Candid with the Gubernatorial Candidates (PA Physician – Fall 2014)

Don’t forget to vote on Nov. 4, 2014!

Tom Corbett (Republican) Residence: Shaler, Allegheny County Occupation: Governor of the Commonwealth of Pennsylvania

Tom Wolf (Democrat) Residence: Mount Wolf, York County Occupation: Chairman and CEO, The Wolf Organization,

As Pennsylvania physicians vote for a governor this fall, they should be aware of each candidate’s views on health care issues in the commonwealth. To help assess the candidates, PAMED asked each candidate to share his opinions on five issues that will affect physicians and patients during the next four years. Here are their responses.

Pennsylvania Physician: We believe that physicians who provide emergency care face unique challenges that merit higher standards in liability protection. Would you support legislation setting the standard of clear and convincing evidence of gross negligence to find liability in emergency care?

Corbett: I believe that Pennsylvania must continue to examine methods of reforming our medical liability system. The Fair Share Act—which I signed into law in 2011—was a positive first step in eliminating an environment that fostered rising health care costs and out-of-control medical liability insurance.

In addition, working in partnership with PAMED, I am proud to have enacted the “Apology Rule” in 2013. This legislation enables a health care professional to express empathy for an unexpected outcome without fear of admitting fault.

While we have made significant strides in enhancing Pennsylvania’s liability protections over the past three years, there is still work to be done. Clear and convincing evidence of gross negligence appears to be an appropriate legal standard to protect our practitioners and attract talented physicians to our emergency rooms. I would welcome an opportunity to examine whether that standard could be implemented while preserving access to appropriate remedies when an incident occurs.

Wolf: I believe our policies need to fairly balance and protect patients’ safety while ensuring emergency medical care providers are able to effectively fulfill their responsibilities. I think reviewing how the Supreme Court’s changes to [Pennsylvania] rules of Civil Procedure and the Mcare Act have impacted medical malpractice insurance rates, and patient safety will help us explore ways to address any imbalances. If, after thoroughly looking at the issues, there is a problem, then I will work with key stakeholders to propose a legislative fix.

PP: Given the significant disparity in training between physicians and other practitioners, PAMED is focused on promoting the physician-led team. Do you support the concept of the physicianled team as an alternative to scope-of-practice expansion and independent practice by allied health practitioners?

Corbett: I am not convinced that the expansion of scope of practice—such as for nurse practitioners or other practitioners—is the proper route to address our workforce shortage for primary care needs. Physician-led delivery offers promising cost consolidation in service delivery and enhancements in patient outcomes. I would have concerns about efforts to further compartmentalize service delivery unless the efforts could be justified with clear data.

Wolf: I believe that we need to promote health care systems that are focused on the needs of patients. I know it requires a team of experts to work collaboratively to address the complex needs of patients. That is why I have called for the expanded use of Patient- Centered Medical Homes as a tool to improve health outcomes for residents across the commonwealth.

PP: Attracting physicians to work in Pennsylvania—particularly in underserved areas—has been difficult. Do you support expansion of the Primary Health Care Loan Repayment Program and increasing the level of loan repayment in that program?

Corbett: Yes. I believe it is incumbent upon state government to ensure that all Pennsylvanians—regardless of geographic region—maintain access to quality, affordable health care. It is for this reason that my HealthyPA proposal continues supporting loan-forgiveness programs designed to provide primary health care practitioners with incentive to work in underserved regions of the commonwealth.

Wolf: Yes. As Governor, I will dedicate additional state funding to expand the number of primary care physicians who can participate in the state’s debt-relief program for medical professionals and increase the number of residency slots for primary care doctors. This additional funding will allow Pennsylvania to keep primary care doctors in the state by offering a loan repayment program that is competitive with other states. [Also,] it will allow us to increase the number of physicians working in Pennsylvania—especially in rural and underserved areas.

PP: Would you sign legislation that bans noncompete clauses and restrictive covenants in physicians’ employment contracts?

Corbett: Such a law to ban noncompete clauses would face a long road in the General Assembly; I do not foresee such a measure—which would involve the commonwealth interfering in the private affairs of service providers and their employers—navigating the legislature in the current or upcoming legislative session. A more effective measure would be outreach and education to new physicians, such as information with which to approach [the] “standard contract” stances of employers, limiting the duration and geographic scope of noncompete clauses, and [the] wherewithal to negotiate appropriate buyout clauses.

Wolf: I know we need to make Pennsylvania an attractive place for all workers. And I know that there are places in the commonwealth that are struggling to attract high-quality health care providers. As Governor, I will coordinate a multiparty discussion with my Insurance Secretary, Health Secretary, General Counsel, and Labor Secretary, along with outside experts, to fashion an understanding that works for all parties in this area and puts patients’ access to quality care first.

PP: Please comment on your No. 1 health care priority.

Corbett: The No. 1 priority of my administration with respect to health care policy centers on providing all Pennsylvanians with access to quality and affordable health care. My HealthyPA proposal is designed to achieve this goal by focusing on three key tenets:

  • Increasing Access. Increase our investment in primary health care practitioners, and promote recruiting and retaining health care professionals in underserved regions of the state.
  • Ensuring Quality. HealthyPA continues to protect older Pennsylvanians and individuals with physical disabilities by ensuring they receive the treatment they require and deserve.
  • Providing Affordability. HealthyPA will realize $125 million in savings from the implementation of the Medicaid Reforms and Private Coverage Option contained within our waiver application with the federal government.

Wolf: My No. 1 health care priority is to expand Medicaid and improve access to high-quality medical care for residents across the commonwealth. Governor Corbett’s HealthyPA is just another move by his administration to direct taxpayers’ dollars to private companies at the expense of hardworking Pennsylvanians.

As Governor, I will expand access to Medicaid, which will increase health care coverage to nearly half a million Pennsylvanians, save the commonwealth millions of dollars, and pump billions into the state’s economy.