Talking Points: Mcare abatement, Mcare phase-out and coverage of the uninsured
The situation in Harrisburg will be very fluid between now and your visit to state legislators on June 5 or 6. Bill numbers will change, so it’s difficult to predict what specific pieces of legislation will be the central focus by June 5 or 6. Watch the Society’s website for more news updates.
But in general, when talking to your legislators it’s important to not point fingers, and to focus on explaining how the issues will affect your practice of medicine and access to care for your patients—their constituents. Don’t blame anyone, consider this as an opportunity to achieve significant goals and, always emphasize that we are willing to work together with all stakeholders, and stick to the following points.
Key points
on Mcare
- To keep access to care, Pennsylvania needs a plan that will achieve three equally critical goals:
- Extend Mcare abatement for 2008 to protect physician recruitment and retention and thereby access to care;
- Phase out the Mcare Fund while minimizing the financial burden on present and future Pennsylvania physicians; and
- Address the needs of uninsured and underinsured through expansion of health insurance coverage
- This may be our last chance to achieve Mcare abatement and phase-out, since the Mcare Fund’s Health Care Provider Retention Account has a surplus. Most legislators support the Mcare abatement, and many will support the phase-out plan supported by the Medical Society. But, during the upcoming state budget debate, we must guard against those funds being re-directed to other programs.
- It’s critical to focus on shoring up our physician work force today, because it’s clear that a “perfect storm” of crumbling access is in our near future—the combination of an aging baby-boomer population, an aging physician work force, and increasing demands for care.
- When there are fewer physicians, there will be more and more Pennsylvanians who can’t get access to care. That’s why we need both Mcare abatement and Mcare phase-out to minimize the burden on physicians, keep them here, and enable us to recruit young physicians.
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Mcare abatement
- The cost of medical liability insurance is still too high. While there have been some very successful tort reforms, lack of a cap on non-economic damages means that abatement is essential to maintaining your practice of medicine and preserving access for your patients and your community.
- Failure to extend abatement will impact your practice and your patients by forcing you to [insert the actual belt-tightening actions you’ve taken, such as not hiring a new physician, other new staff, curtailing high-risk services, or not buying new equipment. But don’t make predictions or exaggerate the situation.]
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Mcare phase-out
- Many legislators support the Mcare phase-out plan to pay for the Mcare Fund's “unfunded liability” or “tail” with cigarette tax dollars.
- Without a plan to ensure that the unfunded liability is paid off, young Pennsylvania physicians fresh out of training will each face a bill of almost $80,000 in order to begin practice here. This would be in addition to the burden of their medical school loans. Would you come here?
- Dealing with the periodic adjustments of the commercial insurance market is far better than the current situation—an annual battle to secure the funds necessary for abatement.
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Reality Check |
| When the Mcare fund is “phased out,” physicians will still be required to carry $1 million in liability insurance coverage. The Medical Society’s goal is to protect physicians from increased financial burden in that process. | |
- A plan for Mcare phase-out is the right thing to do to protect our patients’ access to care for the long run.
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Covering the uninsured
- One uninsured person is one too many. Pennsylvania should make health insurance affordable and available to all who want it.
- While coverage for the uninsured and underinsured is a basic goal of the physician community, we can only achieve access for the uninsured if our other goals are also met—Mcare abatement and phase-out are equally important.
- While on the surface it’s hard to argue against any given plan to help the uninsured, the new product must be crafted in such a way that it covers the expenses of the services provided.
- A new insurance product that does not recognize the sensitive balance of health care funding could have unintended consequences that could impact those with other insurance products.
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Last Updated: 8/13/2008