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 May Here come the lawyers: Providence battles in court Action’s about to happen in the anti-trust lawsuit against Providence Health Plans by two radiology groups who are being bumped from its PPO network on July 1. A hearing is set for June 20 in U.S. District Court on an injunction sought by the physicians with a decision likely within a few days. Meanwhile, Providence attorneys have until June 1 to submit their response. Then the radiologists have 10 days to rebut their arguments, said Dr. Paul Meunier, of Body Imaging, who filed the lawsuit along with Dr. Gerald Warnock of Epic Imaging. “Our fate now is in the hands of the court; any physician in private practice is subject to what follows,” he said. The radiologists may have an ally in their ring – the American Medical Association whose attorneys have this matter under consideration. The AMA could file an amicus brief or join the lawsuit, said Meunier, who sought their help rather than ask the Oregon Medical Association, which, he said, lacks the financial resources to become involved. The AMA is a natural fit, he said, because they already have taken a position against economic credentialing and consider it unethical and illegal. Hillsboro fight: Part II Tuality Community Hospital and Providence Health System are in the boxing ring again. In 2006 Providence hopes to begin construction on an 8.97-acre site known as the Tanasbourne Medical Plaza. Architectural drawings include four medical office buildings and parking for 1,411 cars. Diagnostic imaging will be among the services offered. An ambulatory surgical center may also be built. “Other plans for services are still under discussion,” said Marcia Williams, public relations director. What’s the big deal? Competition. Tuality Community Hospital fears the new project, located just five miles away, will take away its most lucrative business, making it difficult to survive as a full service hospital. Its attorney, David Noren, has asked Hillsboro’s Planning Director Winslow Brooks to require a conditional use permit before either an ambulatory surgical or a diagnostic imaging center could be built. Such a permit requires a public hearing. Brooks is expected to rule by late May, and his decision can be appealed to the city’s Planning and Zoning Hearings Board. Kid care(less) Calling Kevin Mannix. And Ron Saxton. And maybe Vicki Walker. Here’s some stump material for the upcoming gubernatorial race. Last August, Governor Ted Kulongoski announced an initiative to expand coverage for uninsured children. Dubbed Kid Care, the program started in September with a four-month pilot in Hood River and Lincoln counties. Despite calling it one of his “top priorities,” the program not only failed to meet its goal, but fewer children had coverage in those counties upon its conclusion. “It’s a damnation,” said Ellen Pinney, executive director of the Oregon Health Action Campaign. “Either the governor did not oversee it sufficiently, or he never intended it to meet its potential.” Freudian prescribers Psychiatrists have hired one of the toughest sharp shooters in the Capitol – Mark Nelson, who now counts 33 clients among his entourage, including Pfizer, R.J. Reynolds and Anheuser-Busch – to fight their battle against legislation that would allow psychologists to prescribe drugs. A $40,000 check rolled in just about the same time “to combat this legislation,” according to Dr. Alex Burt, president of the Oregon Psychiatric Association (Current Issues, April, May, June 2005, Vol. 21, No. 2). Nelson, with a little help from McCulley and Scott Gallant, convinced the Democratic Senate to kill Senate Bill 407. “I took it as a compliment; Mark’s a pretty big gun next to me,” said Damiana Merryweather who lobbies for the psychologists. “They could tell we were gaining ground and traction with legislators, and this issue had legs. We see this as a turf battle to protect psychiatrists and physicians in their scope of practice. It has nothing to do with what’s best for Oregonians.” On the record with Dr. Eric Walsh Dr. Eric Walsh may hold a medical degree, but he talks like an economist. With the cost of health care inflating faster than a balloon on a helium tank, he wants the community to take a hard look at the numbers. Walsh spoke with Associate Editor Matthew Kish from his office at Oregon Health & Science University where he’s an associate professor and directs the Portland Family Practice Residency Program. He also chairs the Health Services Commission that oversees the prioritized list for the Oregon Health Plan, which is now charged with looking at the cost effectiveness of those services. A former rural practitioner, Walsh also chimed in on how to lure more graduates away from the I-5 corridor. OHN: What’s wrong with our health care system? EW: We haven’t established any way to measure the value of what we do in either financial or social terms. There’s endless expansion but little quality control or ability to contract or take away things that don’t work or are too expensive. SEIU bills on the rocks With intentions as pure as Rocky Mountain snow, SEIU introduced a set of cost savings bills in February. What remains is a pile of slush that looks like the slop on the side of the road after the snowplows go by. The four bills, Senate Bills 501–504 would respectively require more insurance transparency, regulate hospital rates, strengthen the certificate of need process and mandate a certain level of charity care. Rate regulation and charity care are both near death in committee. To increase the calamity, the bill to strengthen the certificate of need got so turned around SEIU didn’t even support the version the Health Policy Committee originally passed. Pooling teachers As the weather heats up, it should come as no surprise to hear people talking about pools. The pool on the lips of legislators, however, doesn’t have anything to do with chaise lounges and beach towels. Rather, lawmakers are again pondering whether all schoolteachers should be wrapped up in a health benefit pool. The idea could generate as much as $180 million in savings over five years, according to some actuaries. In May, Senate Bill 639 had its first hearing. Hygienists score first win of 2005 in Salem The first health policy bill – with real teeth – has been turned into law (House Bill 2426). Very soon dental hygienists with a limited access permit can begin treating the uninsured, pregnant women, and people who receive services at a rural, neighborhood or community health clinic – without a dentist standing over their shoulder. The Board of Dentistry can expand its scope of practice ever further. Until now these hygienists could only work alone in nursing homes and schools. The Oregon Dental Association withdrew its opposition after lobbyist Paul Cosgrove amended the bill, limiting the access points, and it flew through both chambers without a negative vote. Rutledge to leave The announcement that Ken Rutledge will leave the Oregon Association of Hospitals and Health Systems after 17 years at the helm has spurred a round of applause as well as a few puzzled looks. “He’s represented his constituents very well,” said Jim Kronenberg, chief operating officer of the Oregon Medical Association. “Although we’ve had our differences, we’ve always been able to maintain a collaborative and generally positive relationship.” Others cite Rutledge’s work on the Oregon Health Plan, Medicare funding, the provider tax, transparency, access and raising money for tort reform campaigns as some of his greatest accomplishments. The departure of one of the highest profile health policy makers during a legislative session, however, has left some people bewildered. “I’m flabbergasted,” said Ellen Pinney, executive director of the Oregon Health Action Campaign. Also in this issue...
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