Veterans Day

This day we remember our nation’s veterans and the sacrifices they offered for our freedoms.  Veterans Day is especially poignant for me and my family.  After the Japanese attacked Pearl Harbor, my uncles--all second generation Japanese Americans--volunteered to serve our nation in WWII.  They were among the first to volunteer at the draft office on the morning of December 8th, 1941.  One of them, my uncle Roy, never made it home from the war.  My wife’s father and uncles also served valiantly in WWII.  Three of her uncles paid the ultimate sacrifice in that conflict.  How blessed we are to be the children and grandchildren of that generation of Americans who were willing to give so much for the freedoms we continue to enjoy today.  

Today is also a day to remember and appreciate the men and women who are currently serving in the armed forces, both at home and abroad.  May we keep them and their loved ones in our thoughts and prayers.  I was pleased that Utahns so overwhelmingly showed their support for Constitutional Amendment B, allowing deployed soldiers to be exempt from property taxes.  We need to do everything we can to support our men and women in the military; this was a much-needed, common-sense measure.  

I hope that we as Utahns and Americans will pause for a moment today to appreciate our freedoms and those who paid the price for us to have them.  Let us honor their sacrifices by living lives of giving and lifting and serving others, and building a better future for our posterity.

ShiozaWON!

I am overwhelmed with the amount of support that I have received from each of you! This was a great victory for our community and state and I am honored to serve as our next State Senator!

NOW THE REAL WORK BEGINS!

Last night’s Presidential results further prove that now, more than ever, Utah will need a Health Care Expert in the State Legislature to help us navigate through the Affordable Care Act.

With your continued support we will make sure that common sense prevails and that the decisions that are made on a State level will benefit ALL UTAHNS!

As always, I am only a phone call away. I have been elected to represent you and the issues that our communities feel are most important. Do not hesitate to call or e-mail me if you have questions and concerns!

Thank you again for your support and hours of help!

-Brian Shiozawa

State Senator, District 8

To Decrease Medical Costs We Must Expand Medical Student Positions

Utah is at a critical period in our access to affordable healthcare. Recent reports show that
we are one of the most under-served states in the county for Primary Care physicians.
This lack of patient access to our healthcare system results in higher medical costs,
increased waiting periods for patients, and in our more rural areas – forces patients to
travel long distances just to receive the attention they needs.

We have heard much in the news detailing what contributes to such high medical costs
in our healthcare system. One of the major contributors – and is a direct result of Utah
not having enough physicians – is the large amount of people that go to the Emergency
Room. Many of these patients see the Emergency Room as last resort – a “safety net”
even – to receive the medical attention they need. The vast majority of issues that our
Emergency Room patients face could be taken care of by Primary Care physicians, if
only our State had enough to serve our population.

ER care is expensive. However, if a patient has no other options and needs to be seen,
they have no other choice. We need more Primary care doctors to give patients the
opportunity to be seen and treated in outpatient clinics on a timely and affordable basis.

Here in Utah we are fortunate to have a highly rated Medical School at the University
of Utah. When I applied to the University Medical School twenty years ago, there were
102 positions for the first year class and Utah had a population of about 2 million. Today,
Utah has a population of nearly 3 million, an increase of over 30%, but the Utah Medical
school class was recently reduced to 82 positions, about a 20% decrease. To better serve
our community, we must rectify this disconnect and see that our desperate need for more
physicians and providers is met.

This reduction in positions at the University of Utah Medical School has resulted in
a great “brain drain” in our community – where many bright and capable students are
forced to look outside the state for Medical School, often to never return. Increasing the
medical school class size would allow us to retain more students and train them locally.
Studies have shown that medical students often choose to stay and practice where they
are taught. To help solve Utah’s desperate need for more Family Care physicians, we
must expand the class size of our local Medical School.

I recently met with Dr. Vivian Lee, a leader at the University of Utah Medical School,
and discussed plans and funding to increase the class size back to at least the previous
size. Estimated costs would be $12 million dollars, with a portion of that paid in tuition
by students. These costs for the increase in the class size at the University of Utah are
actually much lower than comparable per-student costs in other states. Part of the reason
for the lower cost in Utah is that we already have existing classrooms and teaching staff.
It would be funding well-spent as we could retain more of our own local students and
train more needed doctors to serve our growing population.

As an emergency room physician and a concerned resident of Utah, this is one solution
that I hope to propose as a State Senator to help meet our ever increasing health care
access needs in Utah. This is a common-sense measure that will benefit Utahans
immediately and in the long run.

Dr. Shiozawa is a family physician and emergency room doctor who is
running for State Senate District 8. He can be reached at (801) 230-3406.

Dr. Brian Shiozawa
3177 E. Fort Union Blvd
Cottonwood Heights
(801) 230-3406

A Voice for the Voiceless in the Utah State Legislature

Autism Speaks is a national advocacy group representing the tens of thousands of parents across the nation who have children with Autism. Recently, Autism Speaks released a public service announcement highlighting the prevalence of Autism in our society with Tommy Hilfiger – a parent of child with Autism – providing the commentary.

