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Testimony of Dr. Dwight Michael before the Pennsylvania Senate Banking and Insurance Committee

12/16/2009

Good morning Chairman White and distinguished members of the Senate Banking and Insurance Committee. 

I am Dwight Michael, a Family Physician. 

I am here to share my reformed and informed belief that Senate Bill 400 is by far the best way to provide high-quality, affordable, accessible healthcare to all PennsyIvanians at a cost to practically all of us that is less than what we currently pay.  

I am in my 25th year of practice in Gettysburg, Pa.  Our group of 5 family physicians is independent.  I am a Republican and have been fairly conservative in my views over the years.  I formulate my own opinions based on my research and my experiences. 

I have been asked to focus my comments on why SB 400 is beneficial to physicians.

First, SB 400 will allow physicians to focus much more of our time on the actual care of the patient.  With our present multipayer system, we spend an increasing and inordinate amount of time dealing with pre-authorization of care ordered.

This care includes: Medications, treatments, diagnostic procedures such as CAT scans, MRIs, xrays, and lab work.

Denials by insurance companies are all too frequent.  The time spent to gain coverage for the recommended care is increasingly burdensome.  A study from the journal, Public Affairs, May 2009, concludes that each physician in America spends $68,000/year just interact with the private health insurance industry.

Our practice participates with 20 different insurance companies, all of which have their own set of rules and hoops to jump through.  I have become convinced that their “rules” have much more to do with their profit margin than they do with good patient care.

SB 400 will streamline our care by providing one set of rules by which to practice, based on clinical effectiveness research, clinical outcomes studies that prove the benefit of care we provide, both testing and treatments.

This bill will markedly simplify the current environment in which we work.  It truly will give us more time to see patients.

Second, SB 400 will provide improved ability to track and trend physicians’ care with its emphasis on the use of information technology.  If there are providers who are not providing the standard of care, these providers will receive constructive criticism with expectation that they will improve their care to their patients. 

Third, SB 400 will strengthen the patient/physician relationship.  How?  Patients will be able to choose their providers of care and stay with them.  The present Private Health Insurance dominated system causes patients to leave my practice because their employer can no longer afford the plan they have.

If their plan changes to one that we do not participate in, then the patient is practically forced to leave our practice for a physician’s practice that participates in their plan. 
This happens every year in my practice.

SB 400 actually gives the patient the right to choose and stay with their providers.  The insurance industry no longer controls this choice with their preferred networks.

I went into Family Practice so that I could take care of patients and their families over the course of many years.  I believe that I can provide better care to patients because I know and understand the patient and the people around the patient over time.  This has played out in some of my families.  Our present lack of a coordinated healthcare system necessitates employers’ frequent decisions to change health insurance plans just so they can afford coverage.  This trend has greatly compromised the continuity of care that I believe is so important to quality of care. 

Fourth, I believe that SB 400 will provide “fair reimbursement” for providers’ services.  Fees for independent providers’ services and global payments for hospitals’ and other institutions’ services will be negotiated annually based on the previous year’s expenditures.

One of the stated goals of SB 400 is to strengthen primary care.  This is critical to improved care throughout the state and nation.

We, as a nation, are presently spending at least an extra $400 billion dollars a year in excessive administrative costs due to the Private Health Insurance industry’s role as the middleman.

I believe that if we eliminate the excessive administrative costs of the Private Health Insurance industry, we can save huge sums of money that can be used to provide better care of all Pennsylvanians and can fairly reimburse providers for their care.

Enacted SB 400 will be a win-win for the citizens of Pennsylvania, patients and providers alike.

By the way, don’t forget the 2+ billion dollars per year in savings we will achieve with the reduction in the costs of healthcare premiums of governmental employees when all levels of government in Pennsylvania are considered.

Fifth, I believe that even though the excellent medical liability piece of last year’s bill has been removed, SB 400 will provide an improved medical liability environment in Pennsylvania for all providers.

Presently, part of the award in a medical liability case includes “medical expenses”.  SB 400 will pay for medical expenses and therefore this cost will not be added to the award granted to the plaintiff.

This improved medical liability environment will make Pennsylvania a much more attractive state for physicians to practice.  I repeat, physicians will want to work in Pennsylvania.

I have followed developments in Washington very carefully this year.  At this moment, I believe that their “solution” will fall woefully short of the mark of providing affordable, accessible, high-quality healthcare for all.  Our state government has received a few black eyes recently.  When your committee leads the way, when our legislators pass SB 400, and when SB 400 is enacted, your will be honored by Pennsylvanians, young and old.  Future generations will thank you.
You will be the saviors of our state’s healthcare system.

You will do this while allowing almost all taxpayers to spend much less on healthcare, all costs considered.

Future generations of Americans will credit you as the fathers of our nation’s exemplary, civilized healthcare system, a system in which every person receives healthcare.  Pennsylvania will be the state that blazes the trail our nation finally takes to provide civilized healthcare for all.

Thank you!