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20 Hartford Business Journal • August 10, 2015 www.HartfordBusiness.com OPINION & COMMENTARY EDITORIAL Mileage tax no way to pay for transportation overhaul S tate lawmakers may hold a special session this fall to adopt funding mecha- nisms that will finance Gov. Dannel P. Malloy's ambitious $100 billion, 30-year transportation overhaul. Among the proposals that could be on the table is a mileage tax, which would tax residents based on how much they drive. To put it plainly a mileage tax is a bad idea, particularly if the gas tax remains intact as well. A mileage tax, which hasn't yet been adopted by any state (for good reason), could take various forms but most likely would hit the pocketbooks of most or all Connecticut drivers. That would further increase the cost of living in a state already well-known as being one of the most high-cost states in the U.S. We understand that if Malloy's trans- portation agenda — which includes investments in highways, rail, bicycle paths, airports and seaports — is going to come to fruition, the state will need to raise additional revenues, but there are better, more strategic ways to do it. For example, instead of whacking all Connecticut drivers with a mileage tax, why not put tolls at our state's borders and transfer some of the tax burden to out-of- staters? Yes, we know tolls aren't popular among the electorate, but strategically, they could lessen the need for more wide- ranging tax hikes. Another option more suitable than a mileage tax could be congestion pricing, which would charge drivers a fee for using express lanes on Connecticut thorough- fares burdened by major traffic problems. At least that would give drivers some added benefit for the extra costs they are paying. It could also ease rush-hour bottlenecks. The Transportation Finance Panel has been asked to provide financing recommen- dations to state lawmakers by mid-October. We understand they have a very difficult task. Trying to generate an extra $100 billion in funding will be impossible without rais- ing new revenues from somewhere. The fact that gas-tax receipts, which are a primary funding mechanism for transportation in Connecticut, are declining as more people purchase fuel-efficient cars makes the task even harder. But adopting a mileage tax seems to be more controversial than other options that will be considered. In fact, that's a key reason no other state has gone down the path of fully embracing a mileage tax. Oregon is currently piloting a program that taxes drivers 1.5 cents per mile driven. The state is asking for 5,000 volunteers to join the program by installing in their vehicle a mileage recording device. So, not only are drivers burdened by higher costs to drive their vehicle, but they also have to bear Big Brother overlooking their odometer. That rings of government intrusion of privacy. Malloy's transportation agenda is laudable, but if it significantly adds to the already high-cost of living and doing business in the state, then lawmakers have a duty to deter- mine if the ends truly justify the means. After all, what good are new roads and bridges if there aren't enough people living in the state to use them? n OTHER VOICES State medical society still has important influence By Robert D. Russo and Matthew C. Katz W ith apologies to Mark Twain, reports of the death of organized medicine have been greatly exaggerated. In a recent HBJ article ("Healthcare con- solidation means waning influence for medi- cal societies") two Hartford-area physicians shared their opinions and perspectives about organized medicine and the role of the medi- cal society in today's practice environment. Connecticut is not the only state facing membership challenges in a rapidly-evolving healthcare environment. Medical societies across the country — states, counties, locals, specialties — are all confronting these issues. As the state's largest medical association, CSMS has members in every county, every specialty and every practice model. We con- sider all Connecticut physicians to be potential members, and we do not limit our activities to a certain type of practice or employment status. In terms of legislative and regulatory influ- ence, CSMS physician advocacy isn't limited to just one or two bills during the months of the legislative session. Our work goes on throughout the year, and has an impact on physicians at every stage of practice, in every specialty, in every county. In Hartford, CSMS has repeatedly and suc- cessfully led efforts to defeat bills that would worsen the state's already-bad medical liability environment. CSMS physician leaders were invited to participate in the Bipartisan Roundta- ble on Hospitals and Healthcare, co-chaired by Sen. President Martin Looney (D-New Haven) and Sen. Minority Leader Len Fasano (R-North Haven) and many of the concerns our physi- cians