Autism Spectrum Disorder (ASD) is a complex neurobehavioral disorder that affects thousands of Utah pediatric patients.  Nationally, it is estimated that 1 in 88 patients is affected by autism spectrum disorder.  The prevalence is estimated to be even higher in Utah possibly affecting 1 in 47 children.  Why this prevalence is so high is not clear.  What is clear is that autism is even more common than many diseases such as breast cancer or juvenile diabetes.  Autism has devastating effects on the patients physically, behaviorally and intellectually.  It is often associated with other specific disease such as gastrointestinal and lung diseases.  Autism has collateral emotional, physical and financial stress on their families.

As we study autism, we learn about its complex genetic and environmental causes.  There are some studies that suggest that it may be decreased with prenatal vitamin and folate supplements. So far however, we have no single definitive cause and so more medical research still needs to be done.  We have made significant progress in treatment. One effective, evidence based therapy is early diagnosis and early intervention such as Applied Behavior Analysis (ABA) on affected children.  There are clear improvements in those who receive this treatment. 

From a health care standpoint this is effective and high quality care.  From a fiscal standpoint, such prevention just makes sense.  With early intervention patients can have long lasting improvements in social interactions, communication and behavior.  This may avoid very costly long term care or even institutionalization.  Some patients even are able to move off the ASD spectrum with therapy and support.

Utah needs to re-evaluate the current health care insurance definition and coverage of Autism.   Autism is a real disease.  We need to define it.   We need to treat it just like we do other serious, long term afflictions such as diabetes and high blood pressure, for which we know that intervention has long term positive health and financial benefits. 

Parents and families should not have to face bankruptcy or foreclosure just to see that their children receive necessary treatments. We can and must do better as a society.

Previous efforts in the State Legislature have failed to fully address the problems that parents of children with Autism face in ensuring that their children are insured and receive effective treatments. As our next State Senator I will continue the dialogue and further the action surrounding Autism to see that it is fully addressed in the home, the clinic and in the Legislature.

Dr. Brian Shiozawa is a family physician and emergency room doctor who is running for State Senate District 8. He can be reached at (801) 230-3406.

Reducing the Costs of Defensive Medicine

Defensive medicine costs are a big deal. They add so much in terms of actual dollar amounts to everyone's bills, whether in the clinic or in a hospital setting. Many studies estimate that up to 20-40% or more of our medical bills are inflated by defensive medicine costs. Given the huge costs we face, reduction of these would help reduce medical costs a lot.

Even more, excessive and unnecessary tests are dangerous to patients. For example, an Abdominal CT scan adds up to 30-50 times the radiation exposure of an ordinary x-ray. Imagine the effects this could have on your body in terms of injury. And this is done just because a doctor is in fear of being sued.

Here is one way I propose to reduce defensive medicine costs: I am one of the two physician members on the Lt Gov. Task Force for Medical Liability reform. We are working on a specific plan to help patients and physicians resolve medical injury disputes more quickly and less expensively through face-to face early communication between patients and hospitals and doctors when a suspected medical induced injury occurs. We believe that this new system, already successfully used in Washington and Michigan, will enable resolution with fairer, quicker compensation and preservation of the doctor-patient relationship. This early resolution process is virtually cost-free compared to the traditional tort system that involves formal lawsuits and all of the associated attorney fees. We are going to test this at the Univ. of Utah and hopefully then at IHC and HCA, etc.  This system benefits and makes sense for all parties involved.

Here's another idea: I would like to explore further a "de facto" protocol for medical quality of care as well. This is a system wherein we develop specific evidence-based guidelines for quality of care. In other words, we would develop specific testing protocols for a condition like chest pain. Affected parties of patients, trial attorneys and physicians could review and agree to these ahead of time. These protocols would ensure the high quality care based on the best medical practices. It would maintain quality for patients and reduce unnecessary other unneeded defensive testing.

Reforming healthcare is an important priority for me. It’s a task that will require bipartisan cooperation, with lawmakers from both parties coming together to figure out what is best for Utah. I am confident that I can and will be an effective part of this process and a strong representative of SD 8 residents.

Decreasing Classroom Sizes

As a physician, I realize just how crowded our clinics and ERs can be.  Access to see a physician is very difficult on a same day basis, and so many patients resort to Urgent Care facilities or to the ER at their local/regional hospitals.  This is just not optimal care.  Patients and physicians begin the important health care encounter often as strangers.  Many times previous records are unavailable, and so each encounter literally starts from scratch.  This adds increased expenses as redundant or unnecessary tests are done, it adds risk to the encounter as patients are treated by someone who is unknown to them and important parts of their history may not be known, etc.  Quality of care suffers.

To address this problem, many clinics are adding mid-level providers such as physician assistants and Nurse Practitioners to their health care team.  This effectively expands the number of patients who can be seen each day and improves access and quality of care, as it reduces delays in being seen.

