President’s

The Legislative Process or Annapolis Antics

Richard T. Scholz, M.D. 

The legal advocacy aspect of local medical associations and Med-Chi is arguably the most salient and important role that organized medicine has in supporting public health, the practice of medicine, and patient’s rights in Maryland.  The legislative process can be so complex as to discourage involvement by the average citizen but is at the heart of our democratic government. 

Maryland has a bicameral (“two rooms” or two houses – House of Delegates and Senate) legislature that meets for 90 days from early January until April.  The Maryland General Assembly (its formal title) is comprised of 47 senators and 141 delegates from 47 legislative districts.  Twelve of the senators and 33 of the delegates are lawyers or 24% of the General Assembly.  Now that Andy Harris has left for Congress, Delegate Dan Morhaim is the only physician in the Assembly (.5%).  

The General Assembly meets in the Maryland State House which has the distinction of being the oldest state capitol still in continuous use and is the only state house to have served as the nation’s capitol, which it did from November, 1783 until August of 1784.  It is here, in the old senate chamber, that George Washington resigned his commission as commander-in-chief of the Continental Army.  This is considered to be a seminal event in the formation of a democratic republic in the United States as he voluntary relinquished power when he could easily have become king or dictator due his popularity, indeed, adulation by the people.  Recent events in the world at large illustrate how uncommon the voluntary ceding of such power is.  It is also where the Treaty of Paris which ended the Revolutionary War was ratified.  The old senate chamber is preserved and is worth a trip to see. 

About 2,500 bills are introduced each year and those that have any relevance to medicine are culled from the others each Friday by the legislative staff of Med-Chi and our Lobbyists, The law firm of Schwartz, Metz and Wise.  These are divided into three categories – bills that pertain to public health, boards and commissions, and health insurance and are referred to the three eponymous sub-committees.  On Sunday, these committees each have a conference call to discuss the bills and make a recommendation to support the bill, oppose it or to take no position. Each Monday night, the Legislative Council of MedChi meets in full session at the Med-Chi headquarters and each bill is discussed and voted on based on the committee’s recommendation.   

The bills may be simply rubber stamped by the full council if there is nothing controversial about them or there may be heated (and sometimes prolonged) debate by the group at large. Sometimes the bills are tabled until further information is obtained or referred to other committees for re-evaluation. It is here that sometimes specialties are at odds – the debate over ownership of radiotherapy and imaging devices by physicians for whom radiation therapy and radiation are not their primary focus of practice comes to mind.  Issues of personal ideology may also play a role such as ones point of view about the best way to deliver health care (single payor, private insurance, strict fee-for-service, etc.) abortion and the like.  Other controversies may be the extent to which public health laws should infringe on personal liberty (motorcycle helmet laws, smoking in cars with young children, and insurance mandates – requiring insurance companies to cover certain drugs and procedures).  Many bills are so complex that it requires the legal skills of our lobbyists (all three of whom are lawyers) to interpret the intent of the bill and its potential effects on medicine.  Sometimes, even they are unsure.  

It is this committee that when I first attended impressed me with the dedication of the members.  It takes some interest and motivation to go to downtown Baltimore on freezing cold winter nights and eat deli sandwiches for dinner all through January and February. Physicians come from as far away as Western Maryland and the Eastern Shore to attend these meetings. 

The bills are opposed or supported actively by our lobbyists but also by the efforts of individual members of MedChi who take the time to contact or meet with representatives in Annapolis or elsewhere.  MedChi and component societies also buy tickets to fundraisers for selected representatives and actually attend them in order to forge personal relationships with legislators.  Obviously a representative will pay more attention to someone they know when contacted about bills than an anonymous voice from the crowd.  Sometimes members testify on certain bills before house or senate committees.  (I did this during an attempt two years ago to strengthen the apology law in Maryland.  I waited forever to testify but was rewarded by being present for one of the rare times when the governor testified before a committee - on an unrelated matter). 

As in any such process there are tedious, boring times punctuated by exciting victories and interesting controversy.  The Assignment of Benefits legislation was an unexpected and last minute victory of great significance.  All of us remember the special session to deal with the malpractice crisis several years ago.  Conversely, there are bills that are low profile that may have great impact on public health or the practice of medicine. 

This constitutes my next to last message in our newsletter as Carol Ritter will be assuming the role of President on March 10.  I would urge all of you to attend as this is a fun event with excellent food! 

It has been an honor to serve as president.  I do, of course, wonder if my presidency has been a positive event for the BCMA, but  I have no doubt that it was immensely beneficial to me because of all the wonderful people that I met and all that I learned about organized medicine in Maryland and the United States.