Citizens' Council on Health Care

CCHC HEALTH eNEWS

Friday, May 24, 2002

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Providing news and commentary on health care policy,

health insurance issues, and medical confidentiality. =====================================================

* CCHC REPORT: MINNESOTA PASSES HEALTH POWERS ACT

Due process violations enacted...

* NO SOCIAL SECURITY NUMBER; NO CARE

One man's story of denial...

* IOM STUDY BLAMES DEATHS ON LACK OF INSURANCE

Over 18,000 people die, claims the Institute of Medicine...

* INSURED TEEN DIES - GOVERNMENT PLAN REFUSES TO FUND TRANSPLANT Oregon Health Plan calls treatment experimental...

* GROUP RECEIVES VERICHIP; FDA INVESTIGATES MANUFACTURER

A computer chip under the skin; an unauthorized statement...

* MALPRACTICE COSTS DRIVE DOCTORS OUT OF BUSINESS

37% of New Jersey doctors (9,000) losing their insurance...

* DOCTORS MOVING FROM HMOs TO CASH-ONLY PRACTICE

Discounted rates and annual memberships available...

* ACTION ITEM: PUBLIC COMMENTS ON PATIENT CARE ACCOUNTS SOUGHT* IRS to rule soon...

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* CCHC Commentary included

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CCHC REPORT: MINNESOTA PASSES HEALTH POWERS ACT

After both House and Senate initially refused to accept the conference committee version of the bill, on May 18th late at night a newly amended bill passed the House 117-16 and the Senate 55 - 3. But the powers granted to health officials by the Minnesota Emergency Health Powers Act (HF 3031) are not limited to bioterrorism or to the declaration of a public health emergency

Although several citizen organizations testified multiple times against the provision, the MN Department of Health received authority to quarantine individuals and groups suspected of having a communicable or potentially communicable disease without a court order - 365 days a year.

"No public health emergency must be declared. No bioterrorism attack need ever occur. No judge must be consulted. The commissioner of health, an unelected official, has sole discretion and power to take away an individual's liberty for at least two days. Proponents did their best to focus everyone's attention on bioterrorism. The fact that due process rights were being dismissed in non-emergency situations got very little discussion," says Twila Brase, president of CCHC.

The new law requires the commissioner of health to apply for a court order within 24 hours after detention begins. If a court order is not received within 48 hours, the detainee or detainees must be released. This contradicts current Minnesota law which requires a judge be consulted and a court order obtained before a person with a known communicable disease can be detained.

Additional concerns cited by CCHC include:

1) Health officials and health care practitioners have no duty to disclose to citizens their right to refuse state-ordered medical testing and treatment.

2) Although a CCHC amendment to prohibit commandeering of essential medical supplies was adopted, state control of medical decisions is not prohibited when state officials assume control of health care facilities in a declared emergency.

3) The definition of public health emergency is broader than bioterrorism, allowing broader application of health powers, and commandeering of property.

ACROSS THE NATION: Nine states have enacted a version of the model legislation proposed in October 2001 by the Centers for Disease

New Mexico and North Carolina have studies in progress and in another nine states the legislation is defeated or inactive: Washington, Idaho, Wyoming, Nebraska, Oklahoma, Mississippi, Kentucky, Wisconsin, and Connecticut.

-Citizens' Council on Health Care

-May 24, 2002

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MESSAGE FROM CCHC's PRESIDENT:

This email publication is free, but it is not free to

produce. Please consider providing CCHC with a tax-

deductible contribution. Online credit card contributions

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NO SOCIAL SECURITY NUMBER; NO CARE

Today, I was refused medical treatment on a routine office visit because I do not have, and could not provide, a photo ID.

My appointment, which had been scheduled for six weeks in advance, was with Dermatologist Patricia L. Wilson (of Dermatology Associates,

Huntsville, Alabama, 539-2741). When I arrived at the office the

attendant asked me to fill out the necessary forms and submit a photo ID. I told her I would be paying with cash and there would be no need to file with any insurance company. I then asked why a photo ID needed. I was told that it was office policy. When I explained that I do not have a photo ID, the office manager, Martin Beck, said the doctor would not provide the requested service unless I submitted a photo ID. I left without treatment.

I'm sending this out primarily for the benefit of those readers who still don't understand the far-reaching implications of President Bush's Homeland Security initiative which includes proposed federal

standards for nationalized driver's licenses incorporating biometric

identification linked to personal data and other identifying information stored on an imbedded microchip.

Some people still have the false notion that they can simply "erase" the chip or render it inoperable to avoid undesirable consequences. To those, I would say that a simpler solution would be to just throw the card away altogether. The result will be the same: You will be denied access to, and use of all goods, services and rights dependant

upon possession and display of the "voluntary" IDs.

As most readers know, I was denied renewal of my Alabama driver's license due to my religious objections with regard to mandatory

submission of a social security number. I subsequently filed suit and we are currently awaiting reply from the Alabama Supreme Court on our Petition for Certiorari in that matter. (The state will not issue a "non-driver" photo ID to anyone eligible for a driver's license, and they demand an SSN from applicants for non-driver IDs

anyway. So that is not an option.)

