LANSING – Rep. George Cushingberry Jr. (D-Detroit) is floating a proposal that he says could save the state budget $2 billion while both addressing the problem of uncompensated care and access to health care.

Cushingberry said he is pitching his proposal as legislative leaders and the governor work out 2009-10 budget targets, but the savings would be realized over an unspecified period of time.

Cushingberry said he wants to see a universal health care system, which he said would address the problem of hospitals having to provide $500 million in uncompensated care each year, in turn lowering insurance costs and how much the state has to spend on health care programs.

He is also proposing eliminating state grants, which appear to be targeted toward the Healthy Michigan program, and having the state go back to a fee-for-service model that would marry administration of mental and physical health care payments.

Cushingberry said there are health maintenance organizations for both mental and physical health and there should be a way to combine those and make the programs more efficient.

The state Medicaid system still has a fee-for-service component for residents who are ineligible for HMOs or who live in a part of the state where HMO coverage is unavailable, but Community Health budget chair Rep. Gary McDowell (D-Rudyard) said the state has moved away from that system because HMOs have provided a higher level of care.

McDowell and Sen. Roger Kahn (R-Saginaw Twp.) are currently working on a proposal that would establish a tax on physicians, known as a quality assurance assessment program, or QAAP.

QAAPs allow the state to receive more federal Medicaid money, increase reimbursements to providers and free up general fund obligations.

The state currently has a QAAP for nursing homes, health maintenance organizations, hospitals and community mental health providers.

McDowell said such a program could bring in $300-$500 million more in Medicaid dollars to the state.

McDowell said he was unfamiliar with Cushingberry’s proposal, but the Appropriations chair could be looking at a physician QAAP and eliminating state grants as “seed money” for a universal health care program in Michigan.

However, McDowell said the physician QAAP would have to go toward reimbursing the physicians who take on Medicaid patients.

The Michigan State Medical Society has a policy opposing a physician QAAP, said spokesperson Dave Fox.

Governor Jennifer Granholm proposed a physician QAAP in her 2005-06 budget, but it was never adopted after strong opposition from physician groups.

“We can’t cut their payments any more and expect them to see more Medicaid patients,” McDowell said, adding he and Kahn were approached by some physician groups about creating the physician QAAP.

Various health organizations contacted on Tuesday had not heard of Cushingberry’s proposal and a spokesperson for House Speaker Andy Dillon (D-Redford Twp.) also did not respond to whether he has spoken to Cushingberry about it.

This story was provided by Gongwer News Service. To subscribe, click on Gongwer.Com

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