MassHealth and Commonwealth Care have together enrolled some 135,000 new members since last June. MassHealth and all of health reform’s supporters can be proud of this remarkable achievement.

This fast ramp-up has undoubtedly put a strain on the enrollment infrastructure at MassHealth. Health reform’s success requires prompt processing of applications and other forms. Once the individual mandate becomes operative, this function will be even more crucial.

In recent months, we have heard growing reports of delays and frustrations when uninsured people attempt to enroll in coverage. Outreach workers and staff at providers have encountered various obstacles when trying to help clients. In an effort to better understand the issues, Community Partners has posted an online survey to gather information from the field.

If you have experiences to share, please click here to complete the survey. The results will be shared with state officials to help them improve the system.

Another solid appointment to the Health and Human Services team was announced today: Barbara Leadholm as the new Commissioner of Mental Health. Here’s the announcement:

Ms. Leadholm has a broad and thorough understanding of the mental health system and consumers’ diverse needs. Her clinical knowledge and leadership skills will enable DMH to set an ambitious agenda focused on providing quality services; improving access; and empowering consumers and their families.

Leadholm has more than 30 years of experience in behavioral health, including six years at DMH in the 1990s. From 1993-96, she served as Metro South Area Director and was responsible for strategic planning, operations and administration. Ms. Leadholm also served as Assistant Commissioner for Policy and Planning (1990-93). In addition, she served in a number of leadership capacities at what was previously called the Department of Welfare, including Director of Chronic and Specialty Hospitals; Director of CommonHealth and Special Populations; and Provider Manager for Mental Health and Mental Retardation.

Most recently, Ms. Leadholm has been a Vice President at Magellan Health Services. During her 10 years with the company, she has worked in public sector business development and overseen operations for a number of large health plans and their contracts for behavioral health services. Most recently, Ms. Leadholm developed the “carve-in” product that integrates health plans and public sector programs to serve people in need.

Ms. Leadholm began her career as a psychiatric nurse clinician. She earned her Master of Science in Psychiatric Nursing from Boston College and her Master of Business Administration from Boston University. Barbara Leadholm will begin her new role in the first half of September. Until that time, current Chief of Staff Patricia Mackin will serve as Interim Commissioner for DMH.

Tom Dehner, who has served as acting Medicaid Director since Beth Waldman’s departure in January, has been named by HHS Secretary Judy Ann Bigby as the permanent director. Tom has been a great friend to the health care access and advocacy community, even during times when they were not supposed to be friendly to us. We think it’s a great appointment and offer our congrats to Tom. Here’s the Secretary’s announcement:

As Medicaid Director, Tom is responsible for MassHealth as a whole, and he will have the authority to run the entire Medicaid program. In addition, because MassHealth serves members across all of our EOHHS agencies, the Medicaid Director works closely with our EOHHS Assistant Secretaries to ensure that MassHealth collaborates with other agencies to coordinate and enhance services across the Secretariat.

Mr. Dehner has served as the Office of Medicaid’s Acting Director since January 2006. Previously, Mr. Dehner served as Deputy Medicaid Director and was responsible for managing MassHealth’s operational and clinical work, including the MassHealth Operations Unit, which enrolls eligible individuals, pays provider claims and manages customer service. His accomplishments include the management of an enrollment outreach grant program that has awarded over $3.5 million in grants to community-based organizations and the creation of an agency-wide initiative to enhance program integrity efforts.

From 2003-04, Mr. Dehner was Chief of Staff for the Commonwealth’s Division of Medical Assistance. In this role, he advised the Commissioner and directed senior management in setting organizational priorities and implementing strategic initiatives. Mr. Dehner also served as Deputy General Counsel for the Senate Committee on Ways and Means from 1999-2003.

That’s the provocative question posed in and article in today’s NYTimes Week In Review section — click here.

How to fix the health care system? Easy, liberals say. If Washington would just force cuts in prescription drug prices and insurance company profits, plenty of money would be left over to cover the uninsured. Conservatives prefer to argue that the answer lies in forcing people to pay more of their own medical costs.

But many health care economists say both sides are wrong. These economists, some of whom are also doctors, say the partisan fight over insurers and drug makers is a distraction from a bigger problem: the relatively high salaries paid to American doctors, and even more importantly, the way they are compensated.