If sufficient numbers of people do not begin now to object to universal demands for submission of state-issued IDs as a condition for services, there will soon come a time when all activity will

necessitate possession of some form of chip-imbedded ID, and there will be no viable opportunity for objection.

Scott McDonald

Source: Email from Scott McDonald, SCAN THIS NEWS, 3/13/02

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STUDY BLAMES DEATHS ON LACK OF INSURANCE

Adult Americans are dying because they aren't covered by health insurance, lack preventive services or do not receive a timely diagnosis and appropriate care -- 18,314 adults each year, to be exact -- according to a report from the Institute of Medicine (IOM), a nonprofit organization that advises Congress on health issues.

The report looked at the health care received by uninsured adults

-- whether uninsured by choice (as is the case with many young and health adults) or due to lack of the availability of affordable insurance.

Thirty million working-age Americans, one in seven, lack employer-provided insurance and don't qualify for government medical care programs.

o About 10 million children lack insurance; elderly

Americans are covered by Medicare.

o The estimated additional deaths among the uninsured

include about 1,400 people with high blood pressure, 400

to 600 with breast cancer, and 1,500 diagnosed with HIV.

o Uninsured trauma victims are less likely to be admitted to

a hospital, receive the full range of needed services, and

are 37 percent more likely to die of their injuries.

Uninsured people with colon or breast cancer face a 50 percent higher mortality risk, the report states.

Source: Steve Sternberg, "Study Blames 18,000 Deaths in USA on Lack of Insurance," USA Today, May 22, 2002; Institute of Medicine, "Care Without Coverage: Too Little, Too Late" (Washington, D.C.: National Academy Press, 2002).

Text of story:

2-insurance-deaths.htm

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INSURED TEEN DIES - STATE PLAN REFUSES TO FUND TRANSPLANT

One person who couldn't get care was Brandy Stroeder, age 19, who died April 8 while waiting for a lung-liver-heart transplant in Oregon. It may sound like a real-life version of "John Q" except the insurance plan that refused to pay for Ms. Stroeder's $250,000 transplant was not one of those nasty profit-crazed private insurance companies, but the state-owned and funded Oregon Health Plan, which said the procedure was experimental. Private sources actually raised $300,000 to pay for the procedure, but healthy organs were not found in time to save her life.

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FAMILY RECEIVES CHIP; FDA INVESTIGATES MANUFACTURER

As noted by the LA Times, "Eight people will be injected

with silicon chips Friday, making them scannable just like

a jar of peanut butter in the supermarket checkout line."

A family of three, a man with Alzheimer's and four executives at Applied Digital Solutions got a computerized device the size of a grain of rice inserted under the skin in their upper back. Scanners will be able to read an identification number which can be cross referenced in a central computer registry. A more complex chip to allow GPS transmission is already in the works. As big as a quarter, it would require surgical insertion.

The VeriChip is made by Applied Digital Solutions (ADS), which claims a waiting list of 4,000 people and plans for a ChipMobile to do on the spot insertion on Florida's senior citizen population.

But Marc Rotenberg at the Electronic Privacy Information Center cautions that chipping individuals may be an "easier way to manage someone, like putting a leash on a pet."

Meanwhile, TechLive reports that the Food and Drug Administration has launched a formal investigation into the company. The FDA had informally by email allowed the marketing of the device on the basis of it solely being an identification system. As long as no medical data was on the chip and it wasn't linked to a database, the company could market it.

Now, however, the company's has publicized the VeriChip as a life- saving device with the inclusion of medical information and a link to a database. They have also claimed FDA approval, which could be a violation of the law. If fines are levied and the FDA decides to regulate it as a medical device, the company could lose

millions in the application process. On the news of the FDA

investigation, and the abrupt resignation of its auditor, ADS stock dropped 50 percent of its value.

-Citizens' Council on Health Care

-May 24, 2002

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WILL MALPRACTICE SUITS PROMPT "DOCTOR FLIGHT" IN NEW JERSEY NEXT?

Doctors in such states as Mississippi and Texas are either quitting or fleeing to practice medicine elsewhere because of out-off-sight jury awards in malpractice cases. They soon may be joined by New Jersey physicians.

Earlier this month, the American College of Obstetricians and Gynecologists named New Jersey one of nine "red alert" states where lack of tort reform is endangering health care.

Here's why:

o Last week, New Jersey's largest malpractice insurer, the

MIIX group, announced it had essentially decided to fold

up shop.

o Founded by doctors to insure themselves and other doctors,

MIIX has lost more than $200 million in the past 15 months

-- and their decision means that about 9,000 New Jersey

doctors, 37 percent of the state total, may soon lose

their insurance.

o Additionally, three malpractice insurers stopped doing

business in the state in 2001.

o Thanks to skyrocketing jury awards, New Jersey hospitals

have seen malpractice insurance premiums jump 250 percent

over the past three years.

