UNION OF AMERICAN PHYSICIANS AND DENTISTS LEADS STRIKE AT UNIVERSITY OF CALIFORNIA HOSPITALS

DOCTORS STRIKE at UC HOSPITALS      

For physicians work stoppage is almost unheard of -- these are the guys who treat patients under fire in war zones and whose lives are 7 years shorter than the rest of the population because of the stress entailed at being available at all hours for a lifetime. 

But now the tide has turned. Healthcare conglomerates have converted doctors into healthcare providers and often employ less trained associates to do the job -- give 'em a white coat and set 'em loose on patients while profits soar to top executives. 

It is not hard in that context to understand why UC or any other competitive company engaged in selling healthcare services and products might want to exploit its workers. Yesterday it was the garment workers. Today it is the physicians' turn. 

This time the target is the doctors who take care of the students at UC.  Over a year ago the doctors learned that they needed to be organized, not just for wages, but also to be enabled to provide the best health care they can. Over this length of time the Union of American Physicians and Dentists (UAPD) has had to contend repeatedly with unfair labor practices (ULPs) perpetrated by UC. As a result the UAPD determined that "a ULP strike is the only way to compel UC to follow the laws that govern bargaining."

Stuart A. Bussey, MD, president of the UAPD, stated that "UC has a history of disrespecting workers during negotiations, and we're no exception to that." 

Doctors at all 10 campus health centers are ready to strike. There will be six picketing sites, UC Berkeley at UHS Tang Center, UC Davis at the Student Health and Wellness Center, UC Santa Cruz at the Student Health Center, UC Irvine at the Student Health Center, UCLA at the Ashe Student Student Health and Welfare Center, and UC San Diego at Student Health Services. 

PROPOSITION 45 HEATS UP

Enter now Paul Y. Song, MD, into the Proposition 45 debate. Actually, he's been there all along, has already appeared in my edits, testified at the all day hearing on 45 before it was known as Proposition 45,  and is said by some to be a prospective candidate for insurance commissioner.

In his editorial entitled "Why Are CA Doctors Breaking Their Hippocratic Oath on Prop. 45," Song asserts that the doctors and nurses opposed to 45 are protecting the insurance industry. He says "it is unconscionable." His main point seems to be that there is no conflict with the "independent commission" whereas "Covered California is actually run by purely political appointees." THAT is no news to us -- we don't know of any commission where prospective appointees are required to pass achievement tests and demonstrate that they know anything other than how to make political contributions. Song points out that some of the Covered California persons "have a long cozy history with the private insurance industry." Song points out with some relish that "it is the private health insurance industry and their administrators, many of whom have never cared for a patient, who are denying care, while telling doctors what treatment and drugs they can provide."

Song says that Prop. 45 "would simply apply the same regulatory framework to health insurance which has proven so successful regulating auto, home, and medical malpractice insurance in California." He likens Prop. 45 to Prop. 103 vis-a-vis auto insurance rates.

The juicier parts of Song's editorial include his telling certain persons and groups to "stop spreading ... lies." Take a look at it, and Young's editorial, and Bussey's. In many ways Prop. 45 is more substantial as important legislation than Prop. 46.

Our point is that while Prop. 45 if it passes will have the bite of law, its eventual teeth will be in the rules and regulations that follow. The proponents will need to make sure that the rules and regs are composed by forces that want it to succeed. Are they ready and prepared for the job?

References

You can follow Paul Y. Song on Twitter at www.twitter.com/paulysong; Bussey's editorial is referenced in our previous post & appears in UAPD Pulse; Young's editorial is referenced in our two previous posts and on the website for the California Neurology Society 

Proposition 45: pro and con

Robyn G. Young, MD, president, California Neurology Society, presents her case for Prop. 45 in her editorial available on ca-neuro-society.org (it is also summarized in our previous blog in the end-of-article listing of references).

Now comes Stuart A. Bussey, MD, JD, president, Union of American Physicians and Dentists, who writes in the "The UAPD Pulse" why Prop. 45 does not deserve passage.

Bussey's piece makes these points:

1. Prop 45 would shift regulatory authority from an independent commission to one political figure who would then become a "pressure point" subject to special interests.

Comment: the independent commission is also subject to special interest pressure, but it's more difficult to get to an entire committee than one person. On the other hand, commissioners get their jobs by appointment, political appointment, not by scoring well on achievement tests.

2. Bussey points out that under the ACA administrative costs are limited to 20% -- anything over that "must revert back to patient services."

Comment: Trouble is that the insurance companies often try to sneak administrative costs into the "patient services" sector. Example are utilization reviews requested by insurance companies that seek to disguise them as "consultations."

3. If  Prop. 45 passes a likely revenge step the insurance companies will take will be to slash provider reimbursement. Agreed, that's what they'll do, not that they don't already do it. The independent commission has not roared its disapproval of provider abuse.

Comment: It's also likely that the insurance companies and MPNs (Medical  Provider Networks) will jettison hundreds of doctors as a way to reduce expenses (not that that hasn't already been done). That in turn will force the remaining doctors to see more patients faster (the short visit you get now will be made even shorter).

My opinion: if Proposition 45 passes, the next step will be the implementation of rules and regulations. Proponents should be ready to take that matter on from Day One. That means day-to-day readiness to participate in the regulatory process. Proponents feel they have a better chance at fair regulation with Proposition 45 than without it. Opponents are skeptical, and with good reason, e.g., the unions bent over backwards to get Brown elected Governor only to find out yesterday that he vetoed all three of their bills. Would a single insurance commissioner be different?

The latest re the ACA: a laboratory in San Jose has just  billed a doctor's office for laboratory work done for Medicare patients. The lab in question said that changes in the Affordable Care Act made in January of 2014 allows them to do so. We'll look into this matter and see what the current insurance commissioner wants to do --  it'll be a prelude to what he'd do were Proposition 45 to pass.

In our next blog, we're planning on a few parting shots re Prop. 46,

Question: When should lawyers be tested for drugs?

Answer: When they're awake.