Today, our public school classroom sizes are growing and often overcrowded.  I often hear reports from teachers that their students are literally seated on the floor due to lack of space. Furthermore, we know that each year there are thousands of additional students added to the growing ranks of those currently enrolled.  An additional challenge is the increasing number of students for whom English is a second language.  As a result of the overcrowded classes and increasingly diverse student population, excellence in teaching and quality can suffer. Teachers, no matter how hard-working or dedicated, cannot care for these many students as they would like.  Such frustrating conditions lead to lower scores, teacher burnout and attrition of our best teachers.

One remedy would be to use “mid-level providers” in the classes as well.  We should explore using more teacher’s aides, who could assist the teacher and create a team approach.  The teacher’s aides (TAs) could be specialized in math, reading, art etc.  The TAs could then “functionally” decrease the class size and allow the teacher to focus on those who need particular mentoring.  Quality would improve.  Furthermore, teacher’s aides, both part-time and full-time, could be hired at lower cost than full time teachers and allow education budgets to be stretched more effectively. I have heard many reports that aides are also able to foster a better general atmosphere in the class with better communication, less disruptive behavior and in general a more organized and effective experience for the students and the teachers.

Education quality and funding and large classroom sizes remain at the forefront of our challenges as a State.  It is a challenge that we will need to address this upcoming Legislative session.  This is a realistic, practical solution that we can and should implement soon.

Civil Political Discourse

The other night, I attended the Murray Chamber of Commerce’s “Meet the Candidates Night”.  It was a great event and a great chance for the various candidates to introduce themselves and their platforms.  One of the questions I was asked had to do with negative campaigning, specifically from the Republican party criticizing two of the incumbent Democratic Representatives.  Both have served multiple terms in the House and are well-respected.  I was asked if this criticism was hypocritical as Senator Hatch has served even longer.

We have all been inundated with negative attack ads, at the national, state, and local levels. I think everyone is fed up with it--and rightly so.  It’s tragic that rather than positively describing our plans for how to improve government and solve the problems we’re dealing with, many politicians focus on perceived negative traits or unsavory past rhetoric of their opponents.  Most of this negativity flows from party affiliation, with Republicans pouncing on opportunities to attack Democrats, and vice versa.  This kind of campaigning distracts us from the big issues such as healthcare reform, jobs and the economy, and improving education. This kind of quarreling is anathema to the bipartisan cooperation that is essential to finding the right solutions to our nation and state’s very serious concerns.  It was immensely satisfying to observe, after months of negative ads from both sides, Pres. Obama and Mitt Romney speaking cordially and graciously to one another at the Al Smith Dinner recently.  They acknowledged each other’s families and individual strengths.  We need more civility, common sense, and respect in our political discourse.  That is the difference between politics and statesmanship.  

Thoughts on Public Education

Tonight we enjoyed a nice VoteShiozawa cottage meeting hosted by Gloria Johnson, in Cottonwood Heights.  We had an engaging discussion with many of her neighbors about a number of topics including last night's Presidential debate.  We also discussed public education and some current concerns. These include large classroom sizes and methods to remedy this.  One obvious solution is to hire more teachers.  However, the cost of implementing this fix would be up to tens of millions of dollars and could be cost prohibitive.  Another concept would be to use a "mid-level provider" much like we do in clinics and hospitals.  For example, many physician practices which are very crowded are using physician assistants (PAs) and Nurse practitioners to increase the number of providers and to increase the accessibility of the clinics to patients.  Patients under this plan have a much better chance of being seen on a timely, even same-day basis.  This has the other advantage of keeping many of them out of the very expensive ER setting.

So, consider doing a similar staffing model in the classroom using teachers aides.  Teachers aides could assist the classroom teacher, who could then both teach and supervise.  The individual students would get valuable and personal interaction, despite the large numbers in the classroom.  This concept would effectively reduce the classroom size and increase the face-to-face interaction with the teacher and the aides. Teachers aides would also be much less expensive to hire and could be specialized to teach important topics like reading, math, language, music and the arts, for example. 

We all recognize the importance of good, quality education. We also know that each year, the number of new students in Utah schools increases by 8,000-12,000.  This is both a blessing and a challenge. How can we handle the increase in students, maintain quality and achieve reasonable classroom size?  This concept of aides is one that we can and should pursue more.

Utah's Patient Advocate on the Hill

As many of you know by now, I have been serving our community as an Emergency Department physician for the past 20 years. Each day I have the opportunity to treat those who are sick or injured and work with them to improve their health and get them feeling better. 

As an Emergency Department physician my first and only priority is to help people get better. Each day I treat patients from all walks of life and from all social and economic backgrounds. I have firsthand knowledge and experience of the issues they face – not just with their health, but in trying to afford health care as well. I have seen too many instances where people have put off treatment – only to have their condition worsen – because they have been afraid of how much it would cost them to get better. 

That is why I have been actively engaged the past few years as a Patient Advocate up on Capitol Hill. As a physician, I am committed to helping patients improve their health. As an individual, I am committed to helping all of us receive more affordable healthcare. No one should have to put their health - and their family – in danger because of fear of the costs attributed with treatment. We can do better – we have done better –and we will continue to improve. 

