target, payment rates are cut to make up the difference.
Congress must act before the end of the year in order to avoid the deeper cuts. Please visit the MMA’s Grassroots Action Center online at www.MMAonline.net to e-mail your representatives and urge them to stop these cuts.
MMA Urges USDA to Drop Juice from WIC-Eligible Foods
Fruit juice is one of the culprits responsible for a doubling of the number of overweight children in the past 20 years, according to the MMA’s Obesity Task Force.
That’s why the MMA has urged the U.S. Department of Agriculture to cut it from the list of eligible foods in the WIC program for low-income women and children and to add fruits and vegetables instead.
“Remember that WIC is providing nutritional support to our poorest families … our families who are least able to purchase good, healthy food for themselves. In providing juice, we are not doing them any favors,” said Sarah Jane Schwarzenberg, M.D., a pediatrician on the MMA Obesity Task Force, in an interview on KARE-11 TV.
MMA President David Luehr, M.D., in a letter to the director of the WIC program, explained why it’s important for federal programs to help reduce obesity: “Obesity puts children at risk for developing high blood pressure, high cholesterol, and type 2 diabetes as well as bone and joint problems, and depression.”
Currently, any fruit or vegetable juice or juice blend is WIC-eligible, but fruits and most vegetables are not.
Improvements are on the way, however. The Department of Agriculture has proposed new rules that match recommendations of the American Academy of Pediatrics. Juice would be limited to 4 oz. a day, and cash vouchers would allow for the purchase of fruits and vegetables.
The MMA strongly supports this change. But in his letter, Luehr urged the Department of Agriculture to “go even further and entirely eliminate juice from the list of WIC-eligible foods.”
Juice has the same number of calories per ounce as pop and, because too many children sip it throughout the day, it is a factor in increasing the number of overweight kids, according to members of the Obesity Task Force.
“There’s no real value of juice in a child’s diet,” Schwarzenberg was quoted as saying in the Star Tribune. “Juice should be considered a treat, the same way you might consider a candy bar.”
Minnesota Public Radio and WCCO radio also broadcast interviews with Schwarzenberg about why the MMA was making its “no juice” recommendation.
The MMA Board of Trustees in January accepted the recommendation of the MMA Task Force on Obesity that the MMA comment on WIC’s food package at the appropriate time. The proposed new rule was published in the August 7 Federal Register, and comments will be accepted until November 6, 2006.