By Stephen Follansbee, MD and Steve Heilig, MPH The California Medical Association can be a formidable force in Sacramento health policy. The CMA House of Delegations meeting, scheduled for October this year, is the opportunity for physicians to guide the CMA on important issues and set the priority for these efforts. Your elected SFMS delegates have introduced a roster of policy resolutions to be debated at the meeting. As your representatives, we thought you might like to see what we will be addressing – along with the many other resolutions introduced from other delegations throughout the state. The SFMS is a relatively small but relatively “loud” presence each year, with a good track record of successful policies; here is our list. In November we will publish a scorecard on what we were able to get adopted; and then the real work begins in the halls of politics, translating these words into something that benefits patients, the public, and physicians all over our state – and beyond as some of these would then be referred on to the AMA. SFMS Proposed Policies for 2011 (authors in italics): Reduction of Subsidies of Tobacco in Films ( Fung ): Did you know that the movie industry gets big tax credits for filming, including when they portray tobacco use? UCSF researchers have shown this is true – that taxpayers subsidize tobacco marketing, in effect – and we hope to stop that. Unethical Rebates from Pharmaceutical Companies ( Susens ): Some drug makers still offer money to doctors who prescribe their products. Some doctors take that money. This is against ethical codes and we hope to stop that. Deceptive Pregnancy ‘Crisis/Counseling’ Centers ( Lopato ): As reported in the Chronicle , certain “clinics” are in fact “pro-life" centers which seek to divert women from considering abortion with misinformation and fear. We would require full disclosure of what is and is not offered at such places. Regulation of Electronic Cigarettes ( Fouras, Aragon ): These nicotine delivery devices may have their place as harm reduction, but they need more regulation for both users and the public, and this resolution would require that. Supporting The California Cancer Research Act ( Margolin ): The CRCA will be on the ballot, increasing tobacco taxes for cancer research, and we ask the CMA to join the full-court press to help it pass in this "no new taxes” era. Clinical Research - Banning "Seeding" and Similar Marketing Trials ( Susens ): Pharmaceutical companies do marketing in the guise of “research” even after the medication is approved, with unwarranted cost and safety implications; we hope to stop that. Healthy Food Marketing for Children ( Desai, Schickedanz, Udovic-Constant ): The obesity epidemic too often starts in childhood, and better “selling” of healthy food is indicated; this would encourage that on various fronts. Opposing Legal Prohibition of Circumcision ( Tabas ): This intrusion was blocked from the state ballot, but will likely be back, and we want CMA and AMA on record in opposition for next time. Firearms and Censorship ( Follansbee ): Another intrusion, courtesy of the gun lobby, prohibits Florida physicians from even talking with patients about the risk of guns in the home. We hope to stop this there and before it spreads. Contraception as a Fully-Covered Health Insurance Benefit ( Silverman, Desai, Myers ): This has now been adopted as national policy, but attempts to overturn it are already promised. We want CMA and AMA on record in support of full coverage. Increasing Organ Donation via Presumed Consent ( Follansbee, Margolin ): The waiting lines for organs get longer, and more people die while waiting. It is time for some changes in organ policy and we are asking CMA to weigh in, based upon evidence, ethics, and what some other nations are doing. Clinical Sense and Costs at the FDA; Generic vs. Brand Medications ( Susens ): When a generic medication mysteriously goes back to “brand," and the price skyrockets, that seems wrong, and we think the FDA should take a closer look. Vision Screening for School-Aged Children ( Leung ): Too much pediatric poor vision is missed, and schools may be a good place to screen for that and refer to early intervention. Emergency Department Overcrowding ( Maa, Curran ): When emergency departments get too crowded, some hospitals have “triaged” based on financial considerations. That’s not good; there must be better ways, and we'll ask CMA to try to find them. As you can see, it's a full and diverse roster. As already mentioned, there will be much more from other delegates around the state; any CMA member can propose a resolution, and perhaps we can help you bring good ideas forward next year. As for this year, stay tuned. Stephen Follansbee is an SFMS past-president, chairs the SFMS delegation to the CMA, and is an infectious disease specialist at Kaiser San Francisco and a clinical professor at UCSF. Steve Heilig is on the SFMS staff.