Health

Detect and Prevent

Health of Individual
Some Of My Health Care Agenda

Tanning Beds
I am a dermatologist and I am very interested in the health of the individual. It is one of the foremost reasons that I am running to replace our current representative. Dermatologists know that tanning bed exposure by young people is causing malignant melanoma and other skin cancers due to the dangerous ultraviolet light (UVL) required for tanning. Dermatologists only recent political activity in Michigan has been trying to get legislation, which has been enacted in other states, to prohibit persons under the age of 18 from using commercial tanning beds. My short proposed legislation prohibiting persons under the age of 18 from using commercial tanning beds. On Dec, 18, 2015, the FDA issued proposed regulations that would ban individuals under the age of 18 from using commercial tanning beds. It is important that Michigan law prohibits people under the age of 18 from using commercial tanning beds in order to enforce the proposed FDA ban.

Covid-19 and Public Health Policy
Hopefully, covid-19 will not be a problem when this election takes place in Nov., 2022. However, the public should know where I stand on public health policy concerning covid. I will support the directives of our public health officials. They are the experts on public health,

Dr. Fata
In Michigan House District 45 (Rochester Hills) Dr. Fata fraudulently and criminally treated over 550 patients, most with poisonous chemotherapy. Tom McMillin and Michael Webber the recent term limited house reps were very quiet on this serious breach of medical care in their district. They should have been the ones leading the effort to make sure that there will not be future Dr. Fatas. Michael Webber's glaring lack of leadership abilities certainly failed this district in the time of their greatest crisis. Look at all of the protests and demands for action by Flint's reps due to the crisis in Flint because the state did not protect the people in Flint. The State of Michigan was informed about Dr. Fata in 2010, and allowed him to practice medicine until he was arrested by the feds in 2013. We do not know what the state did concerning the complaint filed against Dr. Fata in 2010 because the inadequate investigation is sealed due to privacy rules. Who was responsible and why? We should know what was done in order to facilitate changes to protect the public in the future. The responsible state agency stated that not enough was done concerning the Fata complaint, and steps have been taken so it will not happen again. What Steps??? Citizens of Michigan and especially the house rep of district 45 should not be complacent on this issue. I want to know how we will be protected from future Dr. Fatas. I want transparency and accountability at state agencies. There should be an appeals process of complaints that is handled outside of the medical licensing board. More has to be done to protect the public and quality of life in Michigan.

Drug Overdose Deaths
Drug overdoses accounted for 1,745 deaths in Michigan in 2014, 2,335 deaths in 2016, and 2743 in 2020 as the upward trend continues. Opioids such as heroin laced with fentanyl and painkillers are the big killers.

In December, 2017, a new law was signed which required physicians to have a “bona fide” relationship with a patient who is prescribed a narcotic. The physician must use the Michigan Automated Prescription System (MAPS), which keeps track of opioid prescriptions and is time consuming to use. Hopefully, this will decrease narcotic prescriptions.

Cheap heroin despite high demand indicates that too much of it is on the streets. More has to be done to clean our streets of heroin. Active heroin addiction should be classified as a severe emotional illness and public health problem that requires mandatory inpatient treatment and long term outpatient treatment. Heroin addiction is very hard to cure in spite of very good and intense treatment. The opioid antagonist naloxone (Narcan) should be an over the counter (OTC) product so that it is easy to obtain. The saying, an ounce of prevention is worth a pound of cure, certainly applies to this problem.

Legionnaire's Disease
The public was not informed of the spike in cases of Legionnaire's Disease and resulting deaths in Flint (Genesee County) in 2014 and 2015 until January of 2016. The health officials responsible for protecting the public covered up the outbreak of the deadly disease. At the time of the outbreaks no proper investigation was done to determine and eliminate the source of the bacteria, and now it is too late. Subsequently, there have been excuses and finger pointing among agencies that are suppose to protect the public. In 1996 Oakland County saw a spike of the disease, quickly investigated, identified, and decontaminated the source. The Macomb County Health Department publishes monthly updates and totals for several years of reportable disease information on its web site. As a member of the Macomb County Medical Society I see it on the last page of their bimonthly journal Macomb Medicus. Would the results in Flint have been different if the Genesee County Health Department had to monthly publish up to date reportable disease information on its web site and actively inform the public? Should this be mandated by law? Should new protocols be mandated for what public agencies should do when this type of problem is identified? More has to be done to protect the public and quality of life in Michigan.