Source: Editorial, "Born to Sue," Wall Street Journal, May 17, 2002.

Source: Taken directly from Daily Policy Digest, National Center for Policy Analysis, 5/17/02.

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DOCTORS MOVING FROM HMOs TO CASH-ONLY PRACTICE

The Chicago Tribune on May 11 reported on the increasing

number of physicians nationwide who have dropped their contracts with managed care plans and are asking their patients to pay for services in cash.

Although a 1999 American Medical Association survey found

that about 90% of physicians had at least one contract with a managed care or private health plan, the Tribune reports that "shrinking" reimbursements from health insurers and Medicare, increased medical malpractice costs and the "restrictions of managed care" have prompted some doctors to end their participation in the plans. The physicians who decide to leave managed care plans "usually are more established doctors" with insured and uninsured patients who can afford to pay for services in cash.

Patients with health insurance can submit claims for reimbursement, the Tribune reports. Some doctors also offer discounted rates for

patients who pay cash for services, and some physician networks charge an annual membership fee for discounted rates. "I think that this is a trend that ... is probably just starting," Paul Ginsburg, president of the Center for Studying Health System Change,

said, adding, "But it has the potential to affect a lot more doctors and patients ... and to stimulate a response from health plans" (Anderson, Chicago Tribune,5/12).

Source: Taken directly from "Increasing Number of Doctors Leaving

Managed Care, Moving Toward Cash-Only Practices," Kaiser Daily Health

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ACTION ITEM: PUBLIC COMMENTS ON PCA SOUGHT FOR IRS RULING

The Internal Revenue Service will soon issue a ruling to clarify how "patient directed healthcare" type accounts, may be operationalized. The true Medical Savings Account, with patient contributions and patient ownership of the dollars, does not appear to be included (see bullet point #2). Only

employer-funded and employer-owned patient care accounts are under consideration, such as those provided by Definity and Lumens.

Comments are being taken by:

Mr. Bill Sweetnam ( FAX 202.622.6415)

The Office of Tax Policy

1500 Pennsylvania NW

Room 1334

Washington D.C. 20220

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CCHC COMMENTARY: As good as a patient care account sounds, real cost-saving incentives do not emerge until the patient holds the dollars. Patient care accounts are a simple improvement of the use it or lose it flexible spending accounts.

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The Wye River Group on Healthcare has distributed a message document that can be used for comments sent in to the IRS:

Wye River Group on Health Care:

TALKING POINTS for IRS rulings on Patient Directed Healthcare:

* Employers Cannot Sustain the Current Explosive Growth in Health Care Costs. For the last few years, health care costs have risen at a rate that

most companies find unsustainable. They have increased at several

multiples of the general inflation rate and seriously threaten the

economic recovery. Employers seek new health care solutions that can

both control costs and increase employee control over and

satisfaction with their health care.

* New Products Respond to the Needs of Employers and Employees. The health care marketplace has created new products that allow

patients to take a greater role in their own care. These new health

benefit products have a variety of names including Personal Care

Account (PCA), Health Savings Account, Health Care Account, etc.

Their common trait is that they only provide reimbursement for health

benefits allowable under section 213d of the Internal Revenue Code

and are paid for solely by employer monies.

* Patient Care Accounts Put Employees in Control of Their Health Care

Decisions.

These accounts give people greater freedom to choose the doctors and

types of care they want. People also have more flexibility in

spending funds for their health care needs when they need it.

* Patient Care Accounts Promote Greater Responsibility for Routine

Care Decisions and Spending.

Through these accounts, people will become more aware of the actual

costs of health care and will have an incentive to choose more

wisely. Just as in other industries, consumers will demand higher

quality, more responsive service, and better value for discretionary,

routine, and elective services. As more people become actively

involved in controlling their health care decisions and spending, it

will lower overall health care cost increases.

* Regulatory Action Must Not Stifle the Marketplace.

Any regulatory action that would cripple emerging solutions to an

affordable, sustainable, quality-enhancing system should be avoided.

These new approaches promise increased customer satisfaction,

individual control, and cost-effective health care decisions. A

careful, balanced regulatory approach will not stifle these and other

marketplace innovations and allow the health care marketplace to test

and deliver new solutions to the health-care crisis, while also

preventing abuses and protecting individuals.

-Citizens' Council on Health Care

-May 24, 2002

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NOTE: These news items have been taken directly

from email received by CCHC or from Internet

newspaper publications. Titles in ALL CAPS are

CCHC creations except for those heading articles

from the National Center for Policy Analysis,

the Health Law Pulse, PrivacySecurityNetwork,

and LIST.HEALTHPLAN. Credit to the sending

organization or news service is listed at the

end of each article. ================================================

CITIZENS' COUNCIL ON HEALTH CARE

1954 UNIVERSITY AVE. W., SUITE 8

ST. PAUL, MN 55104, 651-646-8935

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Citizens' Council on Health Care

1954 University Ave.W., Suite 8

St. Paul, MN 55104

651-646-8935 phone

651-646-0100 fax

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