Reference Commtitee B:
Health Care Financing and Health System Reform
Resolution 201-03: State-Funded Health Insurance
Resolution 202-03: Consumerist Single Payer System
Resolution 203a-03: Patient Education on Health System Reform
Resolution 204-03: Clarifying CMA’s Health Care Financing
Policies
Resolution 205-03: Federal Health Care
Reform
Resolution 206a-03: Financial Incentives to Promote
Health
Resolution 207-03: Reinventing a Viable Health Care
System
Resolution 208-03: Federal Health Reserve
Board
Resolution 209-03: Government-Funded Health
Care
Resolution 210a-03: Employer-offered Alternatives to
HMOs
Resolution 211-03: Priority Opportunity for Expanded
Coverage and Tax Equity
Resolution 212-03: Alcoholic
Beverage Tax
Resolution 213a-03: Medicare Reform
Resolution 214a-03: Eligibility Age for Medicare Patients
Resolution 215a-03: Medi-Cal Exclusion of Hospice
Resolution 216a-03: Accountability of California’s Child Protective
Services
Resolution 217a-03: "Concierge Care"
Resolution 218-03: Augmentation to California Trauma
Budget
Resolution 219-03: Medicaid Block Grants
Resolution 220-03: Clarifying CMA’s Health Care Financing
Policies
Resolution 221-03: Medicare Pharmaceutical
Benefit
Report B-1-03: Medicare Patient Access to
Implantable Morphine Pumps
Report B-2-03: Policy
Review
Resolution 201-03:
State-Funded Health Insurance
ACTION: Withdrawn
Resolution 202-3: Consumerist Single-Payer
System
RESOLVED: That CMA reverse its
policy of opposition to any form of single payer health care; and be it further
RESOLVED: That CMA convene a conference of consumers, businesses,
health-related organizations, the media and legislators in order to study the
feasibility of a "Consumerist Single Payer System" for the State of
California.
ACTION: Referred for study and report back
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Resolution 203a-03: Patient Education on Health System Reform
RESOLVED: That CMA continue to keep its physician members apprised
of the current events in health care through a variety of means, including the
use of the media; and be it further
RESOLVED: That CMA evaluate the use of a patient education program that would
encourage patients to become involved with CMA efforts to stabilize the health
care delivery system; and be it further
RESOLVED: That CMA design and implement a statewide program to enlist patient
support of major CMA issues (e.g., MICRA, Medicare and Medi-Cal funding).
ACTION: Substitute adopted
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Resolution 204-03: Clarifying CMA’s Health Care Financing
Policies
RESOLVED: That CMA reaffirm its policy endorsing
legislation for health care financial reform incorporating the principles as
adopted by the CMA Board of Trustees on November 21, 2002; and be it further
RESOLVED: That any CMA sponsorship or support of specific legislation on
access to care, whose core features include an employer mandate, shall require
Board of Trustees or House of Delegates approval.
ACTION: Substitute adopted for combined Resolutions
204-03 and 220-03
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Resolution 205-03: Federal Health Care Reform
RESOLVED:
That CMA support efforts to allow individuals choice in their type of health
plan, with some responsibility for payment at point of service, in association
with Universal Compulsory Catastrophic Health Insurance (UCCHI), achievable by
federal enactment of the following measures: (1) end employer purchase of health
insurance; (2) allow individuals/families free choice of health plans,
physicians and hospitals; (3) begin universal compulsory catastrophic health
insurance (UCCHI); (4) begin voluntary (non-mandated) employee-designated,
employer-provided defined contributions to UCCHI, that are tax deductible to the
employer and excluded from taxes for the employee; (5) provide tax credits,
inverse to income, for purchasing health insurance, refundable for the poor; (6)
encourage universal medical savings accounts for satisfying deductibles with
private money; (7) change Medicare from a transfer payment (Ponzi-scheme) to an
investment based system; (8) end prohibition against balance billing in federal
and private health insurance with the provision that the patient has prior
knowledge; and (9) create a Federal Health Reserve Board (FHRB) that is
appointed by the President from districts, and isolated from politics; and be it
further
RESOLVED: That the California Delegation to the AMA be requested to promote
these measures by introducing them for national implementation.
ACTION: Referred for study and report back
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Resolution 206a-03: Financial Incentives to Promote
Health
RESOLVED: That CMA support efforts by businesses and
employers to offer educational options to employees on the costs of high-risk
behavior and to promote healthy lifestyle changes.
ACTION: Substitute adopted
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Resolution 207-03: Reinventing a Viable Health Care System
RESOLVED: That CMA take a leadership role in reinventing a viable
health care system; and be it further
RESOLVED: That CMA create a coalition with primary stakeholders charged with
redesigning, promoting, lobbying for and implementing a new health care delivery
system and changing the health care paradigm in California.
ACTION: Referred for study and report back
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Resolution 208-03: Federal Health Reserve Board
RESOLVED:
That CMA, through its AMA delegation, propose that the United States Congress
create an independent Federal Health Reserve System with a Board appointed by
the President from districts, approved by the Congress, and isolated from
politics and special interests in order to advance health care in the United
States, with the following duties: (1) promote freedom of choice, equality and
justice for patients and physicians; (2) specify benefits qualifying for maximum
dollar tax credits to be determined by the Congress; (3) determine percentage of
maximum tax credit for which each plan qualifies; (4) require detailed
disclosure by insurers of each plan’s benefit package to prospective buyers; (5)
conduct national clinical trials for new procedures to determine their tax
deductibility status; (6) vary tax non-deductible co-payments for services
depending on growth of health care spending; (7) require full disclosure of
rates by hospitals in a system where a given hospital charges the same rate for
all payers, but in which each hospital has its own schedule of charges, all
posted on the Internet; (8) require full disclosure of all physicians’ fee
schedules, posted with credentials on the Internet; (9) after public
plebiscites, set priorities for spending and costly remedies; and (10) supervise
negotiations between groups of physicians and insurers in all matters of
insurance coverage, including reimbursement.
