American Academy of Pediatrics, District II, New York State
Positions on Pending Legislation in New York State
Memo of Opposition for A.592
Expanded “Religious” Exemption from Immunization
January 17, 2012
Contact: Elie Ward, Director of Policy & Advocacy
eward@aap.net
518-441-4544
The American Academy of Pediatrics, District II, New York State, representing almost 6,000 pediatricians across the state, opposes A592. This bill will expand the ability of parents to claim a “religious” exemption to avoid immunizing their children.
New York State already has religious exemption legislation and a functional regulatory structure. Families who have true religious issues with immunization, can, and do meet the tenets of their religious beliefs within the context of current law. If there are problems with the implementation of the current law and regulation in specific school districts, then those problems should be addressed and resolved.
This bill however, has very little to do with religion. Rather it provides an option for an exemption without clearly stating the decision basis for such an exemption. It is to all extents and purposes a philosophic exemption, since a parent need only state that they are opposed to immunization for “religious” reasons. Every state that has implemented a philosophic exemption has seen a reduction in the percent of children immunized.
Taken in any other context, this bill would allow a person to say that their “religion” doesn’t allow speed limits therefore they don’t need to obey the speed limit; or their “religion” provides for carrying a concealed weapon at all times and therefore they can do that. And all they would have to do, if this legislation was more broadly applied, is self attest to their “religious” belief re speed limits or concealed weapons.
Civil liberties are an important part of our lives, but civil liberties and social responsibility are always held in balance by the concept of public good. That is why, although we have free speech, we cannot yell “Fire” in a crowded public place, unless, of course, there is a fire.
Universal immunization is a public good. Families who participate in other public goods, such a public school, day care, summer camp, play groups need to take the responsibility to immunize their children so that all children are protected. Immunization works to protect all children through the concept of herd immunity. No vaccination is 100% effective in every child. Protection is afforded through universal immunization which offers protection because most children are immunized, therefore disease cannot spread. If we allow parents who are afraid of vaccination, those who are persuaded by anti-scientific information on the internet, those who believe that somehow vaccines cause all kinds of problems, to decide that their “religion” allows them to reject immunization, then children who are medically fragile and cannot be immunized for medical reasons, or children who are the younger siblings of those in groups and have not yet been immunized will be open to infection. We will allow herd immunization to be breached.
Public and private efforts over the last two decades have resulted in the eradication of most childhood diseases from our state and our country. Parents who chose not to immunize their children have every right to make that decision. But they do not have a right to include that child in public school or group day care, where their lack of immunization has the potential to cause harm to other children. Parents who chose not to immunize can also chose to home school. Or if they are part of an unrecognized religion that rejects immunization, they can come together with other families who are of the same faith and start a school to educate their children.
Here in New York State we have had recent outbreaks of measles and of whooping cough. All of our children are just one plane ride away from infection if we do not assure that all children are appropriately immunized against childhood diseases which in the past have maimed and in fact killed our children.
We are firmly opposed to this insidious and dangerous legislation and urge you to soundly reject it.
Immunization has been one of this country’s greatest public health successes. We cannot allow overconfidence to weaken our children’s safety net and once again have to care for children disabled by measles and polio, and other crippling childhood diseases. The children of New York are depending on you to help keep them safe.
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Memo of Opposition
A593
January 17, 2012
Contact: Elie Ward, Director of Policy & Advocacy
eward@aap.net
518-441-4544
The American Academy of Pediatrics, District II, New York State, representing more than 5,000 pediatricians across the state, opposes A593. This bill is not required. We have no reports of physicians being overruled or challenged by school districts in the rare instances where they request a medical exemption from immunization requirements for child patient. If pediatricians are not asking for or supporting this legislation, a good question would be, who is supporting this bill and why are they doing so.
New York State already has adequate protections for physicians who have child patients for whom immunization is not medically appropriate.
If there are problems with the implementation of the current law and regulation in specific school districts, then those problems should be addressed and resolved. But, again, we have not gotten any reports from our members across the state that this is a problem.
Universal immunization is a public good. Immunization works to protect all children through the concept of herd immunity. No vaccination is 100%. Protection is afforded through universal immunization which offers protection because most children are immunized, therefore disease cannot spread.
Here in New York State we have had recent outbreaks of measles and of whooping cough. All of our children are just one plane ride away from infection if we do not assure that all children are appropriately immunized against childhood diseases which in the past have maimed and in fact killed our children.
This is not a problem across the state. And it does not require legislation redress.
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Memo of Support
A.02474A
January 17, 2012
Contact: Elie Ward, Director of Policy & Advocacy
eward@aap.net
518-441-4544
The American Academy of Pediatrics, representing more than 5,500 pediatricians across the state supports A.02474/S.3186 providing legal support for physicians to negotiate with insurers for fair service and reimbursement contracts.
Due to the current imbalance of negotiating power in favor of the managed care plans, physicians are offered take-it-or-leave-it contracts by health plans that can significantly hamper their ability to provide quality patient care. These contracts often permit burdensome processes and unjustifiably long wait times for obtaining pre-authorization to provide needed patient care; impose limitations on whom a physician or other health care provider may refer a patient for necessary care; permit demands for refunds of payments long after the time that such payments were originally made; permit health plans to make major changes to key elements of a contract without physician consent; and cede to physicians and other health care providers the legal consequences for patients harmed by health plan utilization review decisions.
Right now, the playing field in health care contract negotiations strongly favors large managed care plans and disempowers physicians to represent the needs of their patients.
By allowing independent contractor physicians and health care providers to conduct some collective negotiations while being closely monitored by the state, this bill would give physicians greater ability to advocate for patients in contract negotiations. This bill would also create a system under which the state could closely monitor those negotiations, and any negotiations involving fee-related matters would only be permitted when an individual managed care plan controls a substantial share of the managed care market. This legislation would not authorize strikes or boycotts of health benefit plans by physicians.
We fully support A.0274/S.3186 because we believe it will not only help improve health care, it will also create an equitable partnership between health care service providers and large managed care insurers across the state. This legislation will have the ultimate effect of improving patient care and keeping more highly skilled physicians in New York State.
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Memo of Opposition
A654
January 17, 2012
Contact: Elie Ward, Director of Policy & Advocacy
eward@aap.net
518-441-4544
The American Academy of Pediatrics, District II, New York State, representing more than 5,000 pediatricians across the state, opposes A654.
This bill is not required. Nurse Practitioners currently practice with agreements with physicians, usually pediatricians or family physicians. We have not received any indication that physicians and nurse practitioners disagree on medical exemptions from vaccination. In fact, in the last few years many prohibitions, especially egg based concerns, have been lifted as evidence based research has proven conclusively that many former contra-indications for immunization exemption or delay can and should be reversed. We have no reports of disagreements between nurse practitioners and the physicians with whom they work, in the rare instances where they request a medical exemption from immunization requirements for child patient.
If there are problems between certain physicians and nurse practitioners, then those problems should be addressed and resolved within the confines of their practice agreements.
Universal immunization is a public good. Immunization works to protect all children through the concept of herd immunity. No vaccination is 100%. Protection is afforded through universal immunization which offers protection because most children are immunized, therefore disease cannot spread.
Here in New York State we have had recent outbreaks of measles and of whooping cough. All of our children are just one plane ride away from infection if we do not assure that all children are appropriately immunized against childhood diseases which in the past have maimed and in fact killed our children.
This is not a problem across the state. And it does not require legislation redress.