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Government and People
For Immediate Release
CONTACT: David Love, phone 202-466-1800, ext. 114, e-mail email@example.com -.
Medical Society Provides Testimony on Mayor's Budget Proposal; Expresses Concern Over Lack of Details
March 29, 2001 - Margaret Barron, MD, chair of the Medical Society's Public Health Committee, presented testimony today before the Committee on Human Services regarding DC Mayor Anthony Williams' Fiscal Year 2002 Budget Proposal.
In her testimony before the committee's chair, DC Councilmember Sandy Allen (D, Ward 8), Dr. Barron said: "The Medical Society has been a long-time supporter of the Department of Health, and feels strongly that there must be appropriate funding for the programs that fall under its purview. We support the 18 percent increase in funding that the Mayor proposes for the Department of Health."
Dr. Barron added that the Medical Society: applauds the Mayor's efforts to complete a new State Health Plan that will define a broad-based program for providing health care services to DC citizens: supports the Mayor's plan to redesign the Medical Assistance Administration to be more efficient and inclusive; and supports the Mayor's intention to develop a comprehensive HIV/AIDS Plan as part of the Statewide Coordinated Statement of Need.
Regarding the situation at DC General Hospital, she said: "The Medical Society is concerned by the lack of detail in the budget, particularly as it pertains to the reorganization of services at DC General Hospital. We urge the Mayor and the Control Board to share the transition plan and budget with all hospitals openly.
Based on the unique geographical constraints of Wards 7 and 8, and after analysis of EMS transport data, we know that many of the ambulance runs west of the river [that currently go] to DC General Hospital will be diverted to hospitals other than Greater Southeast Hospital," she added. "These hospitals must begin now to plan the staffing and space to accommodate these patients in their already crowded emergency departments."
Dr. Barron also expressed Medical Society concerns about the proposed cuts in the Addiction, Prevention and Recovery Administration, and the lack of detail in the funding of the Preventive Health Services Administration.
In regard to increased funding of the Medical Assistance Administration, Dr. Barron urged the Mayor not to decrease Disproportionate Share to Hospital (DSH) payments to increase Medicaid eligibility.
"Increasing the number of eligible citizens will increase the use of hospital services," she said. "Hospitals will have an even greater need for the DSH payments."
In conclusion, Dr. Barron encouraged the Mayor and the DC Council to consider creating a cabinet position in this budget for an Emergency Medical Services Department, separate from the Fire Department, and to establish an independent Board of Medicine.
Dr. Barron's testimony can be found on MSDC's web site, www.msdc.org. Click on "Top News." Or, contact David Love (phone 202-466-1800, ext. 114, e-mail firstname.lastname@example.org) to receive a copy.
The Medical Society of the District of Columbia is dedicated to the well being of physicians and their patients in metropolitan Washington. We advocate on behalf of our member physicians of diverse cultural and ethnic backgrounds; we promote high standards of character and professionalism; and we ensure that physicians are-and are recognized as-the primary professionals who define and guarantee high-quality, appropriate, and cost-effective medical care. Above all, we aggressively defend the highest principle of all the integrity of the physician-patient relationship.
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TESTIMONY OF THE MEDICAL SOCIETY OF THE DISTRICT OF
THURSDAY, MARCH 29, 2001
MARGARET BARRON, M.D.
Good Afternoon Chairperson Allen, and members of the Committee on Human Services. My name is Dr. Margaret Barron. I am the Chair of the Public Health Committee of the Medical Society of the District of Columbia. I am appearing this afternoon on behalf of the 2,500 physicians and medical students who are members of the Medical Society of the District of Columbia. I am grateful for the opportunity to present the Medical Society's testimony on the Mayor's Fiscal Year 2002 Budget Proposal.
First, I want to thank Chairperson Allen for your strong support of patient and physician issues. The Medical Society values its relationship with you and looks forward to working with you to assure the health and well being of the residents of the District of Columbia. I also want to thank the other members of the Committee for their past support of the Medical Society. We anticipate a collegial, productive relationship with you this council session.
The Medical Society has been a long-time supporter of the Department of Health and feels strongly that there must be appropriate funding for the programs that fall under its purview. We support the 18% increase in funding that the Mayor proposes for the Department of Health. The Medical Society also supports most of the Mayor's initiatives.
First, we applaud his efforts to complete a new State Health Plan which will define a broad-based program for providing health care services to the citizens of the District; Second, we support his plan to redesign the Medical Assistance Administration to be more efficient and inclusive; and Third, we support his plan to develop a Comprehensive HIV/AIDS Plan as part of the Statewide Coordinated Statement of Need.