 Recently, I have served as the President of the Utah Medical Association. This past session I worked tirelessly to see laws passed that truly advocated for patients. In fact, the last piece of legislation that was passed protects patients who struggle to pay for medications. 

As a physician, I prescribe medications that help to improve the health of my patients. However, studies show that a large portion of the prescriptions that physicians write are not filled, because patients cannot afford them. Too often, patients are faced with the dilemma of either paying for food or purchasing their prescriptions. This should not be the case! 

This past session I helped to pass legislation that puts patients first. Under our old law, doctors were only allowed to give up to 3 days of samples of medications to patients to improve their health. It was my great pleasure to advocate for patients in seeing the law change so doctors can now give free samples to patients for up to 30 days! Now, patients no longer have to face the difficult position of choosing between food and potentially life-saving medications. I helped to pass legislation that makes healthcare more affordable, saves patients’ money, and has the potential to save lives! 

My pledge to you is that I will continue to be a Patient Advocate on the Hill. All of us have been or will be patients. I will do all I can to ensure that you and I receive affordable healthcare. I have many innovative ideas that I will take to the legislature to improve our health care system. They include: 
• Increasing Patient Accessibility 
• Improving Healthcare Quality 
• Reforming Medical Liability 
• Improving and Reforming Medicaid 
• Lowering Healthcare Costs 

I personally have been blessed to work in the Emergency Department for over twenty years. I am grateful to treat patients, whoever they are, wherever they are from, to work hard and do the very best job I can. As a physician I recognize that I do not know everything but I act with patients' welfare in mind and in good faith. I am grateful to advocate for patients in the Emergency Department and will continue to do so at the State Legislature.

Passing On

My aunt died this past week.  I just returned from visiting with family who had gathered from afar.  Despite the sadness surrounding her passing, it was great to look at photos and reflect on her life as a daughter, mother, aunt and friend.  We reminisced about her career as a post-WWII Japanese American school teacher in a virtually all-white community.  It was great to talk with and hug cousins and others whom I had not seen for years and in some cases decades.  We re-connected about careers, children and our memories and hopes.  I even met some relatives for the first time.  The gathering was only for a few short hours, but it was great.

Afterwards, I reflected on this event.  I was sad because this is the final time in this life that I will ever see or touch my Aunt.  Frequently, in my job in the ER I treat dying patients and counsel and console their loved ones.  However, that is a more clinical and professional interaction.  This time it was personal.  This time it was me experiencing the separation and loss.  Experiences like this make life real.  This time made me more empathetic and understanding.

It was also a time for me to make some resolutions.  First, I resolved that I would strive to remember what a wonderful blessing it is to have family, no matter who they are, what they do or where they live.  There is something so special about the common ties of being related.  Next, I resolved that I would take time to visit face-to-face more with family.  Not just via social media--though this would be a good start--but actually to take time to visit their homes, open my home or even consider a reunion.  The last reunion with this branch of the family was back in the 80s. This is way too much time away from each other despite the typical excuses of work and our other activities.  Few of those activities which distract me away from family are nearly as memorable or rewarding.  Lastly, I resolve to serve more and to be served.  For example, I learned of physical illness, emotional hurts, and other problems that afflicted many family members of which I had not been aware.  I wish that I could have added what talents I have in helping them.  I did not know about their lives, and they did ask.  There is something that is enriching about serving others and being served by them.  It creates bonds that time can never break.

My aunt is gone.  Her memory remains and the lessons from her life will continue to enrich mine and the lives of my family.

Shout out to Mary Jo Naylor

I'd like to give a big shout out to Mary Jo Naylor for her excellence in teaching. It's because of great teachers like Mary that Utah's children have been given such a great start in life. Our education system depends upon and thrives because of people who do what she does. It's always satisfying when teachers get the recognition they deserve.

 Her frustration with class sizes that are too large is valid. This is something that lawmakers in Utah need to make a priority. The key to making this happen is definitely going to be funding. This is one of my campaign's highest priorities and I expect this will be one of the biggest priorities on Capitol Hill.

Response to "Desperate parents surrender autistic children to state custody"

My response to an article in the Salt Lake Tribune titled: Desperate parents surrender autistic children to state custody

"Autism is a real neuro behavioural disease. It does have many different presentations and degrees of severity. Some patients can be relatively high functioning, but as this article illustrates, many patients and their loved ones can be devastated for both the short and long term due to the many problems which are so destructive. Further, this disease is widespread with the studies showing up to 1 in 47 children afflicted. It may be even more prevalent. Families suffer in so many ways: financially, emotionally and physically. Unfortunately, due to the many presentations and due lack of primary training in this area, many physicians do not diagnose this condition early nor know the best ways to treat. Research is on going and treatments are evolving that promise to be more effective. 