“I always find it ironic that when I go to doctor groups and such, they always talk about the cost of prescription drugs,” said Dana Goldman, director of health economics at the RAND Corporation, a nonprofit research institute in Santa Monica, Calif. Prescription drugs cost, on average, 30 percent to 50 percent more in the United States than in Europe. But the difference in doctors’ salaries is far larger, Dr. Goldman said.

Doctors in the United States earn two to three times as much as they do in other industrialized countries. Surveys by medical-practice management groups show that American doctors make an average of $200,000 to $300,000 a year. Primary care doctors and pediatricians make less, between $125,000 and $200,000, but in specialties like radiology, physicians can take home $400,000 or more. In Europe, however, doctors made $60,000 to $120,000 in 2002, according to a survey sponsored by the British government in 2004.

We’ve previously highlighted research showing that we pay much more for just about everything in the US health care system — click here for 2/21/07 posting. So why should physician pay be different? Question is: what can we do to change the underlying dynamics that keep costs increasing so relentlessly?

Pay physicians by salary? Ain’t gonna happen.

Decapitate physician payment rates? Don’t hold your breath.

Change the financial incentives underlying physician reimbursement? Now we’re talking. For some of our ideas, see HCFA’s cost control agenda.

Metrowest Daily News has been paying attention to the quality legislation formulated by HCFA’s Consumer Quality Council and filed by Sen. Dick Moore and Rep. Denise Provost. Click here for their recent editorial:

It may be understandable that hospitals and physicians don’t want their mistakes made public, but it’s bad public health policy. Health Care for All, the advocacy group instrumental in pushing last year’s health care reform legislation, wants to change that. It is organizing Consumer Quality Councils to bring the voices of patients to health care providers and pushing legislation to expose medical mistakes to the light of day.

Click here for information on the legislation.

Over three days last week, Charleston, South Carolina hosted hundreds of health care providers, researchers, and advocates for the National Conference on Health Disparities. The city deeply rooted in a history of slave trade and Jim Crow provided a complex backdrop for a dialogue about racial health inequalities. U.S. Congressman James Clyburn (D-SC) brought the conference to Charleston and spoke passionately about the policies and programs needed to address startling gaps in health care education, access and quality, which persist despite progress in ending legal discrimination.

U.S Senator Lindsey Graham (R-SC) concurred with Clyburn, showing his support for policies to promote health equality such as funding for community health centers. Both legislators drew applause, laughs, and an occasional “amen” as they each reflected on the challenges they face moving these issues in Washington DC.

DHHS and CDC experts addressed the complexity of eliminating disparities, while noting recent national and state success stories. Dr. Walter Williams of the U.S. Public Health Service touted the national closing of the racial gap in children’s vaccinations as a major milestone. He credited education and community programming for the success. He described thriving initiatives in South Carolina, detailing a successful model of targeted community health education and chronic disease self management that has reduced amputations among African American diabetics. He emphasized the importance of community based programmatic solutions, supported by state and national policy.

All told, the Conference provided a warm and engaging space of shared learning, reflection, and rejuvenation for disparities advocates across the country. Soldiers in the fight for health equity shared triumphs and challenges, and the difficulty of fighting inequality in a country shaped and defined by it.

Congressman Clyburn provided a constant reminder of hope and inspiration. As Majority Whip, Clyburn is the third-ranking Democrat in the US House of Reps. The African American South Carolinian’s position is noteworthy, given the civil rights battles he has endured over decades and racial struggles in South Carolina in particular. The fight to end disparities is one more civil rights struggle for the country. We are now positioned better than ever to do this, as leaders emerge from communities engaged in emerging strategies that make a difference. The struggle continues, but we are on our way.
Camille Watson

John McDonough is the guest blogger on WBUR’s Commonhealth blog. We talk about health care cost control — or the lack thereof…click here to see the post and comments.

The Center for Studying Health System Change has produced a policy brief looking at MA implementation of Chapter 58 — click here. Center researchers interviewed about 25 MA folks in the spring. A balanced, thoughtful look at implementation process and challenges:

As Massachusetts’ landmark effort to reach nearly universal health coverage unfolds, the state is now focusing on employers to take steps to increase coverage. All employers—except firms with fewer than 11 workers—face new requirements under the 2006 law, including establishing Section 125, or cafeteria, plans to allow workers to purchase insurance with pre-tax dollars and paying a $295 annual fee if they do not make a “fair and reasonable” contribution to the cost of workers’ coverage. Through interviews with Massachusetts health care leaders, the Center for Studying Health System Change (HSC) examined how the law is likely to affect employer decisions to offer health insurance to workers and employee decisions to purchase coverage.