Tobacco 21 for Michigan – Ban Cigarette Sales To Individuals Under 21 Years Old
The path to tobacco addiction starts at a young age and the deadly consequences are well known. California enacted legislation on May 4, 2016, becoming the second state that will not allow individuals under the age of 21 to buy cigarettes, electronic cigarettes, and other tobacco products. Military personnel may continue to buy tobacco products if 18 or older. Hawaii was the first state with similar laws and some cities including New York City have a similar tobacco ban. Ann Arbor and Genesee County have passed Tobacco 21 laws, but are not in force due to over riding Michigan State law concerning the sale of tobacco products. Hopefully, this will get the entire state of Michigan on the same path. It is predicted that the long term health benefits from these laws will be enormous. I feel that Michigan should quickly follow California, Hawaii, and now Ann Arbor and Genesee County in raising the legal age to buy cigarettes and other tobacco products to 21.

San Francisco voters approved on June 5, 2018, by a 70 to 30 percent margin a city ban on selling menthol cigarettes and flavored e-cigarette liquids to decrease smoking and attracting younger smokers. Michigan should have a similar ban.

Protect Patients From Fee Gouging

Fair Taxation of Health Insurance Premiums and Medical Expenses
There is a tremendous disparity in health care in Michigan concerning whether health care is paid with pretax or after tax dollars. Those who self pay with after tax dollars incur a much higher expense.

I would like all medical expenses to be treated equally. Michigan should allow all medical expenses that can be listed on the Federal 1040, Schedule A (and not limited by the 10% rule) to be subtracted from gross income prior to calculating the state income tax.

Two Tier Office Visit Co-Pays Not Fair
There is a disparity in office visit co-pays. Many health insurance policies have a two tier level of co-pays depending on what type of physician is seen. The out of pocket co-pay is higher when a specialist is seen and lower when a primary care physician is seen. The insurance company is dictating who the patient should see based on the differential in office visit co-pays. The insurance company is penalizing the patient based on the patient’s choice of physician, which is not right. The patient will incur the expense of two office visits if a primary care physician is initially seen because the patient is trying to save money based on office visit co-pays, and then a specialist has to be seen. The insurance company’s payment to the physician is based on the level of the office visit billed, and is not specialty based. I will sponsor legislation to prohibit this health care disparity.

Health Insurance Benefits In An Easy To Read Format
Health insurance benefits should be stated to subscribers in a standard easy to read format that can be presented to health care providers.

Rules For Paying Claims
Health insurance companies should not be allowed to formulate their own interpretations of medical billing codes in order to avoid paying claims.

Medical Malpractice
The current medical legal climate (ie. current tort laws known as Tort Reform) must be maintained and improved in order to contain medical costs. I have proposed that the Michigan Constitution be amended in order to preserve Tort Reform by giving certain powers concerning civil suits to the legislative branch that are now currently held by the Michigan Supreme Court. Physician fear of medical malpractice suits must be alleviated in order to reduce the expensive practice of defensive medicine.

Medicaid
I applaud Gov. Synder for approving the expansion of Medicaid in Michigan under the Affordable Care Act better known as Obamacare. The Act gave states the option to expand Medicaid.

Affordable Care Act (Obamacare)
The Affordable Care Act is about 2,000 pages of Federal legislation, and a huge complex topic for the president, senators, and members of congress. State government does not formulate this type of health care legislation, but I will be happy to discuss my views. I am for a single payer healthcare system, but this will not happen for a long time due to a lot of reasons. Therefore, my first priority with the current system is to make all self paid medical expenses a subtraction from income item prior to calculating income tax at the state and federal level in order for everyone to receive the same, equal, and fair tax treatment concerning their medical expenses.