 Clearly, early intervention can be very beneficial. But treatments can be and are expensive--as are too many areas of medical care nowadays--and often not covered by traditional third party insurance, so patients and their families are left to cope with the costs and go without or experience crippling healthcare related costs. I support increased research in the area of autism by our medical centers. We need to know more about causes and develop evidence based treatments. I encourage inquiry by our legislature into fairer and more effective ways to fund treatment of autism. Our current legislation in Utah is incomplete and we need together to meet as patients, families, insurers and medical providers to resolve this problem of recognition and under treatment of this condition." 

 Brian Shiozawa MD FACEP

Women's State Legislative Council of Utah

I had a great time at the Canyons District PTA event on Tuesday night at Jordan High School.  It was great to share my passion for public education with others who are concerned about our state's public education system.

Utah's Jobless Rate

Interpreting and attributing Utah’s jobless rate falling to 5.8% can be complicated, but one thing is clear: Utah is doing something right.  Governor Herbert calls it ‘wise economic stewardship and fiscal prudence’.  I agree, but will add that there is indeed something special about the people here in Utah.  I’ve lived in other parts of the country, and I’m impressed that there’s a special spirit of hard work, responsibility, and innovation in this state.  

Still, 5.8% is not something we should settle for.  Putting Utahns back to work is a priority for me.  

I’m an avid reader, and I stumbled across an interesting quote recently in a novel.  Two men are riding in a train out in the old American west, reflecting on their condition and their fare in life.  One expresses his regret at moving his family to the area.  He  was seeking opportunity, leaving behind a job that didn’t challenge or satisfy him.  He remarks, “I wasn’t makin’ anything back there, just working sunup to sundown on the farm.”  His friend replies “It will be the same here.  Wherever a man is, there is work to do.  That’s the very best part.”  

This response startles him, and he asks “The very best part?” His wise friend affirms, “The very best part.  My friend, there is a Hell.  It’s when a man has a family to support, has his health, and is ready to work, and there is no work to do.  When he stands with empty hands and sees his children going hungry, his wife without the things to do with.  I hope you never have to try it”.

I am not blind to the struggles that many Utahns have faced during this Great Recession--I see them everyday.  I treat them in the ER when they have lost their insurance from their employer and when they can’t afford to go anywhere else for healthcare.  I care deeply for these people, and I have solutions that will help create more jobs for Utahns.  

By electing me, you have the opportunity to be represented by a Senator with experience in healthcare and small business, a Senator who will always listen and respond and have a dialogue with you.  Vote Brian Shiozawa on Nov. 6th.

Politics Up Close: Senate Candidate Brian Shiozawa

Listen as I talk the issues with KCPW! This radio interview aired on Friday, September  21st.  We talk about healthcare reform, funding for public education, and the campaign to represent Senate District 8!

Politics Up Close: Senate Candidate Brian Shiozawa, The Tribune’s Thomas Burr

My Year in the UMA

Last Friday, I was joined by my wonderful family as I passed the torch of leadership of the Utah Medical Association to its new President, Dr. Brian Hales.  This was a bittersweet experience for me; I will miss my time as President, but I know that Dr. Hales has much to add in this new role.  I think this is an appropriate time for me to reflect on the things we were able to accomplish in the last year.

Here are a couple of legislative highlights:

House Bill:  this legislation which we advocated, was to allow physician offices the right to dispense free samples of medications for up to 30 days or longer, depending on medical necessity.  Previously, DOPL regulations prohibited clinics sending home more than 3 days worth of medications.  We recognize that patients often do not fill their prescriptions due to cost and studies have shown that over half of prescriptions are never filled thus putting the patient in significant danger.  By increasing this sampling time, doctors can  provide free medications, for a significant length of time, to patients who may not be able to afford them.

Another bill dealt with the treatment of cancer patients.  This bill allows oncologists and cancer clinics to treat patients at the time of service at the clinic with specific anti cancer medications provided at cost.  Previously, patients had to leave the clinic and obtain their oncology medications.  Often, patients are very ill from the disease itself or from the side effects of their treatments.  This bill helps patients to obtain these vital medications and then post treatment to go directly to their homes or rehab centers without the delay in getting their medications filled or ordered.

I really liked both of these bills as they truly helped patients.  

SJR 15 was a very important bill that I testified on before the Senate Committee.  In late 2011, a District Court ruling struck down protection of peer review in hospitals.  This ruling created the dangerous potential of limiting the frank and open discussion by physicians and  hospital personnel about patient complaints, injury and system problems. The result would be lack of discussion due to fear of litigation. This bill restored an amendments of the Rules of Civil Procedure, the confidentiality and peer review protection.  This restored the confidential review of cases in order to improve quality care.  Importantly, the bill did not limit the rights of the patient to their records nor inhibit their rights to litigation, if they choose.