Market observers believe many small firms may be unaware of specific requirements and that some could prove onerous. Moreover, the largest impact on small employers may come from the individual mandate for all residents to have a minimum level of health insurance. This mandate may add costs for firms if more workers take up coverage offers, seek more generous coverage or pressure employers to offer coverage. Despite reform of the individual and small group markets, including development of new insurance products, concerns remain about the affordability of coverage and the ability to stem rising health care costs.

The Department of Revenue has released its draft Schedule HC (HC for Health Care), the tax form people will use to indicate compliance with the health insurance individual mandate.

DOR is asking for comments on the draft. You care read more about DOR’s role in health reform, the draft schedule, and how to submit comments here.

The form is fairly straightforward. It’s clear the designers struggled to keep it to 2 pages. The affordability and lowest premiums available tables will be included in the instructions, which are not yet online. We won’t get a sense of how daunting this will be for people until we see the instructions. DOR needed to get the form out, so that it can be approved in time for tax software firms to include it in their tax packages.

We’d encourage people to send their comments to DOR, and use the comments here to share their thoughts.

Despite strong consumer and physician outcry, DOI finalizes the Young Adults Plan regulations with no changes

The Division of Insurance finalized its Young Adults Plan (YAP) regulations this week. The YAP regulations were promulgated as emergency regulations in April and DOI held a hearing in May to hear from members of the public. Though all but 2 testifiers (Tom Nyzio from the Massachusetts Association of Health Plans and Bob Carey from the Connector) expressed concerns with the current content of the regulations, DOI finalized the regulations with no substantive changes.

Of greatest concern to physicians and consumers – YAPs are allowed to cap the benefits they provide to as little as $50,000 per year. Not only do these caps undermine the purpose of insurance, but they also put young adults who have accidents or are diagnosed with serious illnesses at risk of financial ruin and barriers to care. Click here for more information on that hearing and to read ACT!!’s testimony.

We hope that DOI will keep a close eye on the impact of these caps and consider revisiting this issue soon.

Romney mentions health care in New Hampshire — click here – count the ironies:

Romney did speak against what he calls “Hilarycare” or “socialized medicine” and told the crowd a private, market-based solution to health care can work. “Do we want everybody insured? Yeah. But we don’t want to have the government do it,” Romney said. He said moving toward a European system is not the way to go, arguing that Europe has not seen anywhere near the economic success the United States has since World War II.

Of the 155,000 persons enrolled in health insurance since Gov. Mitt Romney signed Chapter 58 in April 2006, more than 130,000 of them have coverage funded almost entirely by government. It’s true you can call the four Commonwealth Care health plans private, and it’s true that three of them cater almost exclusively to the MassHealth market.

If you don’t want to “have the government do it”, then there’s got to be a significant role for employers. Romney, of course, vetoed the sections of Chapter 58 that put responsibility on employers — the Democratic legislature overrode those vetoes.

By the way, what is Romney’s “private, market based solution” to health care? Please (we mean it — please click!)click here to view the cutting edge latest from the Romney campaign on his daring plans to reform the nation’s health care system.

Ha ha ha.

MIT economist and Connector Board Member Jonathan Gruber has attempted to translate the MA health reform plan into a national health coverage model: Taking Massachusetts National — Incremental Universalism for the United States. Click here for the overview of his plan. Gruber presented his ideas at a Brookings Institution forum on paths to universal coverage, which included three other sets of coverage expansion ideas. Click here for a link to the forum, held on July 17 at the National Press Club in DC.

Hard to believe — looks like reauthorization of the State Children’s Health Insurance Program, set to expire on 9/30/07, is shaping up as the major domestic policy brawl in Washington DC this coming fall. Today’s NYTimes editorial – “Vetoing Children’s Health” — nails it well:

The Senate would still leave millions of children uninsured and would discourage any additional states from covering low-income parents — reducing the likelihood that they would enroll their children. Senate Democrats believe this is the best that could be achieved. Now it will be up to the full Senate to approve the bill by a veto-proof margin. Meanwhile, House Democrats have their sights on a bigger increase — some $50 billion over five years to cover even more uninsured children.

