Doctors Rail Against Licensing Fee Increase Despite Medical Board Insolvency
People dying because they can’t afford insulin. An older couple choosing to end their lives together in a murder-suicide because they can’t afford medical treatment. Patients going bankrupt because of surprise out-of- network medical bills.
These are sad but true stories of healthcare in America.
So it was shocking, to say the least, when doctors on the Medical Board of California were outraged when it was announced at the last quarterly meeting that their license fees would have to be increased or else the agency would soon be broke – or, as the executive director said, “insolvent.”
The outlook sounded dire. Executive Director Kimberly Kirchmeyer pointed out that despite an anticipated annual budget of $75 million for this fiscal year, and $78 million anticipated for 2020/2021, it was still not enough to keep the Board financially viable. That is, unless licensing fees were raised.
Reaction from the doctor board members was swift, especially from those who also belong to the California Medical Association, the doctor lobby group whose primary purpose is to protect physicians’ financial interests. Former CMA president Dr. Richard Thorp, one of the new board members, immediately claimed that increasing fees was unfair to doctors, saying, “There should be some other recourse to this rather than be handcuffed and held captive.” The other former CMA president on the Board, Dr. Dev Gnanadev, called for a report on how much other states charge their doctors for licensing fees, suspecting that California could be overcharging.
So just how much does California demand for a license to practice medicine? No one could say initially. None of the doctors on the Board apparently knew. Someone finally looked it up: $783 for a two-year renewal fee. That breaks down to a mere $1.07 per day. Pocket change, really. Plus, these licensing fees have not been increased for 13 years – not since 2006.
And what was the proposed increase? While no final decision has been made, Kirchmeyer estimated that the higher fees could be between $1050 and $1150 for two years. If the Board went with the higher figure, that would still make the daily cost of a medical license in California only $1.57 per day. That’s definitely less than a cheap cup of coffee, a gallon of gasoline, or a glass of inferior wine.
The reason given for the license fee increase and the Medical Board’s financial woes was the Attorney General’s office, which had announced it was raising its fees after ten years. Beginning September 1st, the AG’s office will increase the hourly rate for attorney services from $170 to $220, which is an increase of 30%. Paralegal fees were also going up a surprising 71%, from $120 to $205 per hour, and auditor fees were almost doubling. While the Medical Board members did not begrudge lawyers a higher salary, they were definitely upset with the new paralegal pay.
It was embarrassing to watch these Board doctors whine over such an insignificant increase in fees. From the way they were acting, you would think they had been asked to relinquish 50% of their income, instead of a measly $1.57 per day.
Not one doctor asked how this budget shortfall would affect patient safety and the Board’s ability to investigate patients’ doctor complaints. Only Board member Kristina Lawson, J.D. asked how the agency would be able to fulfill its obligation of consumer protection, but that question went unanswered.
It was odd that the Board as a whole seemed to be blind-sided by this fee announcement. Don’t they read the materials for the meeting ahead of time?
Finally, Californians are used to paying more for everything from housing to gasoline to even Girl Scout cookies. Why would a few extra cents a day to practice medicine rankle this Board? Given that California has more doctors than any other state (140,000 total, 115,000 living here), it makes sense that it would cost a tad more to regulate all of them. Besides, if more doctors behaved, the Board would not have to investigate so many for infractions like personal addictions, overprescribing opioids, sexual misconduct, and DUIs. (Gross negligence such as surgical errors make up a smaller percentage of disciplinary cases.)
It was disheartening to see this Board more concerned about a possible 50-cent a day licensing fee increase than the financial viability of this regulating agency. Perhaps they need to re-evaluate the reason they applied to the Board. Are they really interested in protecting the public – or more focused on protecting doctors? It was obvious from this meeting that the safety of California consumers is a low priority compared to physicians’ wallets.
Despite all this whining, any increase will still have to wait until next year to find out whether the state legislature will need to authorize one. Until then, we will have to wait and see whether the budget problems affect the Board’s ability to protect Californians from dangerous doctors.