Another rewarding role was to be the physician representative on the Utah State Medical Liability Reform Committee.  Chaired by Lt Gov. Bell, this committee has worked with many stakeholders including the trial attorneys, Utah Medical Association, Department of Health, etc. to consider alternatives to current medical liability system which is very problematic.  The current liability system is fraught with adversarial, hugely expensive legal proceedings which does not help the injured patient.  We are studying an early dispute resolution program as an alternative to the traditional tort system.  This program, if adopted would allow patients and physicians to communicate and resolve their disputes sooner and in a much more open and collegial manner.  Similar programs in Michigan have found much lower costs, fairer and quicker dispute resolution;  further, patients retain their ability to opt out to the traditional system if needed.

These are just a few of the legislative highlights of the past year for me.  It was engaging, and rewarding as we successfully advocated for patient care, public health and preserving the doctor patient relationship.

Healthcare Reform is an extremely important issue to me, and I hope to continue to fight for reasonable, bipartisan healthcare reform on Capitol Hill.  

Remembering 9/11

Today we remember with sadness the tragedy of 9/11.  We give thanks for all those who have and continue to give their lives for our great nation's freedoms.  May we never forget the lives sacrificed on that day, or the unity and somber pride we felt as Americans that day and every day since.

Like most Americans, I remember exactly where I was when I heard the news of that awful morning.  We were eating breakfast as a family when a call came on the phone to turn on the news.  I remember tears being shed as we held each other in shock and fear.

That night, we watched on television as the Cadets of the United States Military Academy at West Point held a candelight vigil, the first time in history that such an event was held for an event other than the death of a current Cadet.  Our oldest son, Brian, had just recently begun his first year of training there.  My wife, Joye, and I were proud of his decision to serve but we worried as we wondered what his military service might bring in the surely troubling and difficult years ahead.

Fortunately, this great nation has risen from the ashes of that tragedy.  We are blessed to continue to enjoy the freedoms espoused in our Constitution.  I am reminded of the lyrics of the beautiful hymn “America the Beautiful”:

“O beautiful for heroes proved

In liberating strife.

Who more than self their country loved

And mercy more than life!

America! America!

May God thy gold refine

Till all success be nobleness

And every gain divine!

O beautiful for patriot dream

That sees beyond the years

Thine alabaster cities gleam

Undimmed by human tears!

America! America!

God shed his grace on thee

And crown thy good with brotherhood

From sea to shining sea!”

Foundations

Something that has been on my mind a great deal recently is the idea of foundations.  The foundation of good public education is good teachers; the foundation of a good healthcare system is a strong doctor-patient relationship; the foundation of strong small businesses is fiscal responsibility; and as I’ve met with many people in District 8, I’ve been impressed more and more that the foundation of our society is families. Truly, nothing is more crucial to good society than strong families--in every form they take--producing good, contributing citizens.


So naturally, one of the most important commitments a candidate for state office can offer is to strengthen families. When families succeed, people succeed, and those people go on to solve problems they encounter in the world around them.

My campaign’s three primary focuses--affordable, bipartisan healthcare reform, improving public education, and providing strong support for small businesses--all serve to help families succeed.  I know this because these have all helped and blessed my family.

My wife, Joye, and I have been married for thirty years. She is the foundation of our family, and I owe my happiness and the happiness of our family to her. Together, we’ve raised our four children here in Utah and we can say enthusiastically that truly, ‘this is the place’. When we married, we faced the  uncertainties faced by all families--we didn’t know where work and child-rearing would take us, or what struggles we might face along the way.  Fortunately, we have been able to raise our family in Utah. Our children all attended public high schools in Salt Lake City.  Because of good teachers and good administrators, they were well prepared to enter college and begin pursuing the careers of their choice. Utah’s business-friendly environment has fostered a climate that gives them confidence in being able to find jobs and provide for their own families.  And through all of this, our high-quality healthcare system has kept them healthy and fit for the daily challenges of life.  Nothing has been so rewarding as to raise our children together in this great State, and that’s a feeling we share with so many great people in SD8.

But, these three systems--healthcare, education, and small business--require responsible stewardship.  The families of Utah deserve a government that will help public schools, hospitals, and businesses to better serve those who need and use them.  As a candidate to represent you and yours on Capitol Hill, you have my promise that I will always represent you effectively.  Your interests will be my interests. I will fight to make sure that your family’s needs are a priority.

Sign-Drop Blitz

We had a great turnout at our campaign sign-drop event today.  Support is growing and the word is getting out! Find out more about my candidacy at my website and get involved. Let's take this message of practical, bipartisan healthcare reform, support for public schools and small business all the way to Capitol Hill this fall!

Campaign Billboard

Check out our new campaign billboard as you drive north on Highland Drive near 6200 South!

Autism in Utah

I enjoyed attending the recent Autism Conference at Sugarhouse  Park.  Autism is a neuro- behavioral disease which has recently received increased attention locally and nationally.  There is an especially high prevalence of autism in Utah. The conference was well attended and very informative.  Even as a physician I learned a great deal, especially about the efficacy of early recognition and treatment.  Such early diagnosis and intervention by trained medical personnel can result in better outcomes and improved prognosis.  This can result in lifelong benefits of improved academic, behavioral and social functioning of the autism patient.  However, many patients remain untreated and under-treated due to lack of insurance or private funds by patient's families.  This  under-treated condition then becomes chronic, resulting in huge medical, social and long term economic costs, estimated to be 1.5-3 million dollars per patient.  This a huge, unaffordable, unsustainable burden to the patient, their loved ones and our communities.  Some families are forced onto Medicaid insurance due to the costs.