However, we are concerned by the lack of detail in this budget, particularly as it pertains to the reorganization of services at D.C. General Hospital. The Medical Society is on record expressing deep concerns for the Mayor's plan to close D.C. General Hospital. This hospital provides critical emergency and inpatient services for the citizens of the District. We urge the Mayor and the Control Board to share the transition plan and budget with all hospitals openly. Based on the unique geographical constraints of Wards 7 and 8 and after analysis of EMS transport data, we know that many of the ambulance runs west of the river which would have gone to D.C. General Hospital will be diverted to hospitals other than Greater Southeast Hospital. These hospitals must begin now to plan the staffing and space to accommodate these patients in their already crowded Emergency Departments.
The Medical Society is also very concerned about the proposed cuts in the Addiction, Prevention and Recovery Administration. Substance abuse education, acute detoxification and long term treatment of people with drug and alcohol addictions are crucial to the overall health of District residents. Having served the bulk of my professional career as a doctor of emergency medicine, I can recount, first hand, the physiological, social, and mental health complications that arise from the abuse of these substances. As of now, there is virtually no funding for outpatient alcohol rehabilitation and minuscule amounts for inpatient rehabilitation. Crack cocaine is a serious problem but the number of cocaine addicted citizens is dwarfed by the numbers of alcohol-dependent citizens. The proposed cuts in these programs are detrimental to our patients who suffer from diseases of substance abuse.
Anther area of concern in the Mayor's budget is the lack of detail in the funding of the Preventive Health Services Administration. We know that in Fiscal Year 2001 there were significant cuts in the budget of this Administration. Cuts to this budget reduce the amount of funds matched by the federal government.
Additionally, speaking as a clinician, the Mayor's desire to expand screening of ovarian cancer is not an effective use of dollars. Ovarian cancer is rare. There are no proven effective screening measures for the detection of ovarian cancer. The Mayor makes no mention of increasing the funding for screening of the far more common cancers such as prostate and breast cancer. There is no mention of funding to fight the three top non-cancer killers of our citizens: Diabetes, hypertension, and chronic renal failure.
The Medical Society applauds the Mayor for his proposed increased funding of the Medical Assistance Administration. Again, though, the Mayor's budget lacks detail showing how he would use this increase in funding. If we look at the Mayor's Fiscal Year 2001 Supplemental Budget, he has asked for an additional $19 million dollars, of which $15 million dollars would be used to help offset some of the costs associated with the expansion of the Medicaid program. Another $4 million would be used to offset some of the increased costs associated with the District's share of Disproportionate Share to Hospital (DSH) payments. We want to be clear: "You can't rob Peter to pay Paul." Don't decrease DSH payments to hospitals to increase Medicaid eligibility. Increasing the numbers of eligible citizens will increase use of hospital services. Hospitals will have an even greater need for the DSH payments. The Medical Society supports these increases in the Fiscal Year 2001 Supplemental Budget, but we feel that when expanding and redesigning the Medicaid program, the Mayor must give serious thought to increasing the Medicaid reimbursement rates to providers. According to an American Academy of Pediatrics 1999 survey; for an office visit for an established Medicaid patient with high complexity, which Medicaid patients often are, a District physician is paid $40.50 as compared to $61.07 in South Atlantic States, $63.20 for the entire U.S., and $93.67 under Medicare. I make this point to demonstrate that District caregivers are woefully under-reimbursed by the Medicaid program. The overhead a physician must pay to see a Medicaid patient, including what it costs to hire the staff to verify eligibility and to submit the bill to Medicaid, often creates a situation where the physician treats Medicaid patients for little or no reimbursement. This, combined with the very high costs associated with practicing medicine in the District, creates a disincentive for doctors to participate in the Medicaid program. These factors decrease access to quality caregivers for all Medicaid patients. If we increase the number of citizens eligible for Medicaid, we must encourage more health care providers to participate in the program. The Mayor cannot simply expand Medicaid eligibility without submitting a proposal that which will increase reimbursement rates. Our goal is to have Medicaid rates equal to those paid by Medicare. The Medical Society is eager to work with the Council and the Medical Assistance Administration on a plan that will accomplish this goal.
Two final points: one, the Medical Society would like to see the Mayor and the Council seriously consider creating a cabinet position in this budget for an Emergency Medical Services Department (EMS), separate from the Fire Department. Studies by three different outside consulting groups and other interested parties over the last fifteen years have all made this recommendation. It is time to stop studying the problem and do something about it. EMS is a vital member of the healthcare delivery team and deserves the funding which will enable them to do their jobs.
Lastly, we make this impassioned plea to the Council - Establish an independent Board of Medicine. The current structure makes it impossible to respond in a timely manner to complaints and concerns made by our citizens. We must be able to investigate problem physicians quickly and justly so that we can assure our citizens that we have physicians of the highest caliber practicing medicine in the District of Columbia.
I thank you for this opportunity to present this testimony on behalf of the Medical Society of the District of Columbia. The Medical Society stands ready to assist the Council and the Mayor to ensure that District residents have access to and receive the best medical care the country can offer. I will be happy to answer any questions.
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