Freedom of Choice, Competition in Health Care, Cost
The patient will receive better care when the patient is able to choose physicians and health care facilities. The government and private insurance should not unduly restrict the patient's choice. Providers of health care will give better care and value if they are in competition with each other concerning both quality of care and price. The cost of prescription drugs should be controlled through more mandated competition among drug companies, and regulation at both the state and federal level.

Ascension Hospital
Ascension Hospital is house district 55's hospital, and a tremendous asset of the community. What is good for Ascension has to be considered by the house rep from district 55.

Licensing of Physicians
The practice of medicine is undergoing profound changes. What does it mean when you see that your physician is licensed to practice medicine in the state. The license does not mean that the state acknowledges that the doctor is a specialist. In Michigan a physician must renew the license every three years. The requirement of 150 continuing medical education (CME) credits must be met. This equates to the physician participating in roughly 150 hours of approved medical education activity hours every three years. The state does not dictate the content of CME or test the physician when the medical license is renewed. What about medical specialty board (MD and DO) exams which are very rigorous in showing competency concerning knowledge of the specialty, and are now required periodically by all medical specialty boards. The medical specialty boards also set tough ongoing educational and quality assessment requirements to qualify for taking the periodic exam. The requirements, programs, and exams by the medical specialty boards are called Maintenance of Certification (MOC). MOC is time consuming, expensive, and stressful to the physician. Should Maintenance of Certification if met supersede and replace the current state CME requirement for medical license renewal if desired by physicians on an individual basis? That is what I propose. A physician should not be burdened and stressed out by having to meet two sets of educational requirements.

Physician Stress, Burnout, and Right2Care
Physician stress and burn out is real and increasing due to a number of factors. More government and health insurance companies rules and regulations, recent change to ICD-10 coding, electronic health records, electronic prescriptions, Physician Quality Reporting System (PQRS), Maintenance of Certification (MOC) by medical specialty boards, MACRA, and financially penalizing physicians concerning compliance of the above are factors that are stressing out physicians and leading to burnout. Although proponents of these best practices(?) feel that they are improving patient care, the sum of what is being done is overwhelming the physician and increasing the cost of medical care. This could be detrimental to patient care in the long run. MOC requirements as stated above are causing much stress and anxiety among physicians. This has resulted in the action by Right2Care. It has proposed legislation in Michigan that would prohibit insurance companies and hospitals from terminating physicians who do not meet the standards of MOC. This is a complex problem with no easy solution. More information and opinions are needed from all sides and the public concerning this issue. Regardless of your position on what Right2Care proposes it is a sign that physicians are stressed out.

Merging of MDs and DOs
There were historical differences between DOs and MDs, but at this time both groups practice similar medicine. MDs and DOs practice together in your hospital. The two groups are slowly merging concerning residency training, specialty board exams, and professional societies. Should the two separate Michigan state licensing boards of MDs and DOs be merged?

Physicians Assistants, Nurse Practitioners
These licensed healthcare professionals play an important role in delivering healthcare. However, they are not licensed physicians and should not practice independently of direct on site supervision of a licensed physician.

Guns
Guns kill and are a major public health issue. Guns cause many homicides and even more suicides because of their lethal impact. Guns cause much grief and the public pays an economic price. However, guns are legal with rights to ownership firmly established by the Second Amendment. U.S. Supreme Court rulings in 2008 and 2010 upheld the principle of the right to own a gun in the home for personal protection. The rulings left room for federal and state governments to regulate guns and rules for ownership. The right to stun gun ownership for personal protection was upheld by a 6 to 2 ruling of the U.S. Supreme Court in 2016. In that ruling the Court stated that the right to bear arms includes weapons not in existence in 1791. In an important ruling on June 9, 2016, the 9th U.S. Circuit Court of Appeals (California) concluded that the Constitution does not grant citizens the right to carry concealed firearms outside the home. The decision, Peruta v. San Diego, is likely to be the last word on this litigation. On June 20, 2016, the U.S. Supreme Court left in place Connecticut and New York state law that bans the sale of certain types of assault guns and large capacity magazines.

