2012 LEGISLATIVE WRAP-UP: One Must Imagine Sisyphus Happy

Jodi Hicks

In years past, the California Medical Association (CMA) has defended physicians in battles waged by hospitals, health plans and mid-level practitioners, but this year we initiated a few fights of our own. CMA did what physicians do best: we fought to protect patients.

CMA fought to keep patients out of the middle of billing disputes, to educate parents about immunizations, to require mandatory flu vaccinations for health care workers, to remove sugared beverages from schools, to create a physician health program, to expand residency programs, and to save the Healthy Families Program.

Sponsoring legislation is the equivalent of pushing rocks up a hill … or rather, big righteous boulders. The CMA Government Relations team struggled to push those rocks up the legislative hill while fighting off the enemies trying to get in the way, and at the same time stopping the many other rocks being thrown down at us. Sounds dramatic, but by all accounts, it was a crazy, precarious, contentious, hazardous and dramatic pathway to the finish line. We finished with some big wins. We lost a few battles along the way, but we fought for physicians and their patients until the very end.

CMA came out swinging from the starting gate in January. We introduced AB 1742 (Pan), which would have enabled patients to assign their benefits directly to the provider furnishing medical services. Sounds simple enough, but the bill soon came under attack from health plans and culminated in what was described on one blog as the “juiciest” Assembly Health Committee hearings of the year. After much back and forth, the bill came up one vote short before reaching a legislative deadline.

That same week, CMA battled the unions, championing a bill that would mandate flu vaccines for health care providers in hospitals. Against all odds and much opposition, SB 1318 (Wolk) moved through the state Senate in a decisive win for public health. Though CMA was able to maneuver this contentious bill all the way through the Legislature, it was subsequently vetoed by Governor Brown.

CMA also joined a large coalition of health care providers in a valiant attempt to create a physician health program in California. The coalition worked tirelessly to address the opposition’s concerns surrounding funding, oversight and standards, and the bill made it all the way through committee hearings and was on its way to the floor when it stalled. Despite the coalition’s diligence, the overwhelming demands of the opposition damaged the bill beyond repair before the last legislative deadline. Despite an end to this bill, we are confident that the conversation can continue. Physician health is an issue that CMA will look to advance next year.

And then came Rob Schneider. CMA--along with the American Academy of Pediatricians, the Health Officers Association of California and the California Immunization Coalition--sponsored AB 2109 (Pan) in an attempt to decrease the number of parents exempting their children from being vaccinated before entering public schools. Hundreds of anti-vaccine activists flooded the committee hearings to oppose the measure and eventually were joined by Saturday Night Live alum Rob Schneider. Now armed with “celebrity” status, the opposition was able to secure public rallies, television time and social media to oppose our efforts. Despite attempts at negative media attention by the opposition, Governor Brown signed AB 2109 into law hours before the deadline.

The year wouldn’t be complete without CMA revisiting some oldies but goodies, physical therapy and MICRA being no exceptions. Unfinished business from 2011, SB 924 (Steinberg/Price) would have fixed the ambiguity in law as to whether or not medical corporations can legally employ physical therapists; but it would have also allowed patients to directly access physical therapy treatment for 30 business days, at which time a physician would have to sign off on a physical therapy treatment plan. CMA had an official “oppose unless amended” position on the bill, asking for amendments that would have required a medical diagnosis after 30 days of direct treatment. The Assembly Appropriations Committee passed the bill, adding in medical diagnosis as a requirement for direct access. The California Physical Therapy Association again amended the bill on the floor, changing the language so that instead of requiring a diagnosis, it would require an examination or a diagnosis … and as the game of semantics wore on, the bill was quickly sent to the Assembly Rules Committee, where it stayed until its demise.

Two bills that would have weakened the protections of MICRA--SB 1528 (Steinberg) and AB 1062 (Dickenson)--were amended during the last week of the legislative session, adding to the chaos of the final days. The provider community strongly opposed both bills. Thanks to letters and phone calls from physicians across the state, both bills were ultimately killed with astoundingly low vote counts.

The legislative session officially ended early Saturday morning, Sept. 1. CMA’s Government Relations team was at the Capitol until the very end. In the waning hours, CMA successfully negotiated key amendments into a Worker’s Compensation bill and proudly fought to reinstate the Healthy Families Program as part of a complex deal that died sometime after 1 a.m. Despite bipartisan support for our efforts, Healthy Families became collateral damage to partisan politics. CMA continues to work with stakeholders on the transition of kids to Medi-Cal. More to come on this issue …

In his famous essay “The Myth of Sisyphus,” French philosopher Albert Camus tells us that toil is not futile, and that hard work can be noble. CMA toiled throughout the year for physicians, honoring the labor physicians do for their patients every day. The struggle to push those legislative rocks up the hill was performed with pride. As Camus observes, “The struggle itself toward the heights is enough to fill a man’s heart. One must imagine Sisyphus happy.”

Of course, Sisyphus was not pushing the rock while simultaneously fighting lobbyists or Rob Schneider--but I still imagine him happy.

 

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Ms. Hicks is vice president of government relations for the California Medical Association.

Email: jhicks@cmanet.org

For details on the major bills that CMA followed this year, visit www.cal.md/legwrap2012.