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Sombrero

Pima County Medical Society
Home Medical Society of the 17th United States Surgeon General

August/September 2012

Voter Guide: Candidates respond to Society questionnaire as primary approaches
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SOMBRERO – August/September 2012

Sombrero
Pima County Medical Society Officers
President Alan K. Rogers, MD President-Elect Charles Katzenberg, MD Secretary-Treasurer John Curtiss, MD Past-President Timothy C. Fagan, MD

Official Publication of the Pima County Medical Society

Vol. 45 No. 7

PCMS Board of Directors
Diana V. Benenati, MD R. Mark Blew, MD Neil Clements, MD Michael Connolly, DO Executive Director Steve Nash Phone: 795-7985 Fax: 323-9559 E-mail: steve5199@simplybits.net Advertising Bill Fearneyhough Phone: 795-7985 Fax: 323-9559 E-mail: bill5199@simplybits.net

Bruce Coull, MD   (UA College of Medicine) Randall Fehr, MD Alton “Hank” Hallum, MD Evan Kligman, MD Melissa D. Levine, MD Lorraine L. Mackstaller, MD Clifford Martin, MD Kevin Moynahan, MD Soheila Nouri, MD Jane M. Orient, MD Guruprasad Raju, MD Wayne Vose, MD Scott Weiss, MD Victor Sanders, MD (resident) Cambel Berk (student) Christopher Luckow (student)

Members at Large
Kenneth Sandock, MD Richard Dale, MD

Thomas Rothe, MD,   president-elect Michael F. Hamant, MD,   secretary

Board of Mediation
Bennet E. Davis, MD Thomas F. Griffin, MD Charles L. Krone, MD Edward J. Schwager, MD Eric B. Whitacre, MD

At Large ArMA Board
Ana Maria Lopez, MD,

Pima Directors to ArMA Timothy C. Fagan, MD R. Screven Farmer, MD Delegates to AMA
William J. Mangold, MD Thomas H. Hicks, MD Gary Figge, MD (alternate)

Arizona Medical Association Officers
Gary Figge, MD,   immediate past-president

Editor Stuart Faxon Phone: 883-0408 E-mail: tjjackal@comcast.net Please do not submit PDFs as editorial copy. Art Director Alene Randklev, Commercial Printers, Inc. Phone: 623-4775 Fax: 622-8321 E-mail: alene@cptucson.com

Printing Commercial Printers, Inc. Phone: 623-4775 E-mail: andy@cptucson.com Publisher Pima County Medical Society 5199 E. Farness Dr., Tucson, AZ 85712 Phone: (520) 795-7985 Fax: (520) 323-9559 Website: pimamedicalsociety.org

SOMBRERO (ISSN 0279-909X) is published monthly except bimonthly June/July and August/September by the Pima County Medical Society, 5199 E. Farness, Tucson, Ariz. 85712. Annual subscription price is $30. Periodicals paid at Tucson, AZ. POSTMASTER: Send address changes to Pima County Medical Society, 5199 E. Farness Drive, Tucson, Arizona 85712-2134. Opinions expressed are those of the individuals and do not necessarily represent the opinions or policies of the publisher or the PCMS Board of Directors, Executive Officers or the members at large, nor does any product or service advertised carry the endorsement of the society unless expressly stated. Paid advertisements are accepted subject to the approval of the Board of Directors, which retains the right to reject any advertising submitted. Copyright © 2012, Pima County Medical Society. All rights reserved. Reproduction in whole or in part without permission is prohibited.

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Inside
 5 Dr. Alan Rogers on ACA’s “sunshine” law  9 Remembering doctors C. James DeSando, Jr., and M. Wayne Heine.
Special remembrance of Dr. Arnie Hollander by Dr. Sylvain Sidi 12 Voter’s Guide 13 Arizona Legislative District 2 14 Arizona Legislative District 3 15 Arizona Legislative District 4 16 Arizona Legislative District 9 19 Arizona Legislative District 10 22 Arizona Legislative District 11 23 Arizona Legislative District 14 27 Pima County Board of Supervisors District 1 29 Pima County Board of Supervisors District 2 31 Pima County Board of Supervisors District 3 32 Pima County Board of Supervisors District 4 34 Pima County Board of Supervisors District 5 35 US House of Representatives District 1 38 US House of Representatives District 2 40 US House of Representatives District 3 45 US Senate 50 PCMS News

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Established 1971

The ‘sunshine’ law
By Alan Rogers, M.D. PCMS President

Part of the Patient Protection and Affordable Care Act, a.k.a. “ObamaCare,” includes section 6002, the Physician Payment Sunshine Act. This act requires pharmaceutical, medical device, and biological and medical supply makers to report gifts to physicians or teaching hospitals of more than $10 to the Department of Health and Human Services. Reports of gifts must include the date, amount and type of payment, and must be made available to the public for review. Failure to report such payments could incur penalties of up to $1 million. The purpose is to make financial relationships between physicians and medical suppliers transparent to patients and so eliminate undue influence on physician prescribing, and ultimately reduce healthcare costs. Fortunately some items are excluded from reporting, including samples not intended to be sold; educational materials provided to benefit patients; short- term demo periods of medical devices; and discount coupons to be given to patients, to name a few. I admit I accept gifts from reps; most physicians do. Today I got five pedometers. Pharma reps frequently bring me fattening white chocolate mochas from Starbucks. I go to an occasional pharmaceutical dinner at a nice restaurant to hear about diseases pertinent to the product the drug company is marketing. Sixty-six percent of physicians accept samples and 52 percent attend pharma- sponsored events. I do miss all the pads, pens and coffee cups the reps used to bring. As part of pharma voluntary guidelines, these were eliminated a few years ago. Happily I have a huge stockpile of product-labeled pens, but it will irk me when I am eventually forced to buy pens for my office. However, I claim marketing efforts have little influence prescribing. Health plans can show you the high percentage of generic medications all of us prescribe. A survey showed that 84 percent of physicians understand the inherent conflict of interest in financial interactions with pharmaceutical companies, and they avoid them. Despite marketing pressure, I always use the least expensive appropriate medication in order to reduce the patient’s expense.
SOMBRERO – August/September 2012

T

he government is hell-bent on wiping out the pharmaceutical marketing business. It seems those attractive reps are seducing impressionable physicians.