In my opinion more guns mean more killings and suicides. In March, 2016, Jamie Gilt the Florida mother, a strong advocate for guns and the Second Amendment, got shot in the back with her own 45 by her four year old son who was sitting in the back seat of her car. Are more individuals protected by guns or harmed and killed by guns? What can be done? Has the government's power to regulate guns, gun transactions, and deny some individuals the right of gun ownership reached its legal limits? American history, culture, law, tradition, attitude, violence, and the number of guns in the U.S. indicates that very little can be done to control or eliminate this serious public health issue. Certain types of guns and accessories were not designed as personal protection firearms, and have been involved in deadly mass shootings. I enjoyed watching Ted Cruz have fun firing assault weapons and machine guns at a firing range. A very good demonstration why these types of weapons and large capacity magazines should be restricted to firing ranges. However, at the active shooter awareness discussion at the Royal Park Hotel on January 27, 2016, the speakers indicated that prohibiting potent firearms would not reduce mass shootings because a shooter will use another available weapon. The shooting in Las Vegas proved that the speakers, especially Sheriff Michael Bouchard who told me after his presentation that he would not ban large capacity magazines, were very wrong about allowing military type weapons on the streets. The military type weapons the Las Vegas shooter used enabled him to kill and wound vast numbers of individuals. Again, these types of weapons must be banned. The audience favored more severe and enforced penalties for gun violations. I will advocate for that approach. I feel that property owners have the right to prohibit guns on their property. Michigan has good laws concerning gun ownership. However, loopholes concerning pistol permits and registrations should be eliminated. Some long guns should require permits and registrations. Shooters such as the one in Kalamazoo should be examined to determine if something could have been done to prevent those shooting deaths.

With recent U.S. Supreme Court decisions the legalities concerning the Second Amendment and gun ownership have been firmly established. I agree with the recent Peruta v. San Diego ruling, and U.S. Supreme Court approval of state laws that ban the sale of certain types of assault guns and large capacity magazines. I would like Michigan's gun laws to be more like California, which bans assault weapons, large capacity magazines, and reduces concealed carry permits by requiring “good cause” for concealed carry. Citizens have Second Amendment rights to control who owns guns, type of guns, and how and where they are allowed outside of the home. I would like fewer guns in the community.

Abortion - No More Back-Alley Butchers
I was a medical student at the University of Michigan in the mid 1960s. At the time it was in most cases illegal to perform or have an abortion. I accepted the law until exposed to the consequences. In the 1960s it was estimated that over 1,000,000 illegal abortions were performed every year in the U.S.A. The illegal abortion policy was a failure, and women suffered. Many of those illegal abortions were performed by the back-alley butchers. In the ER during Ob-Gyn training at Wayne County General Hospital I saw the results of their work. Everyday sick hemorrhaging, infected, and septic women with a history of having fallen down the stairs and packed with dirty smelly bloody rags were treated. I would tell my mentors that the police should be called and the butchers prosecuted. Nothing was ever done. The response was, The case was not severe enough to get the police involved. Besides, the victims were not talking. I saw the same scene in the ER during my internship at Sinai Hospital of Detroit except the patient was more middle class.

Twenty years latter I asked a neighbor who was a board certified Ob-Gyn physician and a Catholic why he performed legal abortions. Some women need abortions, he replied. It was scary when his home was picketed during a time when other abortion providers were being gunned down.

Abortions are now a legal outpatient procedure usually without side effects and safe. The current licensing requirements in Michigan for abortion providers and clinics are adequate. The abortion patient should be treated with respect and dignity, and not be harassed and pestered. Abortion data indicates that in the U.S. 1,608,620 abortions were performed in the peak year of 1990, and an estimated 1,000,000 abortions were performed in 2013, and subsequent years. The decline in abortions is mainly due to fewer unplanned pregnancies, because the total number of pregnancies (live births plus abortions) has declined yearly since 1990 in the U.S. Fewer unplanned pregnancies are due to better use of birth control and a decrease in teenage sexual activity. A second factor is the decline in the rate of abortions compared to live births, which Right To Life feels is due to their activities. I do not approve of their legal harassment and pestering of the abortion patient. Although birth control does not work all the time the use of birth control and making it a health insurance benefit will reduce the number of abortions. I favor easy access to birth control pills by not requiring a physician visit or a traditional prescription. Planned Parenthood and similar facilities reduce the number of unplanned pregnancies and promote women's health. I fully support Planned Parenthood. About 1,000,000 pregnant women in the U.S. will need to have an abortion this year. It is their legal right to have an abortion, and they are entitled to unencumbered high quality medical care in their community. I do not want to go back to the days of the failed policies that treated women poorly and the back-alley butchers.

