ACTION ALERT

Bills Eroding Corporate Bar Pass Key Committe

AB 646 (Swanson) and AB 648 (Chesbro), two bills which would erode the patient protections of the bar on the corporate practice of medicine in California, took an ominous step towards passage today when they passed the Assembly Business and Professions Committee. AB 646 is sponsored by AFSCME, a labor union interested in unionizing doctors; AB 648 is sponsored by the California Hospital Association, whose members want to hire and control doctors.

One other bill eroding the corporate bar has also been introduced in the Legislature this year: SB 726 (Ashburn).

We need your help to defeat these bills!

AB 646 and AB 648 will both be heard in Assembly Health Committee next Tuesday, April 28. For all doctors who have a member of the Assembly Health Committee in your county, we ask that you and your colleagues CALL, EMAIL, or FAX those legislators and urge them to Vote No on AB 646 and AB 648. Counties with legislators on the Committee include: Sacramento, San Diego, San Bernardino, San Francisco, Tulare, Los Angeles, ACCMA, Santa Barbara, and Ventura County.

Phone calls are most effective, but emails and faxes are important too. A complete list of legislators on the committee can be found at: http://www.assembly.ca.gov/acs/newcomframeset.asp?committee=10. A sample letter and talking points are below.

SB 726 will be heard in Senate Business and Professions Committee on Monday, April 27. For all doctors who have a member of the Senate Business and Professions Committee in your county, we ask that you and your colleagues CALL, EMAIL, or FAX those members and urge them to Vote No on SB 726. Counties with Senators on the Committee include: Santa Barbara, San Diego, Butte-Glenn, Yuba-Sutter-Colusa, ACCMA, Orange, Fresno, Los Angeles, San Francisco, and San Mateo.

Again, phone calls are most effective, but emails and faxes are important too. A complete list of legislators on the committee can be found at: http://www.senate.ca.gov/ftp/sen/committee/STANDING/BUSINESS/_home1/PROFILE.HTM. The same sample letter and talking points apply.

To the extent possible, please let us know what calls, emails, and faxes you are able to generate. This is critical information for our lobbyists when they speak to legislators. If you or your colleagues choose to submit an email or fax to your legislator(s), we strongly encourage that you personalize the letter, which will greatly increase its impact.

Your involvement is critical to ensure that legislators understand the impact these bills will have on the quality of care their constituents receive in California hospitals. We need to let these legislators hear from as many doctors as possible that these bills are bad for patients (their constituents).

More information on these bills can be found on the CMA website at: http://www.cmanet.org/news/hotlist.asp. If you have additional questions, please contact Ned Wigglesworth, Vice President – Communications, California Medical Association, at 916.551.2873 or at nwigglesworth@cmanet.org.

TALKING POINTS

1) The ban on corporations practicing medicine is an important protection for patients in California hospitals. This protection ensures that those who make decisions that affect the provision of medical services (1) understand the quality of care implications of that medical service; (2) have a professional ethical obligation to place the patient's interest first; (3) are subject to the Medical Board of California.

2) AB 646, AB 648, and SB 726 will erode the quality of care in California hospitals. AB 646, AB 648, and SB 726 will grant control over treatment decisions to hospital CEOs and administrative staff who have different motivations and mandates than physicians. This will create conflicted loyalties in an institution that must remain true to the patient's interests, and will erode the quality of care patients receive in California hospitals.

3) Placing doctors under the oversight of hospital administrators and CEOs who are under enormous pressures to cut costs or increase revenue will threaten the independent medical judgment necessary to ensure patients are protected.

4) Hospitals are already interfering with medical staffs' ability to ensure quality care through independent self-governance. For example, some hospitals have adopted medical management protocols which have resulted in inappropriate hospital tests, procedures, and stays, jeopardizing patients and increasing costs.

5) Allowing a hospital to directly employ a physician will NOT increase access to physician services. The hospital will push patients to their preferred provider thereby controlling the competitive market. Other non-employed physicians will not be able to compete and likely be forced out of town resulting in no increased access.

6) CMA supports policies that will truly increase access to care, without compromising the quality of care. The CMA supported bills last year that will provide over $2 million dollars in medical school loan repayment for physicians who agree to practice in these areas. Since loan repayment obligations is one of the primary reasons physicians will not go to underserved areas, this will attract physicians to these areas without compromising the quality of care patients receive.

SAMPLE LETTER

PLEASE ALTER THE FIRST TWO PARAGRAPHS OF THIS LETTER TO REFLECT WHICH BILLS YOU ARE WRITING ABOUT.

Date

Legislator
Address
Address

Dear (Legislator),

I am writing to request that you oppose [AB 646 and AB 648, or SB 726], a [bill(s)] that would eliminate important legal protections for patients by allowing hospitals to directly employ physicians.

It is critical for the integrity of patient care in California hospitals that physicians remain independent from the corporate influence of hospital administrators and CEOs, who must answer to priorities other than patient care. By eliminating this protection for patients, [AB 646 and AB 648 or SB 726] will erode the quality of care those patients receive in California hospitals.

The ban against the corporate practice of medicine provides a fundamental protection for patients by ensuring their physicians' sole interest is what is best for the patient. When hospitals are allowed to directly employ and charge for physician services, quality of care suffers due to the fact that hospitals derive income from patient beds being filled.

I recognize there is a shortage of physicians in some areas. However, there are ways to address that shortage without allowing hospitals to control physician employment. Increasing slots for medical training in California by developing the medical school at UC Merced and expanding access to California's loan repayment program will truly ensure physicians go to and stay in rural and underserved areas.

Simply allowing hospitals to employ physicians may actually result in reduced access and increased costs. Hospital employment of physicians eliminates competition for outpatient services and instead forces all care to be delivered through the hospital. As hospitals gain market share in small communities, physicians not employed will likely be forced out of business and surgery centers outside the hospital will likely be forced to close. This results fewer options for patients and increased costs as the hospital is able to charge higher rates with the elimination of competition.

For these reasons I request that you vote against bills that would allow hospital to directly employ and charge for physician services. Thank you for your consideration.

Sincerely,

MD