Health Care | SBAM on the Issues

Health Care

Health Care Principles

SBAM supports the following policy principles for health care:

HEALTH INFORMATION TECHNOLOGY
  • Universal standards for error reporting and prevention systems.
  • Financial incentives/assistance for healthcare institutions to install and use error reporting and prevention systems.
  • Invest in technology to eliminate errors and reduce time devoted to paperwork by doctors and nurses.
  • Public policy initiative to establish a nationwide comparative health care data system to provide data and information to the provider community, and the public at large, on health care costs, medical services, success rates, case mix adjusted hospital mortality and morbidity rates, all with an eye toward the establishment of best practices, reduced medical errors and overall improvement in patient safety and outcomes.
  • Adopting a federal standard for interoperable medical records. 
  • Promoting the use of electronic medical records and Personal Health Records that contain pertinent medical information on medical history and prescription drugs being used.  Both must be based on a common information system that can be used in all medical facilities.
  • Promoting computer aided decision tools for providers and reminder systems for patients to seek care.  
  • Requiring physicians to order medication via computer or pda (as opposed to handwritten and therefore easily misread orders).  Computer Prescription Order Entry (CPOE) has been shown to reduce errors by as much as 50%.  
  • A functional electronic platform designed with the proper level of patient confidentiality that will allow for easier detection of waste, fraud and abuse of the medical systems.
BEST PRACTICES
  • Reduce clinical practice variation by encouraging the adoption of evidence-based medicine practices at the point-of-care locations, given that patients receive only about 55 percent of evidence-based recommended care.
  • Reduce errors by promoting accepted best clinical and medication safety practices.
  • Reducing acute exacerbations by use of measures that assess the appropriateness of hospital stays and emergency room visits and serve to optimize care for chronically ill patients.
  • Increasing transparency of provider performance for price/quality sensitive consumers by use of decision support tools that result in informed, empowered consumers.
  • Efforts that are designed to drive hospital infection rates to near zero, as well as efforts developed by payers to withhold payment to hospitals whose infection rate is higher than the norm.
  • Efforts in Lansing and Washington to require disclosure by providers of “never events” and all efforts designed to lower the number of “never events” through remunerative or punitive measures. 
  • Until all qualitative, quantitative and medical cost data is fully available to the public and tied to payments, SBAM supports a strong state level Certificate of Need process.
  • The establishment of health courts whose judges would be dedicated full-time to resolving healthcare disputes.  Their rulings would set precedents on which providers and patients could rely.
  • Medical liability reform legislation designed to limit non-economic damages, establish sliding scale contingency fees, require a waiting period before a suit can be filed, reduce statute of limitations and limit qualifications to be an expert witness. 
  • Protection for doctors who follow evidence based medical protocols.   
  • The principle that no employer offering health coverage to their employees could be held liable for medical outcomes of having offered that plan.
  • Opposition to attempts to unreasonably increase the liability of insurance companies, HMOs, and providers.
  • Opposition to patent laws that allow a drug company to arbitrarily block a generic manufacturer simply by re-labeling the drug’s package or filing an appeal to the expiration of the patent.
PEOPLE & CULTURE
  • Individuals should be required to have health insurance coverage, whether purchased directly from an insurer/provider, through an employer-based plan, or from a public program.
  • Redoubling Efforts to Support Health Promotion and Disease Prevention.  Current efforts by the state of Michigan to encourage healthy lifestyles, prevent disease and otherwise promote health should be expanded.  Specifically, the state should consider further steps to support health promotion efforts in the state including workplace initiatives.  Educational interventions on fitness and the effects of obesity should be especially prominent.  Where possible, the state should enhance its programs to facilitate physical fitness.
  • Focusing Efforts to Reduce Prescription Drug Expenditures.  To reduce prescription drug expenditures Michigan should promote the use of generic medications and tiered pharmacy benefit programs that result in higher prices for brand name drugs (non-generic), and even higher prices for lifestyle drugs.
  • Additional conversations and research surrounding the issues of Bioethics, including end of life decisions, organ transplantation, and rationing of care.
  • Efforts to increase the available pool of medical professional at all levels
FINANCING
  • Opposition to any government effort to require small businesses to provide or pay for employee health care benefits.  Employee health care benefits should remain a negotiable issue between the employee and employer.
  • Incentives to encourage group health insurance plans and cafeteria benefit plans as a means to involve individuals in controlling their health care costs.  
  • Allow for 100% deductibility of premiums paid by individuals for themselves or others.
  • Exempt all employee benefit expenses from the calculation of the Michigan Business Tax at the state level, including calculation of the Alternative Profits Tax. 
  • Provide a tax credit to encourage employer based wellness programs.
  • Working towards making HSAs/HRAs more available to small business.
  • Efforts to require substantiation of medical cost reimbursement under HSAs.
  • Opposition to mandated benefits and we will take an aggressive and visible stand against mandated benefits.  
  • Eliminating the cost shift from Medicaid and Medicare by reimbursing providers at the same level as they are reimbursed through the FEHBP.  Doing so will end the “hidden tax” of the cost shift from Medicare and Medicaid to individuals and employers and will add additional pressure to the federal government to focus on quality and reduce the level of waste, fraud and abuse in our systems.
  • Expansion of Michigan’s Medicaid waiver program to allow for more flexibility in the delivery of medical care and cost savings generated from “appropriate” care settings and to capture additional federal funding.  (LAC 4/13/09) (BOARD APPROVED 4/30/09)