A 2012 published study of physician payment disclosure laws in Maine and West Virginia, looking at prescribing of statin drugs and SSRI’s before and after disclosure laws, showed no significant decrease in out-of-pocket expenses to patients or in total prescription costs (Arch Int Med 2012:172:819). The Sunshine Act went into effect in January, but mandatory reporting has been delayed until March of 2013, and the final implementation rule from is pending. However, HHS Secretary Kathleen Sebelius has revealed some aspects of the final rule: marketing of over-the-counter products that presumably would be included under the Sunshine Act will not require reporting. An issue to be settled in the final rule is whether physicians would be able to review payments for accuracy before they are reported to HHS and posted on websites. Will physicians have recourse if they dispute some of the payments? Some pharmaceutical companies have already started voluntary reporting. Go to Pfizer‘s website: (www.pfizer.com/responsibility/ working_with_hcp/payments_report.jsp) and look up your name. I have been attributed $156 of non-cash gifts for 2011 that I assume were mostly lunches brought to my office for me and my staff. There is no detail of what the payments actually represent. Also check Lilly’s site: www.lillyphysicianspaymentregistry.com/Registry/Registry. I got $93 in non-cash items last year from Lilly. A recent survey of physicians showed most support open reporting of payments to healthcare providers, and I would contend the vast majority of us are highly ethical and would never accept questionable payments with an implied prescribing quid pro quo. But the question is, has the elimination of pads, pens and coffee cups reduced the cost of medications to our patients? Clearly not. It remains to be seen if the Sunshine law will reduce costs to patients or be of benefit to anyone. I think not. Undermining the doctor-patient relationship may be the outcome of the Sunshine Act since physician payments are available to the public. Lack of detail about the payments can be misleading and bring patients to the erroneous conclusion of an improper relationship between a drug company and their doctors. For example, a Tucson practice doing research was paid $422,509 by Lilly in 2011, but this entire amount is attributed to a single neurologist in the database.
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The Sunshine Act may have a devastating effect on CME programs. Having been a CME course designer at times, I know the majority of the cost of such programs is paid by pharmaceutical companies. Without pharma sponsorship, many meetings would not be economically viable. How would it be if your cost to attend a national meeting and get CME was the actual production cost? Instead of $400 to attend a national subspecialty meeting, it might be $1,500. Or, what if the difference between the production cost and your tuition was attributed to you as a pharma gift? Meeting attendance would plummet. Ironically, one industry review of the Sunshine Act suggested it would save pharmaceutical companies money by forcing them to market products more effectively. A pharmaceutical sales force calling on physicians is a very expensive proposition particularly when their marketing clout is limited. Could sales reps be eliminated in the near future? In the future, gifts and other transfers of value to physicians could become taxable income. At present, fee-for-service payments to physicians are taxable. But what if at year’s end you receive a 1099 form from the drug company for gifts you have received and now owe 40 percent of the value in taxes? For me this will be the final coffin nail in pharmaceutical sales. No more drug rep lunches in the office. No more Starbucks. n

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SOMBRERO – August/September 2012

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In Memoriam
By Stuart Faxon

Dr. C. James DeSando, Jr., 1936-2012
Dr. C. James DeSando, Jr., longtime Tucson IM physician and interventional cardiologist, who joined PCMS in 1971 and had been retired since 1997, died June 25 in Tucson. He was 73. Carl James DeSando, Jr. was born Oct. 1, 1938 in Rochester, N.Y. He started at seminary, headed for the priesthood, but at some point changed his mind and followed his father into medicine. “Although he ‘retired’ at least three times that I know of,” PCMS Executive Director Steve Dr. C. James DeSando, Jr. Nash said, “I really got to know him when he worked hard to establish and maintain AZ DMAT, the local Disaster Medical Assistance Team. That unit was activated and sent to Katrina, tornado sites, and others in many states.” Dr. DeSando earned his bachelor’s degree in 1960 from Georgetown University College of Arts & Sciences, Washington, D.C. He earned his M.D. in 1964 from Georgetown University School of Medicine, and interned at Emory University School of Medicine’s Grady Memorial Hospital in Atlanta, Ga., affiliated with Emory University School of Medicine, where he also did his IM residency. Later he completed a fellowship in cardiology at The George Washington University School of Medicine. In 196668 he served as a captain in the U.S. Air Force. The Air Force acquainted him with Tucson when he was stationed at Davis-Monthan AFB in 1966, and he began practice here in 1971 as Cardiology Associates P.C. with Dr. Lee. I. Schocket. 2. In 1976 he relocated to Tucson Medical Park West under the banner Southwestern Cardiology Consultants, P.C., with Dr. Jose J. Fernandez. Later they moved to East Knight Drive in Tucson Medical Park. “Jim was active in many associations,” the family told the Arizona Daily Star, “including the American Heart Association Southern Arizona Division, of which he was a past-president. He was recognized as an outstanding teacher, chairman, and consultant in cardiology. After he retired he volunteered with the AZ DMAT, the Tucson Metropolitan Response System, and Physician Education for Bioterrorism as a hospital responder.” As early as 1973 Dr. DeSando was a member of the AMA, ArMA, the heart association, the Association of Interns and Residents, and the Medical Society of Mexico and the United States. He was on the medical staff of Crippled Children’s Clinic [now Children’s Clinics for Rehabilitative Services], and was an associate in medicine at UofA Medical Center. In 1992 he was appointed to the Rehab Institute of Tucson. “Jim’s love for astronomy brought him joy as he watched the stars and shared with others the wonders of the sky, thanks to Dean and Donna at Starizona,” the family told the Star. “He was a historian of Southern Arizona, and loved archaeology, Western horsemanship, and biking. “For more than 40 years Jim bought box tickets to the Tucson Rodeo, knowing he could only go two days himself. He then donated his other tickets so others could enjoy the event. He donated an ECHO machine with upgrades to Carondelet St. Mary’s Hospital as a living gift. His goal was that when he died, a fund would be developed to help with the cost so people could have a procedure even if they could not afford it. For the last four years this machine has been used throughout the hospital. “He loved animals and filled his home with dogs, cats, and horses that never went hungry. Pride, joy, and happiness showed in his love and stories of his family.” Dr. DeSando’s first wife, Sally; his second wife, Monica; brother John; sisters Marie and Theresa; son Carl James “Jimmy” Desando III; daughters Sara Ann, Dianne Marie, and Michele; stepchildren Jonathan and Michelle Wilhelm; two grandchildren; and many nieces and nephews survive him. Memorial services were on June 30 at Bring’s Memorial Chapel, East Broadway in Tucson. Memorial contributions may be made when the ECHO fund at St. Mary’s is set up, or to the American Heart Association, Pima Animal Care, or the Humane Society of the donor’s choice.
8 SOMBRERO – August/September 2012