If more revenue sources are needed, the House should consider a new tax on alcohol, which would also have health benefits, or a reduction in the large subsidies paid to private health plans to participate in Medicare. The important thing is to cover as many uninsured children as politically feasible, and hang the ideological warfare.

Let’s all hang in there for the fight.

Once or twice a year we deviate from health topics to something else. Just finished reading an amazing book, Overthrow, by NYTimes correspondent Stephen Kinzer. He tells 14 stories — each the story of a foreign government the United States deliberately overthrew, beginning in 1893 with Hawaii. I’ve heard parts of each story — what’s most powerful is weaving together all 14 to create a singular and damning portrait of American power. Each overthrow is a tale of greed, arrogance, and stupidity. In the large majority of cases, we left things far worse than we found them. It’s a gripping book, and each story is told like a political thriller.

Here are the 14 with dates and presidents — followed by an observation:
Hawaii — 1893 — B. Harrison
Cuba — 1898 — McKinley
Puerto Rico — 1898 — McKinley
Phillippines — 1898 — McKinley
Nicaragua — 1909 — Taft
Honduras — 1911 — Taft
Iran — 1953 — Eisenhower
Guatemala — 1954 — Eisenhower
South Vietnam — 1963 — Kennedy
Chile - 1973 — Nixon
Grenada — 1982 — Reagan
Panama — 1989 — Bush 1
Afghanistan — 2001 — Bush 2
Iraq — 2003 — Bush 2

Notice a trend? Except for Kennedy in 1963, 13 of 14 overthrows were accomplished by Republican presidents. Kinzer makes no mention of this pattern — and instead draws a portrait of American arrogance. I think there’s always been a large swath of American political culture that rejects this kind of interventionism. It’s not American values — though many Americans support this “muscular” approach — it’s Republican/Red values at work.
John McDonough

Today Office of Medicaid Director Tom Dehner presided over a MassHealth Payment Policy Advisory Board meeting to discuss the new “pay-for-performance” program (P4P) required under the Health Reform law.

The session opened with a presentation by Elizabeth Pressman, director of Primary Providers, on the MassHealth Hospital P4P plan. Section 25 of Chapter 58 requires that part MassHealth hospital rate increases be contingent on “performance,” including reduction of racial and ethnic disparities.

Starting in October, hospitals will be eligible to earn up to $20 million through P4P. There are five areas in which hospitals can earn “points” including maternity and newborn, community acquired pneumonia, surgical infection prevention, children’s asthma, and health disparity. Only two, however, have appropriate benchmarks to establish P4P this year. The other three will reward points for reporting information, and will become full-fledged P4P programs next year. Points will be given for improvement after a hospital has met minimum standards, until a “best practice benchmark” (meeting 100%) is reached. The next step will be implementation, and the creation of a plan for physicians.

Dr. Robin Weinick presented “Recommendations of the Massachusetts Medicaid Disparities Policy Roundtable.” The report can be found here. Even though P4P based racial and ethnic disparities reductions is “uncharted,” the Roundtable made 15 recommendations. The members took into account short versus long term goals, and emphasized the importance of avoiding guidelines that may trigger “cherry picking” patients. While this report is not designed for this year’s Request for Applications, the Board thanked the Roundtable for their hard work and dedication.
Kayte Spector

Looks like President Bush is going to have trouble holding Republicans together to sustain a children’s health insurance veto. This is the latest from our friends at the New England Alliance for Children’s Health:

The Senate Finance Committee has marked-up and passed an SCHIP bill. The bill received strong support and will now head to the Senate floor. The mark was approved by a vote of 17-4. All of the Democrats and 6 Republicans (Grassley, Hatch, Snowe, Smith, Crapo, and Roberts) voted for passage. Lott, Kyl, Ensign, and Bunning were the 4 no votes.

The mark appears to include all of the provisions we outlined earlier this week, along with several additions. Some of these additions include an Express Lane state demo program, mental health parity, and dental health grants. The modified mark can be found at: http://www.familiesusa.org/assets/pdfs/medicaid-coalition-stuff/modified-mark.pdf On the amendment votes, all of the Democrats, and Grassley, Snowe, Smith, and Hatch voted as a block. Roberts voted with the block on all but one instance, and Crapo’s votes varied.

