ustxtxb_obs_1974_07_05_50_00009-00000_000.pdf

Some connections PHILIP OVERTON AUSTIN Legal Counsel, Blue Cross-Blue Shield Vice-President, Blue Shield Legal Counsel, Texas Medical Association Registered Lobbyist, Texas Medical Association Law Offices, Overton, Pickens, and Stone FRANKLIN “ACE” PICKENS AUSTIN Legal Counsel, Blue Cross-Blue Shield Legal Counsel, Texas Medical Association Registered Lobbyist, Texas Medical Association Legal Counsel, State Board of Nurse Examiners Law Offices, Overton, Pickens, and Stone SAM V. STONE AUSTIN Legal Counsel, Texas Medical Association Registered Lobbyist, Texas Medical Association Legal Counsel, State Board of Medical Examiners Law Offices, Overton, Pickens, and Stone DR. JOSEPH PAINTER HOUSTON Chairman, State Health Advisory Committee on Comprehensive Health Planning Board of Directors, Blue Shield Chairman, Executive Committee, Texas Medical Foundation President, Board of Directors, Texas Medical Foundation Past President, Texas Medical Association Council on Tax-Financed Government Programs DR. CHARLES B. DRYDEN WICHITA FALLS Texas Medical Association President, 1973-74 Board of Directors, Blue Shield Executive Committee, Texas Medical Foundation DR. JAMES HALLMARK FORT WORTH Board of Directors, Blue Shield Board of Directors, Texas Medical Foundation DR. JOHN SMITH SAN ANTONIO Board of Directors, Texas Medical Foundation Executive Committee, Texas Medical Foundation Texas Medical Association Council on Medical Legislation DR. N. L. BARKER PARIS President Elect, Texas Medical Association Board of Directors, Texas Medical Foundation State Board of Health Names of Blue Cross-Blue Shield directors and legal advisors taken from 1972 and 1973 annual reports to the State Board of Insurance. Names of Texas Medical Foundation directors taken from 1971 articles of incorporation. Names of Texas Medical Association officers taken from lists provided by the Texas Medical Association. Names of Texas Medical Foundation Executive Committee members taken from correspondence in the Department of Public Welfare files. caid. According to Dr. Bellinger, the principal content of her orientation was a series of lectures on the evils of socialized medicine. No time was given to discussions of the responsibilities of the physician in upholding the standards of the profession. The concerns of the Texas Medical _Association were focused on politics, economics, and maintenance of the holy concept of “fee for service,” which means that no doctor should accept a fixed salary for his work. For the Texas Medical Association, professional standards were reduced to a question of preserving an economic base of control. In her practice in San Antonio, Dr. Bellinger took in many patients who could not afford to pay for services, and she often found herself in the position of having to exert pressure to try to get those patients admitted to hospitals. As a result, she also found herself repeatedly called before committees of her peers for professional review. Sometimes she was even subjected to review for procedures performed by the specialists to whom she referred her patients. The ,second physician willing to speak publicly about the pressures which organized medicine brings to bear upon those who disagree with its philosophy was Dr. Walter,,,Faggett. In testimony delivered before. U.S. Sen. Philip Hart’s Subcommittee on Antitrust and Monopoly, Dr. Faggett said, “There is a peer review board in most local medical societies which does monitor the standards of medical practice. It is interesting that I am probably at risk in testifying, in terms of my own personal relation to the local medical society, as evidenced by the fear of some local physicians to testify because of possible reprisals in the form of difficulty in obtaining licenses, exhaustive review of hospital charts and. Blue Cross-Blue Shield reports and similar methods. There are other ways in which a physician’s services can be subject to pressures by organized medicine, especially from the viewpoint of a specialist who must depend on referrals from other physicians in order to practice. This climate of fear and reprisal is contrary to progress.” TALES OF physicians’ fears of harassment were not entered into testimony before the board of Texas’ DPW when it .was considering TARP. The board did hear objections to the contract on the grounds of conflict of interest, as well as questions concerning fiscal management. The board was read a letter from Rep. Lane Denton of Waco which requested the DPW “demand detailed information about the developmental contract” between Blue Cross-Blue Shield and TMF. The letter Went on to’.itemize those elements of the TARP proposal that Denton thought deserved attention. He pointed out that “the cost of the developmental agreement to TMF is estimated to be $177,300, but the DPW does not have a copy of a budget for the 90-day developmental period.” Dr. Phil Gates, director of medical services for DPW, has still not received that budget, but he was willing to argue before the board on behalf of the contract. \(In conversation, Dr. Gates explained that he has great confidence in TMF Executive Committee Chairman Dr. Joe Painter. Dr. Painter, as former chairman of the TMA Council on Tax-Financed Medical Programs, helped Dr. Gates win TMA support for DPW’s hearing aid program. Dr. Denton also raised the question of whether other groups, besides the DPW, might buy and use the TARP program. He had been informed that “TMF may, in the future, offer private insurance carriers, and other governmental programs such as CHAMPUS [the insurance program for military dependents] and Medicare, TARP-type utilization review as a private ; enterprise of the TMF.” The board did not-f pursue the question of whether tax mon might be used to develop a marketa product. Blue Cross has a history o