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Dr. M. Wayne Heine, 1933-2012
Dr. M. Wayne Heine, Ob/Gyn physician, endocrinologist and educator, key physician in establishing the UofA Ob/Gyn department, who joined PCMS in 1989, died July 24 from pancreatic cancer. He was 79. “Dr. Heine was a beloved physician, educator, and member of the Department of Obstetrics and Gynecology from its beginning in 1970 to 1977,” said Dr. Kathryn Reed, current department head. “He then established an Ob/Gyn department at Texas Tech in Dr. M. Wayne Heine in 1990. Lubbock, and then returned to become department head of Ob/Gyn at the University of Arizona from 1989 to 1994.” Melvin Wayne Heine was born March 21, 1933 in Ellendale, N.D., the third child of Robert and Laura Heine. He grew up in Dade City, Fla. and attended the University of Florida. After three years of college he was accepted at Duke University School of Medicine, from which he graduated in 1958. professional societies and clubs. Of his numerous accomplishments, the ones in which he took the most pride were the teaching awards he received at all three academic institutions where he practiced, and the many med students, residents, and faculty he mentored in his 46-year career. Wayne will be remembered as an honorable man who was always kind and encouraging. He was devoted to his wife Millie, and relished the time he spent with his grandchildren who adored him. He loved to travel, play golf, or share a glass of wine with friends. “He is survived by his wife of 54 years, Millie; sons Phillip Heine, M.D. and Kevin Heine; daughter Taylor Anne Heine; and grandsons James and William Heine. “The family would like to thank the medical staff at Duke Medical Center, Duke Hospice, and the people who assisted Wayne at home for their compassion and capable care.” A memorial service was given on July 28 at Goodson Chapel in the Duke Divinity School, with a reception following at Washington Duke Inn. A memorial service in Tucson was scheduled for a later date. Memorial contributions may be made to the Ob/Gyn Resident Education Fund, Department of Obstetrics and Gynecology, University of Arizona, c/o Sonia Garcia, Box 245078, Tucson 85724. Dr. Kathryn L. Reed, professor and head of the UofA Department of Obstetrics and Gynecology, and The News & Observer of Raleigh, N.C. contributed to this report. The Arizona Daily Star published the Raleigh version July 29.

During medical school he met Mildred Joyce Phillips and they were married in 1958. He interned at the Medical College of Virginia Hospital Division at Richmond, and did his Ob/ Gyn residency at the University of Florida Teaching Hospital and Clinics, Gainesville. In 1962-63 he completed a research fellowship with Worcester Foundation for Reproductive Endocrinology in Shrewsbury, Mass. Will transform the lives of your patients...

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“Wayne spent two years of service in the Army at Fort Benning, Ga. during the Vietnam War,” The [Raleigh, N.C.] News & Observer reported. “At his discharge he was honored with a commendation medal for introducing oral contraceptives to the patients he cared for in the base clinics. He subsequently embarked on a highly successful career in academic medicine. “He was involved in more than 200 publications, and for his entire career was considered one of the premier educators in his field. He held academic positions at the universities of Florida and Arizona. He became the founding chairman of the Department of Obstetrics and Gynecology at Texas Tech University in Lubbock, and opened three other campuses that served as referral sites for the West Texas region. After 12 years at Texas Tech he returned to Tucson and chaired the Department of Obstetrics and Gynecology at the University of Arizona, where he completed his career. “Dr. Heine was an examiner for the American Board of Obstetrics and Gynecology for more than 20 years, and belonged to many
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Arnold Hollander, MD:
A modern Maimonides
An Appreciation by Sylvain Sidi, M.D. Tucson’s medical community recently sustained an immense loss with the passing of Dr. Arnold I. Hollander. The unspeakable grief sustained by his family is matched by the enormous void felt by his friends, colleagues and patients. To speak of Dr. Hollander’s legacy and outstanding accomplishments would fill several pages. One tribute was written 10 years ago by a departing patient who chose to write a note on what we are now accustomed to read on the Internet as Rate Your Physician: “Dr. Hollander was my physician for many years. The latest was about 1990 when I left Tucson. He was tied with one other physician as the best and most caring physician I have ever known. You cannot rate the honest care, interest, and time spent reaching out to me as a patient.” I reflected on these lines and realized they defined the unique relationship Dr. Hollander had with his patients. “Honest care” described his integrity and honesty about the limits of his knowledge. He was especially generous with his availability and the time spent with his patients, not concerned about fractioning it into units of care, but displaying a genuine interest in their welfare. Yes, I could fill several pages with tributes from patients and colleagues but I prefer to address our 35-year personal relationship. Dr. Hollander was my teacher, my mentor, my role model, and my friend. I was his intern, resident, and colleague

Moses ben Maimon, known as Maimonides to Anglophones (1138-1204), is considered the greatest Jewish philosopher of the Medieval era. He is still widely read today, according to the Stanford Encyclopedia of Philosophy.

and met him during those golden years of medicine when teaching and mentoring did not involve computerized data collection, electronic medical records, or programmed preventive care. He was a modern-day Maimonides, who, like him, extolled the qualities of good judgment, kindness and compassion—all framed by the supreme attribute of moderation, the doctrine of the mean between extremes—and whose actions and moral habits were repeated until they became part of his persona. Arnie Hollander was at his best in his office, displaying his talents of observation, knowledge, and hands-on skill. He invited me into his world and I observed firsthand his outstanding clinical judgment—and his supreme skill of engaging patients in conversation, allowing them to talk first, never interrupting them. My recollection of these moments is how much time he would spend with each patient. He always wore a white coat, knew his patient on a first-name basis, and had a phenomenal grasp of each patient’s entire history, thanks to his prodigious photographic memory. Medicine and teaching were his passions, and he had a huge fund of knowledge based on his extensive experience. For example, he had spent time in Molokai, Hawaii in a leper colony, observing and interacting with patients, bringing back teaching slides for the benefit of future students. Long before CT scans and MRI, his favorite topic above all was the workup of a FOU (fever of unknown origin), with all its various
SOMBRERO – August/September 2012