raised were addressed in the package of bills introduced by the two senators. In addition, CSMS-supported legislation passed for opioid overdose prevention, youth athlete concussions, e-cigarettes, pediatric vision screening, and network adequacy for insurance plans. From a regulatory perspective, CSMS repre- sentatives sit on a broad range of state boards and councils: the All Payer Claims Database Advisory Board, the Tobacco and Health Trust Fund Board, the CT Nutrition Council, the CT Public Health Association, the CT Cancer Coalition, and the CT Immunization Coalition. Each of these groups affects the health and well-being of Connecticut residents, so having this consistent physician presence is critical. CSMS physicians are active participants in the state's Concussion Task Force and the Department of Social Services' Medic- aid Advisory Board. CSMS is continuing its collaborative efforts with the Department of Public Health (DPH) on issues of childhood obesity, nutrition and domestic violence. CSMS physician leaders serve as members of the State Innovation Model (SIM) project, which administers a multi-million dollar federal award to expand primary care, provide greater consistency in quality, and promote value for the healthcare dollar. CSMS has representatives on the SIM steer- ing committee, Equity and Access Work Group, Health Information Technology Committee, Practice Transformation Task Force and Quality Council. During last fall's Ebola crisis, CSMS worked closely with DPH to coordinate the sharing of updated clinical guidelines, patient monitoring, office preparedness, and other critical safety information for physi- cians across the state. CSMS is making a difference in less well- known areas of health care, too. As part of a multiyear research project, CSMS is examin- ing the significant racial and ethnic disparities in Connecticut hospital readmissions. Our findings have been published in peer-reviewed medical journals, and presented at national medical meetings. CSMS has used the research to develop innovative and effective cultural competency programs for physicians. In addition to identi- fying the problem, CSMS is committed to find- ing solutions to these disparities. In February, CSMS hosted a symposium bringing together patients and patient advo- cates, physicians, nurses, and other stake- holders from across the state. We presented our disparities research to the participants, then actively engaged them in identifying barriers and developing potential solutions. In addition, we were honored to have the presidents of the American Medical and the National Medical Association as guest speakers; both publicly commended CSMS for bringing Connecticut to the forefront of this important healthcare quality issue. CSMS reaches out to the broader community in many other ways. Partnering with several other groups, we were awarded a national grant to develop a leadership curriculum for young physicians that culminated in a two-day summit for residents and fellows earlier this year. This fall, CSMS will host a program with the VA on caring for patients with Post Traumatic Stress Disorder and Traumatic Brain Injury, as well as the resources available through the Veterans Access, Choice and Accountability Act of 2014 (Choice Act) to improve and expand access to care for our veterans. In November, CSMS will present a full-day program on wellness and integrative medicine. Open to the public, the program will bring together physician leaders, legislators and reg- ulators to discuss new approaches to wellness and integrative medicine. Continuing medical education is essen- tial to maintaining quality patient care, and CSMS supports this effort by serving as the national Accreditation Council for Continu- ing Medical Education (ACCME) designee for Connecticut. CSMS accredits Connecti- cut hospitals and other organizations as providers of continuing medical education (CME). In 2014, CSMS-accredited programs provided nationally-recognized CME credit to 5,106 Connecticut physicians and 3,699 other healthcare professionals. Since our founding in 1792, the practice of medicine has certainly changed. The CSMS com- mitment to represent the interests of physicians and their patients remains as strong as ever. n Dr. Robert D. Russo is president and Mat- thew C. Katz is executive vice president/CEO of the Connecticut State Medical Society. HARTFORDBUSINESS.COM POLL What's the most logical way to pay for Malloy's $100B transportation overhaul? ● Tolls ● Congestion pricing ● Mileage tax ● Other tax hike To vote, go online to HartfordBusiness.com. Last week's poll results: Has Obamacare improved health care in CT? 53.1% Yes 46.9% No ▶ ▶ Malloy's transportation agenda is laudable, but if it significantly adds to the already high-cost of living and doing business in the state, then lawmakers have a duty to determine if the ends truly justify the means.