New England can be proud of our Senators on the Finance Committee. Both Senators Kerry and Snowe were steadfast supporters of the provisions we care so much about. It is very important to thank them for their leadership on the Committee. We encourage all Alliance partners (even those outside MA and ME) to call their offices and thank them for their advocacy for children’s health. Senator Kerry can be reached at: (202) 224-2742 and Senator Snowe can be reached at: (202) 224-5344.

We do not yet know when the bill will move to the Senate floor. We will be in contact as soon as we have more details. Please be on the lookout for another alert tomorrow or Monday which will include action steps and talking points.

Yesterday the Legislature’s Joint Committee on Health Care Financing held a hearing on several important bills, including S. 661/H. 1166: An Act Strengthening Health Reform sponsored by the ACT!! Coalition.

ACT!! organized three panels: employer responsibility, affordability, and benefits. The written testimony can be found here. HCFA’s John McDonough pointed out that the employer responsibility leg of health reform is much shorter than that of individuals and government. While original legislative estimates anticipated employers contributing $171 million for the first two years, latest Patrick administration projections anticipate only $23.6 million from employers.

Rep. Steve D’Amico testified on the imbalanced employer share, stating that many retail and service firms use a business model based on low-paid, part-time employees who don’t receive benefits. The result is employers such as Wal-Mart, which shifts $8.4 million in health costs to the state. Wilnelia Rivera, from Neighbor to Neighbor, testified on amending the definition of the “fair and reasonable” premium contribution from employers, urging that the definition be changed to a 50% contribution, 50% participation rate, with a plan equal to minimum creditable coverage. Felix Arroyo of SEIU615 added that this plan should also include part-time workers.

An affordability panel opened with Mike Fadel, of 1199SEIU urging the Committee to codify recent moves by the Connector: the introduction of a family premium cap for children whose parent[s] are enrolled in CommCare, and the elimination of premiums up to 150% FPL. Jessica Costantino, of AARP, asked the Committee to include all cost sharing in the definition of affordability for the individual mandate, citing the importance of drug affordability. Linda Burgess, of the Greater Boston Interfaith Organization, added that affordability should include a total cost benchmark of 10% of income to prevent unfair discrimination against citizens over 55, who pay higher percentages of income.

Steve Shestakofsky of the Mass. Medical Society urged that tobacco cessation services be made permanent and consistent with the MassHealth smoking cessation pilot program. Lorianne Sainsbury-Wong of Health Law Advocates urged that CommCare plans should include medically necessary non-emergency ambulance coverage, as MassHealth does. Diane Pickles gave a personal story of her ill son as an example of why lifetime benefit caps should not be permitted in creditable plans.

Eileen McAnneny, senior VP for government affairs at the Associated Industries of Massachusetts, opposed the bill, citing four reasons: 1) changing the 33% premium contribution violates the negotiated agreement between businesses and government, 2) changes to Chapter 58 are premature, as we need to allow fair share contribution to work 3) most employers are doing their “fair share” already by covering at least 70% of premiums, and 4) linking the fair share assessment to minimum creditable coverage would violate the federal ERISA law.

Sen. Moore responded sharply to the assertion that the 33% minimum employer contribution was an element of the Chapter 58 compromise: “I was at that negotiation, you were not. That was not part of the deal.”

S.656: An Act to Expand Access to Dental Coverage
Sen. Harriette Chandler, Reps. John Scibak, and Denise Provost voiced support to add dental benefits to CommCare plans above the poverty level. Oral Health Task Force members also promoted inclusion of dental coverage in CommCare. They argued children and adults who lack dental insurance forego preventive and restorative care – care for illnesses and diseases that originate in the mouth.

H.3936: An Act Relative to Massachusetts Artists
Kathy Bitetti, of the Artists’ Foundation opened a panel on this bill to create a new category to determine affordability for people with “combination income.” The panel discussed the hardships of artists’ income which fluctuates seasonally and can be gathered from multiple employers. A new combination income category would alleviate the complications for this group.

S.706: An Act to Provide Access to Most Affordable Health Coverage
Former Green Party gubernatorial candidate Grace Ross suggested that Commonwealth Choice is more like catastrophic care than insurance. She thought if people above 300% FPL were allowed to buy into Commonwealth Care it would alleviate fiscal problems for consumers and providers.