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intricacies and myriads of presentations—which he used as a channel for teaching, and challenging himself, his students and his residents in traditional Socratic method. He was part of that generation of superbly trained internists who came to Tucson in the 1960s, all experts in their fields and all superb teachers. I was privileged to be exposed to that generation, whose teachings were based on two beliefs: First, that the quality of a medical education is best attained under the guidance of outstanding clinicians in an environment of clinical excellence, and second, that the highest quality of medical care is attained through association with a strong educational program. This model was THMEP—Tucson Hospitals Medical Education Program in its beginning years. As residents we were made aware of our responsibilities, acquiring knowledge and skills while providing compassionate care for our patients, aided by expert clinicians, surgeons and specialists who formed our program core. Arnold Hollander was at the center of this constellation of volunteer physicians who rounded at TMC while maintaining their private practices. He nurtured and trained a whole generation of students at UMC and residents at TMC in skills, knowledge, and superb bedside manner. We all wanted to rotate on his service, go to his office, and see him on rounds, hoping some of his skills would rub off on us. After completing my IM and GI training, I joined Dr. Raymond Moldow, who had an office next to Dr. Hollander. Dr. Hollander was in practice with Dr. Anatolio Munoz, the only physician with whom he ever practiced. As the years passed, Dr. Hollander’s practice was always the same, overflowing with a large number of loyal patients trusting his honesty, judgment, and guidance. An outstanding quality I noted was how he separated himself from the business of medicine, not obsessing about receiving compensation. As time passed, the age of the EMR was his litmus test. He knew a computer could not take the place of a doctor and rejected the notion that he needed to spend the greater part of his time focused on the computer rather than in communicating, ordering and reviewing tests. He did not take care of virtual patients. Dr. Abraham Verghese was recently in Tucson and warned about the i-patient, left alone in a bed, wondering where everybody is, especially his attending physician. The famous picture of Dr. William Osler—one hand holding the patient’s, the other his forehead—as a reminder that all the advances in medicine in EMRs will not replace what the patient wants from his doctor: the comforting presence of an attentive physician who conveys an unspoken promise to the patient and family, “I will stay with you through thick and thin.” That was Arnie Hollander’s call,
SOMBRERO – August/September 2012

of a healer first and foremost, and he never espoused the concept of EMRs. Lately, he was slowing down physically with severe back problems, but he was always smiling, energetic, and planning yet another medical conference. His style never changed: spending maximum time interchanging with his patients, his consult requests always personal, and handwritten, with the name of the consultant and the reason for the consultation. When he fell ill in Las Vegas, his loving, devoted wife, Carol, was with him and guided him through these supremely difficult times. Eventually we were able to bring him home to Tucson, where he was hospitalized. As a patient, he revealed extraordinary qualities of courage and tenacity. Though terrible medical issues eventually took him away from us, he continued all along to be a highly organized and involved husband, father, and physician, using his phenomenal memory and multi-tasking capacity to accomplish many plans from his hospital bed. He also had lengthy, delightful conversations with former nurses who visited him about a range of subjects, especially his preferred birding experiences. He remains in my mind as a prodigiously intelligent, unique, and loyal friend, always cheerful, who led a well-lived life and was a model to his peers. As many Jewish colleagues said, he was a mensch—a real man—a man of valor, a modern-day n Maimonides.

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We invited Arizona candidates for offices that have responsibility for health care or health policy to respond. Questions were devised by the PCMS Board of Directors. Letters were mailed to 70 candidates and we followed up with phone calls to the campaigns. Staff replied to queries from campaigns to clarify questions; we did not coach them to answer in any particular manner. During the process, we learned campaigns are deluged with questionnaires similar to ours. We appreciate those who took the time to answer ours, and understand why others did not respond. Back when your Board of Directors conceived this, everyone expected the Independent Redistricting Commission to finalize new districts that gave Tucson less clout. The Board thought we would have fewer candidates from which to choose so it was imperative physicians know for whom they vote. Instead, Pima County got part of an extra congressional district and seven legislative districts instead of six. To find your new district(s), go to azredistricting.org. find “maps” and select “final approved maps.” You will see “Commission Approved Final Congressional Map” Click on Google Maps (KMZ). When the state of Arizona appears, put your cursor on Tucson and start zooming in (you can zoom so far as to get a street view of your house). Repeat the process for the “Commission Approved Final Legislative Map.” If you have trouble, or don’t have a computer, give us a call, 795-7985. Some of the questions the Board devised are “inside medicine” stumpers at which even physicians might scratch their heads. For example, we asked state candidates if they favor the sunrise process. This is basically a hearing that takes place in the late fall and allows many professions to test expanding practice. Let’s say nurse practitioners decided they would like to do brain surgery. In Arizona, this practice expansion would go before a Legislative committee made up of Arizona Senate and House health committee members and stakeholders, like us, would testify. Our question about licenses and certification are aimed directly at the national movement to require maintenance of certification and its offshoot, maintenance of licensure. Thanks for reading. Remember to vote August 28. Primaries are crucial, especially in non-competitive districts. Winners there will serve for years, so make your choice known.

Steve Nash PCMS Executive Director

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Welcome to the 2012 PCMS Voter Guide

SOMBRERO – August/September 2012

ARIZONA LEGISLATIVE RACES

Arizona Senate & House of Representatives
One senator and two representatives are allotted in each Legislative District. Legislative District 2
South of 22nd Street between Stone and Houghton; Includes Green Valley. Candidates - Senate: Democrat Linda Lopez (incumbent) is unopposed in the primary and general election. House: Democrat Andrea Dalessandro and Rosanna Gabaldon; Republican John C. Ackerley. Chair of the Council of Urban Boards of Education and a board member of the National School Boards Association. In 2000 Linda was elected to the Arizona Legislature. She served as State Representative from 2001 to 2008 when she was elected to the State Senate. She is currently a member of the Appropriations, Education, Health, and Public Safety and Human Services committees. She is also a member of the Joint Legislative Budget Committee. She has served in Democratic Caucus leadership positions in both the House and the Senate. Campaign Website: lindalopezforarizona.com

