Issues

2009 State Core Issues

Access to Care

Nearly seven million Californians do not have health insurance – the largest number of uninsured in the nation. The overwhelming majority of those individuals work full time in jobs that either do not provide health insurance or do not pay well enough to afford private insurance. CMA is supportive of a wide range of public policy solutions to address this dilemma including expansion of employer based insurance through state operated insurance pools; mandating individual catastrophic and preventive insurance coupled with Health Savings Accounts; and expansion of the Healthy Families program to cover working parents of children enrolled in that state-federal program.

Managed Care Reform

Managed care is a fact of life in California. But with increased emphasis on insurance company profits, physician-patient relationships are increasingly threatened. Rampant consolidation has resulted in a few HMO’s exerting a disproportionate influence on the California health care marketplace. Currently, a small handful of health insurance companies control over 80 percent of the market in our state. With this substantial market dominance, these companies offer physicians onerous take-it-or-leave-it contracts that often include provisions that are bad for patients and undermine the physician-patient relationship. Physicians must be allowed to advocate for their patients without fear of retaliation from HMO administrators and must remain an integral part of the medical decision making process to preserve the quality of care that California consumers expect and deserve. CMA supports efforts to reform this system so that it allows physicians to practice medicine and treat patients in the manner in which they were trained and uses premium dollars for patient care, not administrative costs or excessive profits.

Scope of Practice

While CMA does not oppose all expansions of scope of practice for non-physician providers, these proposals must be examined carefully to ensure that care of patients is not jeopardized. CMA believes that non-physician practitioners seeking to expand their scope must have the proper experience, training and education to treat patients safely and that the physician is the final decision-maker.

MICRA

MICRA, the Medical Injury Compensation Reform Act of 1975, reformed the medical malpractice insurance system in California. This measure allows for unlimited actual economic damages; a sliding scale of attorney fees; and reasonable limits on non-economic damages in medical malpractice suits. While a medical malpractice insurance crisis is sweeping across America, MICRA has kept the doors of medicine open and has protected the health care safety net in our state by keeping medical malpractice insurance available and affordable in California. CMA supports continuation of MICRA and keeping the cap on non-economic damages at $250,000.

Regulatory Relief

The state legislature frequently involves itself in the practice of medicine by requiring physicians to distribute written materials or verbally inform patients regarding certain clinical or disease related matters. This governmental involvement in the actual practice of medicine is often burdensome and unnecessary. CMA supports efforts to review such mandates already in existence and either sunsetting or at least consolidating some of them into a single physician friendly format.

Budget

CMA strongly supports a state budget that will continue California's obligation to provide health care to the medically indigent and working poor. Program cuts in the area of health care can result in severe public health problems and significant costs to taxpayers in the long term. CMA believes that adequate state funding for Medi-Cal and other programs that provide health care to needy Californians must be preserved.