ACTION: Referred for study and report back
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Resolution 209-03: Government-Funded Health Care
ACTION: Not
adopted
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Resolution 210a-03: Employer-offered Alternatives to
HMOs
RESOLVED: That CMA strongly encourage employers that offer an
HMO to also offer affordable, comprehensive alternatives (for example, a
catastrophic plan coupled with a Medical Savings Account).
ACTION: Substitute adopted
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Resolution 211-03: Priority Opportunity for Expanded Coverage and Tax
Equity
RESOLVED: That CMA will give high priority in 2003 to using
opportunities with the new Congress and administration to urge each California
federal legislator to change tax laws and medical savings account regulations to
assure that all Americans may use pre-tax dollars for their medical care; and be
it further
RESOLVED: That CMA will, in 2003, urge these same California federal
legislators to support refundable tax credits for those uninsured individuals
not able to purchase adequate medical care; and be it further
RESOLVED: That this matter be referred for national action.
ACTION: Adopted
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Resolution 212-03: Alcoholic Beverage
Tax
RESOLVED: That CMA support legislation that would tax the sale
of alcoholic beverages to provide funds to help support our statewide trauma system.
ACTION: Adopted as amended
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Resolution 213a-03: Medicare
Reform
RESOLVED: That CMA continue to advocate for changes within
the Medicare program to assure that access is available for seniors, that
physicians are offered fair reimbursement rates, and that physicians continue to
be offered the choice of participating in or opting out of the Medicare program;
and be it further
RESOLVED: That CMA offer, design and implement, and encourage AMA to offer,
design and implement, programs to assist doctors in opting out of Medicare if
they so choose, and publicize this service widely and actively as a major
emphasis shift.
ACTION: Substitute adopted
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Resolution 214a-03: Eligibility Age for Medicare
Patients
RESOLVED: That CMA evaluate the implications of
incrementally raising the Medicare eligibility age (from the current age of
sixty-five years) within the larger context of any Medicare reform proposal; and be it further
RESOLVED: That this be referred for national action.
ACTION: Substitute adopted
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Resolution 215a-03: Medi-Cal Exclusion of
Hospice
RESOLVED: That CMA join with interested organizations to
educate the public and the California Legislature as to the ethical, medical,
and fiscal impact of loss of hospice care under Medi-Cal; and be it further
RESOLVED: That CMA join with other organizations to maintain access of
Medi-Cal patients to hospice services as necessary.
ACTION: Substitute adopted
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Resolution 216a-03: Accountability of
California’s Child Protective Services
RESOLVED: That CMA endorse
all efforts to assure that the California Child Protective Services is
appropriately audited for clinical performance, and that it has a standardized
approach to provide protection; and that if concerns arise, the state take
appropriate actions to correct them; and be it
further
RESOLVED That CMA request that the California Child Protective Services give
substantial weight to the recommendations of the treating physician in the
disposition of any at-risk child.
ACTION: Substitute adopted
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Resolution 217a-03: "Concierge
Care"
RESOLVED: That CMA acknowledge "concierge care" as an option
for providing medical care to patients in an ethically sound patient-centered environment.
ACTION: Substitute adopted
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Resolution 218-03: Augmentation to California
Trauma Budget
RESOLVED: That CMA consider supporting the development
of a specialty license plate, using the funds generated from this specialty
license plate fee to pay physicians for emergency services; and that these
reimbursements remain in the county in which the license plates were purchased.
ACTION: Adopted as amended
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Resolution 219-03: Medicaid Block
Grants
RESOLVED: That CMA oppose the block granting of Medicaid
programs from the federal government to the states.
ACTION: Adopted as amended
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Resolution 220-03: Clarifying CMA’s Health Care
Financing Policies
ACTION: See Resolution 204a-03
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Resolution 221-03: Medicare Pharmaceutical
Benefit
RESOLVED: That CMA utilize the following principles in
evaluating legislative proposals for the addition of a Medicare pharmaceutical benefit:
1) Any pharmaceutical benefit should be fully funded, as a separate new part
of the Medicare program by additional budgetary allocations and should provide
for adequate accounting so that drug program expenditures can be tracked
separately from all other expenditures;
2) The pharmaceutical benefit should be targeted to reduce hardship for those
with low-incomes and those with catastrophic costs;
3) Any legislation should provide a pharmaceutical benefit that is consistent
across geographic regions and across all Medicare plans;
4) a pharmaceutical benefit should include a tiered deductible and co-payment
structure that encourages economically responsible behavior without interfering
with medically necessary treatment;
5) a pharmaceutical benefit should be designed to prevent adverse
selection;
6) Any pharmaceutical benefit should be designed in a manner that prevents
interference with clinical decision-making and physician prescribing decisions;
and
7) Any pharmaceutical benefit should be designed in a manner that minimizes
the administrative burden placed on physicians.
ACTION: Adopted
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Report B-1-03: Medicare Patient Access to
Implantable Morphine Pumps
RECOMMENDATION 1: That this report be filed for information.
ACTION: Referred for further study and report
back
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Report B-2-03: Policy
Review
RECOMMENDATION 1: That the following policies be allowed to
expire: Resolutions 407-85, 510a-85, 514a-85, 208a-87, 410-88, 212-89 and 402a-89
ACTION: Adopted
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