Linda Lopez
AZ Senate Democrat
Arizona resident for 40 years. She was born in Indiana and lived in the San Francisco Bay Area from the age of 16 until she moved to Tucson. Her son, Aaron, age 40 was born in California. Her daughters, Toni, age 35, and Bobbi, age 33, were born in Tucson. She is married to Rudy Jones. Rudy brought to the family his 3 sons, Roland, Bryan, and Jason. Together Linda and Rudy have 11 wonderful grandsons: Jordan, 21, Kyle, 18, Roland, Jr., 18, Quentin, 15, Dylan, 14, Isayah, 8, Jayden, 4, Io, 3, twins Riley and Brady, 1, and Luca, 4 months. Linda graduated from De Anza High School in El Sobrante, CA and then attended the University of California at Berkeley from 1966 to 1968. She and Aaron moved to Tucson in 1972. Linda completed her Bachelor’s Degree at the University of Arizona in 1990 and attended graduate school for one year. Current Occupation: State Senator, District 2. Linda is also employed by La Frontera Arizona, the state’s largest behavioral health provider. During her 21 years at La Frontera she has served as Child/Family Specialist and Clinical Supervisor of the Child/Family Center and currently is the agency’s Community Relations Coordinator. Her community service has been extensive over the years. She is currently a board member of the Arizona Virtual Academy, the Center for Applied Behavioral Health Policy and Jobs for Arizona Graduates. She also is the Board Chair of the Center for Women Policy Studies, the nation’s first feminist think tank. She is a member of the Arizona Women’s Political Caucus, the National Organization for Women, the NAACP, Compassion & Choices, National Hispanic Caucus of State Legislators, Planned Parenthood, Los Descendientes of Tucson, AAUW, and many more organizations. Political Experience: Linda served as a member of the Sunnyside Unified School District Governing Board for 18 years and completed her service to Sunnyside Community in 2006. During her tenure as a locally elected school board member she also advocated for public education at the state and federal level. She served as President of the Arizona School Boards Association, President of the Arizona Hispanic Caucus of School Board Members and the National Hispanic Caucus of School Board Members. She was also
SOMBRERO – August/September 2012

Questions / Answers:
In recent years the Legislature has cut eligibility, reimbursement and services from Arizona’s Medicaid plan. How will you work to restore eligibility and services or how will you further reduce cost? It is critical to the economic recovery of Arizona to restore the cuts in eligibility, reimbursement and services that have been made over the past few years. The healthcare industry is a key economic driver! I believe that the legislature that Arizona will have beginning in January 2013 will be less conservative than the current legislature. I will work across the aisle as well as with my Democratic colleagues to push for restoration of the cuts. I will continue to collaborate with healthcare providers at all levels to make the case for the importance of the restoration. I also believe it is critical that programs for persons with chronic illnesses such as diabetes, obesity, and heart disease be put in place to manage these illnesses and bring down the cost of emergency services and medications.

Since 2010 no general fund dollars have been used for graduate medical education. Would you support reauthorizing general fund dollars for this purpose?
I absolutely support using general funds for graduate medical education. It is vital to do if we hope to increase the supply of much needed physicians in this state. Arizona has a sunrise process for various professions to use when they seek to expand the areas in which they practice. Do you favor continuing this process? I do favor continuing the sunrise process. Would you deny licenses to physicians who are not boardcertified or who do not undergo recertification examinations? I support denying licenses to physicians who are not boardcertified or who do not undergo recertification examinations. Other issues about which you want physicians to know where you stand. I support the expansion of Medicaid under the ACA.
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Legislative District 3
Tucson mountain foothills from Prince Road on north to Tucson Blvd. to the Tohono O’odham Nation northern line. Candidates— Senate: Democrats Olivia Cajero Bedford (incumbent and Maria Garcia (former incumbent. House—Democrates Sally Ann Gonzales (incumbent) and Marcario Saldate (incumbent).

Association International, Arizona Women’s Caucus, Women in Government and National Conference of State Legislatures. Current Occupation: Senator 2 yrs, Representative 8 yrs. Political Experience: I have been involved in politics since the late 60’s as both my mother, Carmen and Bernardo `Nayo’ Cajero served in the Arizona House of Representatives, for a total of 29 years. Serve on the following committees: Appropriations, Commerce & Energy, Natural Resources & Transportation, and Joint Legislative Budget Committee. Campaign Website: None provided

Olivia Cajero Bedford
AZ Senate Democrat Rep. Cajero Bedford is a native of Tucson and has lived in her Legislative District 27 for most of her life. She is a graduate of Tucson High School and attended Pima Community College and the University of Arizona. Before having the opportunity to serve Tucsonans at the state level, Rep. Cajero Bedford was a business owner and a director of sales and marketing for the tourism/hotel industry. Years of business experience make her a strong advocate of small companies and economic development. As a pro-business legislator, she has enjoyed sitting on the House Commerce Committee, the powerful House Appropriations Committee and House Financial Institutions and Insurance Committee. Rep. Cajero Bedford is a graduate of the Council of State Governments’ Legislative Academy. She has been involved with a number of civic organizations over the years including the Girl Scouts, Arizona Tourism Advisory Council, National Association of Latino Elected Officials, Hospitality Sales and Marketing

Questions / Answers:
In recent years the Legislature has cut eligibility, reimbursement and services from Arizona’s Medicaid plan. How will you work to restore eligibility and services or how will you further reduce cost? I have always fought against cuts to eligibility and reimbursement rates. Much will depend on who wins the presidential election. Since 2010 no general fund dollars have been used for graduate medical education. Would you support reauthorizing general fund dollars for this purpose? Yes Arizona has a sunrise process for various professions to use when they seek to expand the areas in which they practice. Do you favor continuing this process? There should be some government limitations on practices that either don’t work or might harm the public Would you deny licenses to physicians who are not boardcertified or who do not undergo recertification examinations?

Will a Cash Balance Plan provide a larger tax shelter than my 401(k)?

I don’t have enough knowledge on this process. As a lay person, Board-certification sounds desirable. Other issues about which you want physicians to know where you stand. Some of the concerns I’m aware of from doctors, are frivolous lawsuits, high cost of malpractice insurance and the inability to electronically prescribe all schedule ii thru schedule v controlled substances electronically — due to government restrictions. Electronically would be less time-consuming and be more secure transmission of prescriptions.

the qualified plan experts

Maria De La Luz Garcia
AZ Senate Democrat
Bio: Not provided Current occupation: Manager, Raytheon Missile Systems Political experience: Former state senator, appointed in 2010. Campaign Website: Not provided

Kidder Benefits Consultants, Inc.
6015 E. Grant Road Tucson, AZ 85712-2316 520-298-9434 www.askkidder.com

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SOMBRERO – August/September 2012

Questions / Answers:
In recent years the Legislature has cut eligibility, reimbursement and services from Arizona’s Medicaid plan. How will you work to restore eligibility and services or how will you further reduce cost? With the new Affordable Care Act being implemented in 2014, we have the chance to provide healthcare coverage to all Arizonans; however, Gov. Brewer is saying that she may not accept it due to her own beliefs. While we accept coverage for persons, we should fix the reimbursement rate as well. In regards to enrollment, we need to reinstate the KidsCare and stop trying to limit enrollment to this program. Since 2010 no general fund dollars have been used for graduate medical education. Would you support reauthorizing general fund dollars for this purpose? Yes Arizona has a sunrise process for various professions to use when they seek to expand the areas in which they practice. Do you favor continuing this process? Yes Would you deny licenses to physicians who are not boardcertified or who do not undergo recertification examinations? Yes

Arizona has a sunrise process for various professions to use when they seek to expand the areas in which they practice. Do you favor continuing this process? Yes Would you deny licenses to physicians who are not boardcertified or who do not undergo recertification examinations? I would have to study this issue more in order to learn about this issue.

