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. 

Energy in Utah

With gas prices on the rise to record heights, America’s energy independence has never been more of an issue than it is in this election.  Working class Americans are struggling with rising costs all around them: not only is gas more expensive, so is electricity, and with those increased costs, all basic commodities such as food are becoming more expensive.  These prices are subject to numerous factors, and there is no silver bullet that can or will completely alleviate these rising costs.

A topic that arises constantly in the discussion on energy is drilling for oil.  This is particularly important for Utah residents because of the vast amounts of oil and gas considered to be contained in Utah lands.  A recent report by the Government Accountability Office estimates that in the Green River Formation shared by Utah, Colorado and Wyoming, some 3 trillion barrels of recoverable oil lie untouched--that’s enough to power our nation’s vehicle fleet for two hundred years.  Unfortunately, the fact that the majority of these resources are currently under Federal control has taken the choice to develop these resources out of Utahns’ hands.  The benefits that come to a state that utilizes resources like oil are significant.  Similar oil extraction programs are underway in Arkansas, Texas, and Pennsylvania, creating thousands of jobs and adding billions of dollars to these respective states’ economies.

Another hot topic this year is nuclear energy.  The Blue Castle Project near Green River, Utah has polarized the debate.  Those for this new nuclear power plant cite its substantial increase in electric power generation in state.  Detractors are concerned about the large consumption of water from the Colorado river involved as well as the possible effects of a meltdown.  The reality is we need energy and our population is growing.  And there are environmental consequences for all types of energy: nuclear power brings with it the risk of meltdown and concerns regarding waste disposal; hydroelectric power comes at the expense of rivers; traditional coal-derived electricity inherently pollutes.  We must strike a balance of meeting our population’s needs while addressing these real and important consequences.  My son Robert was serving as an LDS missionary in Tokyo, Japan at the time of the historic Fukushima meltdown following the devastating tsunami in Sendai.  My wife Joye and I know firsthand the worry and concern that come with having loved ones in the path of such disasters.  Accordingly, safe implementation of sources of power such as nuclear is a high priority for me.  If the Blue Castle Project is to go forward, it must be accompanied by a specific and safe plan for disposal of waste as well as measures to prevent possible meltdowns.

There are basic policies that our government must practice in order for us to best serve American families that are trying to weather these trying times:
1. First and foremost, ensure the safety of Utah residents.  Dangerous and irresponsible development of energy resources, however profitable, must be discouraged.  
2. Be wise stewards of the environment.  The development of nuclear power in Green River must be carefully considered for its long-term effects, and all pros and cons must be weighed.
3. Use the resources available to us.  Promote the continued development of fossil fuel and renewable energy sources throughout the state.
4. Where necessary, take back Federal lands that rightfully belong to Utah so that Utahns can reap the benefits of responsible development of energy resources.

Together, we can take important steps that will help Utah safely and responsibly utilize our abundant natural resources.