Environment, Climate, Global Warming, and Health
In the history of our planet a species has recently become aware of the fact that they are damaging mother earth. Other species have previously had profound effects on their surroundings, but some Homo sapiens are the first to have the cognitive ability to scientifically gather the facts and formulate the concept of cause and effect. What is the politics behind conservative Republicans denying global warming? Living better is a complex human endeavor of using earth's resources, but not killing the goose that lays the golden eggs. The environment must be protected from too much adverse human activity for good health for all.

Lead Poisoning

The Flint Water Crisis raised the awareness of the dangers of lead poisoning. The standard for allowable exposure to lead should be as close to zero as possible for all citizens of Michigan. Drinking water has to be monitored and pipes replaced where indicated. Old lead paint in homes built before 1978 is still a significant problem, especially in the older sections of our cities where this lead becomes fine lead dust that is inhaled. These cities are aware of the problem and have programs in place to minimize the risks. The state should help with the funding. What about your home if built before 1978. Was lead paint used? If the answer is yes is the paint still firmly stuck to the wall or becoming fine dust? How will you know the answer to these questions? I am concerned!!!

Unacceptable Today

I grew up in Flint in a good house built in 1924. I would assume that it had lead paint. It had a steam heating system with radiators. The furnace and steam pipes were covered with asbestos wraps. The furnace was originally coal, but I remember oil. We were more advanced than the neighbors who were still burning coal. I remember coal trucks, coal chutes, coal bins, coal shovels, coal stokers, cinder pickup, dirt, and the foul air. It was difficult to take a decent shower because of the terrible water pressure due to corrosion and sediment build up in the pipes. The pipes were replaced in the early 1950s. The plumber showed me the old pipes. They barely had an opening. All the new pipes were copper joined together at the joints with a generous amount of lead solder. The shower had great water pressure. The water was straight out of the Flint River. The sewer was the old style combining sanitary with storm. The old pottery sewer pipe did not drain well because tree roots grew into it. The plumber was there on a regular basis to snake out the sewer drain. That crock of pottery for a sewer pipe was replaced in the mid 1950s. Flushing was then without fear of a backup. My older brother earned a PhD in toxicology from the U. of M. He says, Just think as kids we loved and survived playing with mercury. It was shiny, heavy, flowed very well, beaded nicely, and coated pennies well for a nice shine. My mother lived in our home for 62 years. All of my sibs are thriving.

Ted Golden, M.D. Supports the Michigan State Medical Society's Legislative Priorities

Keep Citizens Healthy
Citizens have a responsibility to stay healthy for the good of society. Healthy behavior and life styles should be promoted and rewarded. The state must do more to keep its citizens healthy. It costs everyone a lot of money to treat unhealthy people. As a physician I believed that it was my duty to treat anyone who sought my services to the best of my ability regardless of who they were or their ability to pay. I enjoyed being able to give my patients good health. I believe in the dignity and sanctity of the individual, and so should the state.

Ted Golden, M.D.

Leads to this

Support Ascension Hospital

Unfair taxation of self paid medical expenses more likely to cause

Shooter's AK-47 and two attached 30 round capacity magazines used in Feb. 1, 2018, twin murders in Taylor and Pontiac. Then fired at Michael Bouchard's deputies. Fortunately, this time deputies return fire downed the shooter before more were killed.

Physician.

Dr. Ted Golden has been a member since 1974. Does MSMS support Dr. Golden's Health and Health Care Legislative Priorities?

Dr. Ted Golden has been a member since 1974. Does MSMS Support Dr. Golden's Health and Health Care Legislative Priorities?

Too much of this

Abortion.

Protect!!!

A major health hazard. In 6 minutes on Feb. 14, 2018 this type of gun killed 17 and wounded 17 at a high school in an up scaled Florida community.