Legislative District 4
Covers the Tohono O’odham reservations and goes west to Yuma. Candidates—Senate: Lynn Pancrazi (incumbent) is unopposed in the primary and general election. House— Democrats Juan Carlos Escamilla, Charlene R. Fernandez and Lisa Ontondo.

Charlene R. Fernandez
AZ House Democrat
Fifty-eight-year-old Charlene Fernandez is a resident of Yuma Arizona. She has been married 36 years (Sergio) and has three children (Brian, Carlye, Lisa). She holds a Bachelor’s Degree in Elementary Education. Current Occupation: Administrative Assistant at Arviso Engineering-Geotechnical Testing Services. Political experience: 13+ years Congressional Staffer for two Members of Congress; 5+ years State of Arizona Appointee in Governor Napolitano’s Administration; 8 years Member of the Yuma Union High School Governing Board; First Vice Chair AZ Democratic Party; Chairperson; First Vice Chair-Second Vice Chair; Secretary; Treasurer of Yuma County Democratic Party; 2008 Super-Delegate to the Democratic National Convention. Campaign Website: None provided

Macario Saldate
AZ House Democrat
Currently retired. Previous career: Professor, University of Arizona (UA) Former Director, UA Guadalajara Summer School, Director, Mexican American Studies and Research Center, Director, UA Bilingual Education Teacher Training Program. Current Occupation: Current state representative, LD 27, elected in 2010; Running in LD 3 Political Experience: Former governing board member, Pima County Community College Board of Governors Campaign Website: VoteSaldate.com

Questions / Answers:
In recent years the Legislature has cut eligibility, reimbursement and services from Arizona’s Medicaid plan. How will you work to restore eligibility and services or how will you further reduce cost? To restore eligibility to the previous level I would redirect funding from the State’s private prison initiative to child and family health services. The prison funding should be eliminated because it is unnecessary and costly. I would also cut funding from all State Agencies to systematically decrease the tiers of administration and duplication without affecting the level of services provided to our citizens. These cuts would be sufficient to fully fund AHCCS to the previous eligibility level. The reimbursements to physician and other ancillary service providers should be tied to inflation and no doubt be increased. The cost containment can be addressed by increasing the patient universe to include all State employees, thereby decreasing the morbidity rate of the patients and increasing the revenue. Finally the efforts towards prevention should be drastically intensified.
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Questions / Answers:
In recent years the Legislature has cut eligibility, reimbursement and services from Arizona’s Medicaid plan. How will you work to restore eligibility and services or how will you further reduce cost? AHCCCS’s reimbursement rate is tied to the Medicare fee schedule, just like private insurance carriers follow as well. We need to work at the federal level to change the fee schedule. Once we do that, AHCCCS can provide higher reimbursement. We need to lift the freeze on childless adults. Since 2010 no general fund dollars have been used for graduate medical education. Would you support reauthorizing general fund dollars for this purpose? Yes
SOMBRERO – August/September 2012

Since 2010 no general fund dollars have been used for graduate medical education. Would you support reauthorizing general fund dollars for this purpose? I would support the utilization of general funds for graduate medical education to the extent that those funds are being utilized for graduate education for non-medical disciplines. Arizona has a sunrise process for various professions to use when they seek to expand the areas in which they practice. Do you favor continuing this process? I generally oppose over regulation and support the elimination and/ or consolidation of boards and commissions. My opinion is that the medical community should conduct peer reviews of the proposed expansions and we should not involve governmental agencies. Would you deny licenses to physicians who are not boardcertified or who do not undergo recertification examinations? I would not deny licenses to medical specialists that are not board certified or who have not undergone recertification examinations. While I opine that certifications and continuing education/testing is essential for the protection of the public, those physicians who are not certified or have not completed testing should be provided with time limited provisional licenses to meet such requirements. Other issues about which you want physicians to know where you stand. I support the President’s effort with respect to the Affordable Care Act. The Governor of Arizona has demonstrated her partisanship and aggressiveness towards the Obama Administration and I believe that she will not cooperate in establishing Insurance Exchanges or expanding Medicaid coverage to more families in Arizona. I expect that the Medical Society would advocate for patients and health providers to ensure that a Medicaid/AHCCCS expansion in Arizona occurs and that the State does not continue to expend valuable resources fighting the Federal Government.

Political Experience: Candidate for State House of Representatives, (Old) Legislative District 27, 2010 Election Cycle; 1st Vice Chair, (Old) Legislative District 27 Democratic Party; Executive Committee Member, Pima County Democratic Party; Chair, Ways and Means, Pima County Democratic Party; Precinct and State Committee Man, Arizona Democratic Party; 1st Vice Chair, LGBT Caucus, Arizona Democratic Party; Deputy Director for Southern Arizona, Campaign to Re-elect Attorney General Terry Goddard, 2006 Election Cycle. Campaign Website: DustinCoxForHouse.com

Questions / Answers:
In recent years the Legislature has cut eligibility, reimbursement and services from Arizona’s Medicaid plan. How will you work to restore eligibility and services or how will you further reduce cost? I am committed to restoring the cuts made to AHCCCS that this legislature made. It is unconscionable that this legislature has turned away federal matching dollars for our state Medicaid plan, and that decision has not only left many Arizonans without access to healthcare, but also taken a terrible toll on our providers. AHCCCS must be restored and expanded, and I will sponsor/cosponsor legislation to that effect. Since 2010 no general fund dollars have been used for graduate medical education. Would you support reauthorizing general fund dollars for this purpose? I support reauthorizing general fund dollars for graduate medical education. Arizona has a sunrise process for various professions to use when they seek to expand the areas in which they practice. Do you favor continuing this process? Based on what I know of the process and what I have been able to read about it, I support continuing Arizona’s sunrise process. If any changes need to be made, I would need more information. Would you deny licenses to physicians who are not boardcertified or who do not undergo recertification examinations? With regard to this, I would need further information on the subject before changing the status quo. Based on the short supply of medical professionals we have, especially considering our aging population in Arizona, I am reluctant to deny licenses to physicians who are not board-certified. There are, to my knowledge, any number of physicians who are practicing without board certification in Arizona today, and denying those doctors licenses would leave them and their patients in quite a bind. That being said, I do believe it is important that our medical professionals are adequately prepared to provide the essential care with which they are entrusted. Other issues about which you want physicians to know where you stand. Please visit my website www.DustinCoxForHouse.com to learn more about my background and plan to move Arizona forward.

