Legislative Update
Rep. Anne Donahue
April 7, 2017
It’s the calm before the storm. The House has passed
the budget and sent it to the Senate, and we’re back in committees reviewing
bills from the Senate, with little action on the House floor. Within the next
few weeks, anything significant for this year will start seeing a lot of
action, because once the Senate sends the budget back, the clock starts ticking
for the end of the session.
Senate
Health Care Bills
Our committee is reviewing 7 bills passed by the
Senate, and we will not get to all of them this year, so we are identifying
priorities. Others can still be taken up in the second half of the biennium in
January.
On the top of the priority list is S.133, “An act
relating to examining mental health care and care coordination,” which is reviewing
the public mental health system in Vermont. My first reaction is that it calls
for too much study, and not enough action, given the crisis we are confronting
as a state. We have testimony scheduled for much of next week.
We will also be hearing testimony next week on a
bill that would mandate standards for circulating nurses in hospital operating
rooms. I’m concerned that we may be micro-managing the medical profession if we
step into this one.
We will likely act favorably on a Senate proposal
that requires open meetings (and sets some parameters) for the governing bodies
of accountable care organizations.
We are also close to finishing work on a proposal
for health insurance coverage of services provided via telemedicine. It’s all
part of our brave new world in health care, and holds out promise for
increasing access to care in a rural state like ours, as well as reducing some
costs. But is it really the same as, for example, seeing a therapist
face-to-face?
We are a bit leery, and so are adding an informed
consent requirement that lets patients know what might differ in telemedicine
service delivery, and that they can discontinue it at any time if they are
uncomfortable.
Vermont passed the nation’s most aggressive law some
10 years or so ago to block pharmaceutical companies from buying access to
medical professionals through meals or other gifts, including at conferences.
The pharma companies have fought back by denying Vermont doctors access to
conference lunches and dinners – instead of letting them simply pay their own
way.
So the Senate has passed a bill that would once
again allow for that proverbial “free lunch.” It’s supported by the Vermont
Medical Society, but we’ve been getting a lot of emails from doctors saying
they are proud of Vermont’s standards.
I find it a bit of a double standard when we
legislators gather around for the free munchies being offered in the cafeteria
by one interest group or another, but think doctors can’t withstand influence from
drug companies. On the other hand, big Pharma is probably more invidious in its
intentions than the Alzheimer’s Association (free ice cream this week) or the Bar
Association (wine and cheese) that want to bend our ears.
The final bill from the Senate is a bill for generic
substitution of what are called, “biological products.” Most drugs consist of
pure chemical substances, while biological products are made from a variety of
natural sources (human, animal or microorganism) and replicate natural
substances such as enzymes, antibodies, or hormones in our bodies.
This newly expanding form of drug therapy is very
expensive, and interchangeable versions are expected to be coming to the market
soon. This bill would require pharmacy substitution of “interchangeable
biologics” in the same way that generic substitutions now occur, in other
words, unless otherwise directed by your doctor.
***
Worker’s
Compensation
A bill related to worker’s compensation voted out by
our committee unanimously weeks ago has finally emerged from the House Commerce
Committee on a 9-1-1 vote after lengthy discussion and debate. (A bill that
comes under the subject jurisdiction of more than one committee must be
reviewed by each such committee.)
It would establish two things:
-
That a mental condition that is directly
caused by a work event is covered by worker’s comp in the same way other
injuries or work-related diseases are (in other words, parity); and
-
That in the case of emergency first
responders who experience post traumatic stress disorder, a
presumption would exist that it was caused by the work event, unless proved to
the contrary.
It’s amazing to me that it’s taken almost 20 years
since first passing our health insurance parity bill for mental health we are
finally recognizing that worker’s comp, as well, needs to treat equally all
health conditions that are caused on the job.
The argument against this new bill has been that it
will raise worker’s comp insurance rates – the same argument made against the
parity bill in 1998, and soundly disproven.
I will never forget when I first discovered in 1996 that
because I made the mistake of “choosing” the wrong illness, my hospitalization
for major depression wasn’t covered by the health insurance I was paying for.
I testified at a legislative hearing that next year
in support of the parity bill. It was the first time I had ever entered the
State House, and it was the beginning of the trajectory in advocacy work that has
led me to a place on the State House floor. I will be proud to speak here in
support of parity, once again.
***
Thank
you for the honor of representing you. Please contact me with your questions
and your opinions. You can reach me by message at home at 485-6431, at the
statehouse at 828-2228, or at this email at counterp@tds.net
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