In Utah we have previously had legislation that addressed the recognition of autism as a disease and also insurance coverage.  However, we still have gaps in coverages.  The estimated increase in insurance costs resulting from treating autism, if any, would be relatively small.  The  long term health, social and economic benefits of early treatment to the patient, their families and to the community are very big.  It makes good sense on many levels to address a change in insurance to treat and prevent the consequences of this disease.  It is a common-sense measure for which I am proud to voice my support.

Support for Small Business

I am grateful to be both a healthcare professional and an owner of a small business.  This gives me the great blessing and opportunity to care for people and make positive changes in their healthcare and their lives.  I also appreciate how important it is to have a job and to be able to provide for my family and to provide jobs for others who work with me. 

When my grandparents immigrated to America, they embraced the great American Dream, which includes the freedom to choose a job or profession and then excel in it through hard work, education, and innovation.  This is what has made our communities, our state and our nation great. 

When I started at St. Mark’s Hospital over twenty years ago, we had a modest-sized Emergency Department staffed by five full-time physicians.  Since that time, we have grown our physician group to twenty-three physicians and now care for over 40,000 patients annually.  We strive to provide high quality healthcare and great customer service.  These are the same principles that make any small business successful and provide jobs for many. 

I understand the needs of small businesses and their employees.  I have had to make payroll through challenging economic times and find ways to improve efficiency and provide benefits and care for our fellow employees.  Recently, we merged our group with an even larger group so that now we cover nine hospitals along the Wasatch Front and employ over one hundred physicians.  Altogether this group cares for a significant fraction of emergency and hospitalized patients in this area. 

My experience as a small business owner will guide me to support small businesses throughout Utah as your next State Senator for District 8.  I believe in a balanced budget, fiscal responsibility, and efficiency in our government while providing the highest quality services to our citizens. 

I believe that small business is absolutely essential for the success and prosperity of our state and our country.  I am grateful to be a healthcare professional and grateful to our patients and customers for their trust.  As your next State Senator, I commit myself to represent you effectively and to see that your voice is heard in the Capitol.  I commit myself to supporting measures that will assist Utah’s small businesses as they provide jobs for Utahns, the most important issue in this election.

UPEA Endorsement

This week I was pleased and honored to receive the official endorsement of the Utah Public Employees' Association.  What a fine organization and group of people this represents.  It is hard to overstate the importance of the constituents of this group--our dedicated public employees who make everything run in this state.  The condition of our great State is a tribute to their great work.  I am proud to have the backing of this organization and will strive to represent all of Utah's public employees well if elected.

This endorsement reminds me that this campaign's message of bipartisan healthcare reform and strong support for small business and public education is precisely the message that is resonating with the people of Utah, particularly in Senate District 8.  Republicans, Independents, and Democrats alike are rallying together to see that their views and their concerns regarding these issues are represented fairly and effectively on Capitol Hill.  I am humbled and encouraged by the wonderful support I have received.  I am amazed by the quality of people and families that I have been privileged to encounter as I've been out walking precincts.  There is a reason Utah is the greatest state in this country, and the reason is its people.

I am looking forward to meeting more and more of the wonderful people here in Senate District 8 between now and November.  If you share our enthusiasm for healthcare reform and support for public schools, please get involved with the campaign by visiting voteshiozawa.com/index.php/volunteer.  Together, we can make the changes we want to see on Capitol Hill!

UEA Endorsement

I was pleased to receive the official endorsement of the Utah Education Association and the Canyons Education Association recently.  These influential organizations support our teachers and education system and I am grateful for their support in my campaign to strengthen our education system.

This fall as we embark on a new school year, with an ever-increasing student population, it is a huge challenge to keep our class sizes reasonable and provide adequate funding to maintain excellence in our teachers and their curricula.  We need strong education to launch our students into their careers or higher education.  We are blessed to have a hard-working, young population which attracts business to the state of Utah and which fuels our own economy.  However, in order to maintain this excellence we need to provide the adequate funds and oversight to continue our tradition of strong public education.

This will be one of the big priorities of our legislature in the upcoming legislative session.

My experience in Health Care Reform

This past legislative session, as the President of the Utah Medical Association, I was involved in sponsoring legislation that supports patient advocacy, public health and preserving the doctor–patient relationship.

Here are some highlights:

We were able to enact legislation that increased the amount of free samples that doctors could give to patients from a three-day supply to a month or more.  The effect of this bill will help patients receive medications that they might not otherwise afford and that are vital to their health.  On a similar note, we were able to get legislation passed that allows cancer specialists to dispense cancer-treating medications directly to their sickest patients at the office, at cost to the patient. 