Legislative District 9
Catalina Foothills from Sabino Canyon to I-10 south to Broadway, with a jog north to Prince Road. Candidates—Senate: Democrat Steve Farley; Republican Tyler Mott. House— Democrats Dustin Cox, Mohur Sarah Sidhwa and Victoria Steele. Republican Ethan Orr.

Dustin Cox
AZ House Democrat
Five generations of my family have called Arizona home. I’m a small business owner; I served as executive director of one of Arizona’s oldest nonprofits, and have worked in various other community-focused roles, serving seniors, young people, non-English speakers, low-income earners, and more. And, of course, I would be remiss if I didn’t mention that I am a proud Wildcat alumnus. Current Occupation: Co-Founder and President, CM Concordia Consulting, LLC
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SOMBRERO – August/September 2012

Mohur Sarah Sidhwa
AZ House Democrat
That I was born in India was by chance. That I fell in love with the Bill of Rights and proudly embraced the US Constitution was by choice. I came to Tucson 31 years ago for graduate studies in medical anthropology, and stayed. I have always lived in the district and have had a successful small business here for almost two decades. Over the years I have served on a number of multi-partisan non-profit boards and commissions. I currently serve as a commissioner on the Pima County Women’s Commission as well as on the board of the Pima County Medical Foundation. Additionally, I am a proud member of the League of Women Voters and the Arizona Women’s Political Caucus among other organizations. Current Occupation: Self-employed as a career and business coach. Political experience: I have served as vice-chair of the Arizona Democratic Party as well as the chair of Legislative District 28. As a candidate for the state legislature in 2010, I came within one percent of winning. I’ve followed the legislature closely since the AZcam scandal 20 years ago, and have built up institutional knowledge. I have gained depth and a broad knowledge of issues and have confidence in the relationships I have built on both sides of the aisle over the past many years with the elected, former elected as well other players. Campaign Website: Sidhwa2012.com

seen the consolidation in the market (Carondelet Heart and Vascular Institute moving to St. Mary’s), the loss of beds in rapidly growing cities are weakening the ability to care for existing populations.  Now that the Affordable Care Act is upheld, it will lead to increased coverage for the uninsured. I would argue for the development of state run Health Insurance Exchanges as our best option. Arizona must leverage the situation in a way that is best for our economy and our patients. Since 2010 no general fund dollars have been used for graduate medical education. Would you support reauthorizing general fund dollars for this purpose? Yes. Due to cuts in Medicaid we lost federal funding for this as well. Other jurisdictions have tried to make up the difference, but this is not sustainable and is only a stopgap measure as those jurisdictions are hurting as well. Generally a majority of those who train in Arizona tend to stay in Arizona. We cannot afford to lose a whole generation of physicians to other states. Arizona has a sunrise process for various professions to use when they seek to expand the areas in which they practice. Do you favor continuing this process? Yes. I favor the sunrise process. The floor of the legislature is no place to create physicians. Occasionally there may be need to expand the scope of practice, and the sunrise process is a good place to begin the process. Currently the sunrise process is fairly solid on this issue. Would you deny licenses to physicians who are not boardcertified or who do not undergo recertification examinations? No. I know the issue in some depth. On its surface it seems like a good idea. However, I fear that we would lose good, experienced physicians being tested in disciplines totally unrelated to their practice. Other issues about which you want physicians to know where you stand. 1) My focus will be the 21st century economy and their high paying jobs. This requires an excellent education especially in the sciences to be prepared for the new economy jobs. Science and math literacy are key. Let us never again shortchange our children’s education or their health. I would like to see our high tech companies take on more short-term interns at a younger age. This will expose the youth to other career options. Along with this we also need to have strong apprentice programs and technical schools for those not college bound. These ideas would require a solid public-private partnership. That’s how we build a skilled workforce, compete globally and grow our economy. 2) An urgent situation created in the last couple of sessions of the legislature is that of the seriously mentally ill, and the economic and human toll untreated patients have on society as well as the economy. Too many end up incarcerated or hospitalized at greater expense than the meager sum the legislature saved by cutting the services for the severely mentally ill. 3) My third passion is to fight the erosion of healthcare freedoms for women as seen by the callous way the legislature is micromanaging their reproductive healthcare decisions. I see
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Questions / Answers:
In recent years the Legislature has cut eligibility, reimbursement and services from Arizona’s Medicaid plan. How will you work to restore eligibility and services or how will you further reduce cost? The issue has to be looked at and dealt with as an interconnected complex of systems. This requires commitment and courage and on the part of all the stakeholders and legislators. Arizona’s healthcare infrastructure is in serious trouble and we cannot wait to fix it piece meal. Society has a social obligation to take care of its most needy citizens. Over 20% of Arizonans don’t have health insurance. We need to restore the cuts under AHCCCS as soon as possible and work to restore Prop 204 eligibility.  With hospitals in hub cities like Tucson and Phoenix having the additional burdens of the rural uninsured, it only gets worse. An example of the toll this is taking, I have seen physicians in one specialty (OB/GYN) forced to join larger groups because it is a time intensive field and the reimbursement rates are too low or sometimes nonexistent. I am further concerned about the state of our rural clinics and hospitals and the impact on them and the human toll it takes on our patients if our Medicaid system is not expanded. I am concerned about increased consolidation of the system into just one or two major players. In the Tucson area we have
SOMBRERO – August/September 2012

this as a civil rights issue. Those untrained in the sciences or in medicine have no business setting medical policy. It is time for those physicians on the front lines of patient care to get engaged in politics and make their voices heard. 4) Pima County’s role in the nation’s high tech industry must be supported. We have a diverse high tech industry, and top research facilities here: biotech, solar, optics, astronomy, and pharmaceutical. The University of Arizona’s research arms are second to none. Their public private partnerships have yielded high paying jobs and incubated successful 21st century businesses. That is the new economy!