H.1137: An Act to Establish the Massachusetts Health Care Trust
Single payer proponents touted H. 1137, including Reps. Ellen Story and Scibak. Sen. Steven Tolman told the Committee Chapter 58 “pours more money into a broken system,” and something larger must be done. Many panelists echoed that health care is a right and not a privilege and that health care is currently “held hostage by a free market system.” Notable points also included that in health care financial risks need to be spread over the largest pool possible – which is in this case the entire commonwealth. Ben Day, the Executive Director of MassCare, also stated that subsidized programs in other states (such as TennCare) have had “no lasting impact.”
Kayte Spector

Can’t help wondering about the sense of priorities over at the State’s Division of Insurance. New Commissioner Nonnie Burnes comes out this week with a sort-of deregulation initiative aimed at the auto insurance market. Click here for today’s Globe story and click here for today’s smartly written Globe editorial.

So let’s see. Auto insurance rates have been dropping for years, and this year the rates are more than likely to go down again. Massachusetts, the one state with a regulated auto insurance market, also happens to have the second lowest rate of uninsured drivers among the 50 states. By the way, there’s a direct link between regulation and a lower rate of uninsured drivers. By using regulation to flatten the rates for urban drivers, the state makes insurance more affordable for these folks, making it more likely they will purchase insurance.

So pardon us for asking, but … where’s the problem here? Why is the auto insurance market at the top of DOI’s policy agenda?

Meanwhile, read this posting from David Williams’ Health Business Blog … 26.3% rate increase for David and his business from Blue Cross next year. This story is being repeated all over the state. Businesses of all shapes and sizes are getting socked with huge premium increases. All over the place.

If auto insurance rates were going up 26.3%, there would be hell to pay. And auto insurance costs nothing compared with health insurance.

Maybe someone should tell Commissioner Burnes about this other line of business in her portfolio. Sense of priorities over there leave us scratching our heads.
John McDonough

Massachusetts gets LOTS of NIH research funding — so maybe somebody out there in blog land will take special interest in this announcement:

The Director of the National Institutes of Health is seeking applicants to fill vacant appointments for the 2008 Council of Public Representatives (COPR) Roster. Applications are due Friday, September 14, 2007, and are available online at http://copr.nih.gov/application.asp. COPR is a federal advisory committee, made up of members of the public, who advise the NIH Director on issues related to:
*Public input and participation in NIH activities
*Public input and participation in the NIH research priority setting process
*NIH outreach programs and efforts

The COPR is made up of 21 people from across the country who have been chosen to represent the public through an open application process. They are patients, family members of patients, health care professionals, scientists, health and science communicators, and educators. By serving as a public voice to the NIH, COPR Members
*Bring important matters of public interest to NIH leadership.
*Help increase public participation in the many NIH activities and initiatives that affect the public.
*Increase public understanding of the NIH and its programs.

The COPR meets two times a year on the NIH campus in Bethesda, Maryland. COPR Members also participate in NIH initiatives and take part in public outreach activities throughout the year. NIH is planning to hold a teleconference for potential COPR applicants in August, and will send a notice on the date and time in the coming weeks. Information about the date, time and dial-in information will be posted at http://copr.nih.gov/application.asp. Learn more about COPR at http://copr.nih.gov/index.asp

If you have any questions, please feel free to contact Kelli L. Carrington, M.A. Acting Executive Secretary, NIH Director’s Council of Public Representatives, Office of Communications and Public Liaison, National Institutes of Health at phone: 301-594-4575, fax: 301-435-6372, e-mail: carringk@mail.nih.gov

Let’s just say it: the new Department of Public Health Commissioner John Auerbach is G-O-O-D. His mentor, former DPH Commissioner David Mulligan was the master, and Auerbach may surpass him — in a good way.

Two sides were squaring off on the CVS proposal to open so called “Minute Clinics” for low complexity conditions. CVS on one side, and on the other side were physicians, hospitals, and community health centers. Auerbach announced his decision yesterday (click here for Globe summary) and now has both sides praising and supporting his decision.

Rather than provide a special waiver to CVS, Auerbach will write a new set of rules to enable any entity meeting them (eg: community health centers) to open up a similar clinic. And because new rules require a public hearing, physicians get the day in court they were seeking.

Auerbach is one savvy operator. And, what’s better, in this case good politics also equals good public policy.