The Utah Medical Association also supported legislation to require minors to have a guardian approve their obtaining tanning at local salons.  This requirement will protect youth from excessive UV radiation that has been shown to increase cancer risks.

Another important patient quality measure that we supported restored confidentiality to the ‘peer review’ process.  ‘Peer review’ allows physicians, nurses and other members of the health care team to meet to discuss patient quality care issues and have those issues protected. The legislation, which had strong bipartisan backing, does not hide or obscure patient complaints or errors and does not interfere in the discovery process. This allows for frank and open discussion and is vital to patient quality improvement.

These are some examples of the important advocacy for patients, the public and for the healthcare team that I am pleased to support.

Grassroots Campaign Kickoff

Had a great turnout and great time tonight at our Grassroots Campaign Kickoff at my home.  It is wonderful to have many fantastic supporters and to get the ball rolling throughout the district. Here are some pictures from the event:

Did you see my ad on page 2 of the recent edition of the Valley Journal?

Get Involved!

Had a wonderful fundraiser last week! Many thanks to our many supporters who are helping make the campaign a reality.  

As I've met and talked with more residents of District 8, I'm impressed by the great ideas I'm hearing about needed changes at the state level in education, health care reform, and the need to balance our budget and meet the financial needs of a growing population.  

As a campaign we are going door-to-door and attending public events such as Butlerville Days and the Midvale Harvest Days parade. This is giving me many opportunities to meet and talk with the great residents of this area.  We're enjoying bipartisan support for my solutions to these pressing issues.

I invite you to join with us as we campaign this fall until the election Nov. 6th.  We have many opportunities for you to get involved.  We have a great message and real solutions to the problems Utah faces.  I would love your support!

Affordable Health Care

As an Emergency Physician, I am concerned about the effects of the Affordable Care Act (ACA) on Utah.  I agree that we need affordable health care available to all citizens.  We also need better access for patients.  However, a couple of observations: 

First, Utah currently has about 13% uninsured patients.  Most of these patients have no regular physician.  Currently, due to the EMTALA laws, any person seeking emergency medical care must be seen and treated in the ED at any time without regard to their ability to pay.  This effectively provides a safety net for them.   However, the safety net can entrap patients:  the care is episodic and the patient is often discharged without a primary care doctor relationship.  It is not ideal. Further, ED care is the most expensive outpatient treatment available.  Pres. Obama noted that each ED bill exceeds a thousand dollars or more.  This is NOT affordable or sustainable health care. However, thousands of uninsured Utah patients utilize EDs each month, because they have nowhere else to go. 

Next, under the SCOTUS ruling Utah will choose if we embrace expansion of Medicaid  eligibility.  According to the Dept of Health, the Utah Medicaid expansion under the ACA will provide health insurance to 100,000 or more currently uninsured Utah patients.  This will provide much needed insurance and it will cost millions of tax dollars.  Further, currently Utah is already underserved in Primary care and many specialties.  We do not have enough physicians for our existing patient population.  Adding thousands more to the Medicaid insured pool of patients will further crowd existing clinics and systems.  As a result, Medicaid patients who according to State Medicaid officials already over utilize EDs, will increasingly seek care in EDs due to limited Primary care access. 

The SCOTUS ruling will also affect those currently with private insurance.  The popular provisions such as additional coverage of patients to age 26, elimination of pre-existing conditions, and other modifications has and will raise insurance premiums.  Many patients will opt to use higher deductibles, health savings accounts and other methods to keep their costs down.  In order to save money, these patients may not visit their physicians as much, and get sicker and then, end up in the ED with even more serious conditions. 

From the emergency medicine view, implementation of this far-reaching law will be complex and challenging.  Here are some solutions I propose for increasing affordable and timely medical care: 

Restore the existing University of Utah Medical school class size to at least one hundred students a year.  Cutting class size was short sighted and this needs to be remedied this coming year. While a longer term solution, it will keep more talented Utah college students here and provide for physicians in the future. 

Increase Utah Medicaid community clinic staffing with more same date and weekend appointments.  This will provide lower cost, timelier access for patients and decrease ED over utilization by Medicaid and other patients. Primary care physicians would lead teams of mid level providers, nurse practitioners, etc. to expand affordable access while ensuring quality of care. 

Use coordinated care counseling in the EDs to educate patients on preventative medical care and appropriate utilization, communication and continuity of care with their primary care physicians. 

Encourage insurers and hospitals to establish lower cost urgent care hospital clinics as an alternative to full emergency care. 

Expand community clinics for substance abuse and psychiatric counseling and care.  Currently, thousands of such patients are treated in EDs, each year, due to lack of outpatient facilities. These clinics would be a more effective, lower cost resource for and an alternative to the EDs.  Further, the jails and corrections facilities could also use such clinics and decrease the recidivism rates of their inmates.   

In summary, we are in a crisis regarding health care and reform.  The SCOTUS interpretation of the ACA is both a threat and an opportunity.  How we deal with this will make all the difference.