From: thomas metcalf
To: Legislative Fiscal Analyst Office Dropbox,
Date: Wed Oct 07 18:33:24 MDT 2015
Dear All,
I am writing on behalf of 580 pediatricians of the Utah Chapter of the American Academy of Pediatrics, with a focus on Health of children and adults, and Cost of the proposed Utah Access+.
HEALTH: In a recent conference on Toxic Stress in Children, a study was cited involving 111 children in poverty followed prospectively for 40 years, from ages 0 - 5 in the 1970’s, to the present.  There were four important factors which separated treated from control children in measures of success in adulthood, ranging from blood pressure and cardiovascular risk factors to success in college and jobs. The four were Quality Health Care, Quality Nutrition, Quality Day Care, and Social and Emotional Support.  That is why Expansion of Medicaid is so important, to continue to treat current patients and to pull children out of the “woodwork,” and to give health insurance to all parents to decrease stress and let them be the best parents they can be.

COST: Pediatricians have never made money (or “benefitted”) from Medicaid.  Reimbursement has always been less than the overhead to keep our offices open; thus it is charity care, and we have been able to see only 10 - 20 % of our patient load as Medicaid.  A survey of our chapter this past weekend showed no pediatrician in favor of the tax  proposed; all but one currently see Medicaid patients, and all but two would continue to see Medicaid patients even if a tax were imposed - their reason for being physicians in the first place remains intact.

We thus echo the stance of the Utah Medical Association, “Find other ways for physicians to help,” but not a tax.  Perhaps decreased reimbursement or decreased fees for private patients, which difference could be banked as money to pay part of the state cost.  There are multiple other non-provider sources which also could be tapped.  We want to continue to see Medicaid patients, and we ask the Gang of Six and the Legislature to seek sources that would not place an additional burden on pediatricians and allied health personnel.
Thank you for your consideration,
Tom Metcalf, MD, FAAP   801-599-0218 as needed