As a first step I would work to create legislation to roll back the limitation on the number of adults, and children served under the current Kids Care program, to its previous levels. The state has to seriously rethink and revise its spending priorities. A critical inclusion to such new legislation would be the development of processes to link and otherwise ease barriers to our poorer, remote populations. I would help ensure the easing of geographic barriers in remote rural areas by working to fund the development of more medical clinics and other healthcare service outlets for greater access to more populations across the state. Since 2012 no general fund dollars have been used for graduate medical education. Would you support reauthorizing general fund dollars for this purpose? Arizona is on the cutting edge of medical education with the University of Arizona College of Medicine, UA Cancer Center, UA College of Public Health, and UA BIO5 Institute. We have an opportunity to be a leader in creating health communities, improving the quality of life, and indeed, saving lives. In my opinion it is essential that the Legislature look at funding graduate medical education. Arizona is facing a shortage of doctors, particularly general practitioners. When I am elected, I would be willing to work to bring such legislation to the House floor and seek bipartisan sponsorship. Arizona has a sunrise process for various professions to use when they seek to expand the areas in which they practice. Do you favor continuing this process? I would like to have additional information on this topic before responding. Would you deny licenses to physicians who are not boardcertified or who do not undergo recertification examinations? Yes. We need to ensure that our physicians are not only certified, but that they remain currently informed and trained on best practices in their specialties. Other issues about which you want physicians to know where you stand. I am running for this office because our current legislature has created an oppressive environment for women’s and children’s healthcare that is unprecedented. Once elected to office, I would direct my attention and that of my staff and other resources toward working to repeal or strongly mitigate the many healthcare accessibility restrictions enacted over the last several years. Upon being elected, my staff and I will immediately to implement a prioritized research and resource development plan. As I stated previously, creating a comprehensive healthcare initiative is a key priority for me. A critical component of this plan is to reach out to those we consider to be key healthcare and welfare “community partners” to help us identify the most effective and efficient approaches to our mutual goals of re-establishing healthcare as a right, not a privilege, for all Arizonans. I consider the Pima County Medical Society to be a key partner in that communication outreach plan. This is such a personal issue for me as I have spent most of my professional career to date as a working, single mom who has had to juggle healthcare for my son against grocery and other bills. I feel strongly that people should not die because they cannot afford healthcare or health insurance and that
SOMBRERO – August/September 2012

Victoria Steele
AZ House Democrat
Bio: Born in Franklin, PA, 11-5-56. AZ resident since 1987. One son, Nicholas age 26. Education: Master of Counseling – University of Phoenix 2003; BA, Counseling Psychology 2000; Liberal Arts – Pima Community College 1996-2000; Nursing and Liberal Arts - Clarion University of Pennsylvania 1977-1979. Memberships have included: American Counseling Association; National Board of Certified Counselors; Planned Parenthood; Sierra Club; Emily’s List; Arizona List Current Occupation: Licensed Professional Counselor in Private Practice, since 2005 (Depression, anxiety, grief, couples’ counseling); Faculty Member - University of Phoenix – Faculty, since 2007 Graduate/undergraduate classes: Counseling, Psychology, Human Services; Faculty - Prescott College Cultural Diversity, Counseling, Environmental Psychology Political Experience: Have never held political office. However, as a former news broadcaster with strong communication skills I will be better prepared to make an impact in the House. As a successful business owner, I will represent small business interests and attract new employers to our state. As a college faculty member, I understand the importance of empowerment and protecting education for future generations. As a counselor with compassion and understanding of our struggles, hopes and dreams, I will be a vocal advocate for Arizonans everywhere, particularly as regards health care accessibility to our most neglected populations, women and families. Campaign Website: SteeleForHouse.com

Questions / Answers:
In recent years the Legislature has cut eligibility, reimbursement and services from Medicaid Plan. How will you work to restore eligibility ad services or how will you further reduce costs? It is unconscionable that so many of Arizona’s vulnerable adults as well as children have been locked out of critical preventative and basic health care services because of state dollars being misdirected or otherwise allocated to special interests and programs of lessor importance. It is equally unreasonable that they have placed the burdens of such costs on physicians and hospitals. One of the main reasons I decided to run for office was seeing my clients lose their AHCCCS coverage in the middle of cancer and substance abuse treatment.
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people should become bankrupt because they or a family member gets sick. This is a priority that I plan to fight for, to the full capacity of my position as an elected state legislator.

Arizona has a sunrise process for various professions to use when they seek to expand the areas in which they practice. Do you favor continuing this process? I would like to see the sunrise process streamlined not necessarily done away with however. I think the sunrise process could be part of regular session duties for the legislature thus avoids the long delay that occurs because a quorum of legislators can’t or won’t attend interim sessions. Would you deny licenses to physicians who are not boardcertified or who do not undergo recertification examinations? No, I would not deny licenses to physicians who are not board certified. The lack of access to care will not be ameliorated by that approach. I certainly support thoroughly reviewing licensing standards to ensure that the public is being protected but see no value in enforcing rules that in the end simply result in less access to care by the general public Other issues about which you want physicians to know where you stand: Thank you for your time. Physicians need to realize the importance of comprehensive tax reform in regard to policy and the stabilization of the state’s tax structure. While it is appropriate to advocate for better access to care, such care comes at a cost and often that cost must be borne be government entities. For care to be consistent there has to be a reliable source of income for it to be sustained. This requires overhauling the state’s tax structure. Heretofore legislators from around the state have not had the political will to address this issue. The reality is that without comprehensive tax reform the state will stay on the merry go round of up and down funding for a long time to come.

Legislative District 10
Sabino east to the Rincons. Goes as far west as Tucson Blvd. and south to Los Reales Road. Includes Tucson Country Club. Candidates—Senate: Democrat Dave Bradley, Republican Frank Antenori (incumbent). House: Democrats Stefanie Mach, Brandon Patrick, Bruce Wheeler (incumbent). Republicans Todd A. Clodfelter, Ted Vogt (incumbent).

David Bradley
AZ Senate Democrat
Resident of Tucson for 32 years. Behavioral Health Care CEO for the last 20 years. BS Pyschology, MS in Education and MBA; Married to Debbie D’Amore a lifelong educator, four children and six grandchildren. Navy Veteran. Current occupation: Chief Development Officer La Frontera Arizona Political experience: State Representative 2003-2011 Campaign Website: bradleyforarizona.com

Questions / Answers:
In recent years the Legislature has cut eligibility, reimbursement and services from Arizona’s Medicaid plan. How will you work to restore eligibility and services or how will you further reduce cost? A key issue in the upcoming legislative session will be the expansion of Medicaid which I favor. Morally and fiscally it is the right thing to do for Arizonans. Opting out of the Medicaid expansion will be a disaster for hospitals and other health care providers particularly those in the rural areas of the state. The expansion is not a silver bullet for the resolution of problems related to health care but it will go a long way to offsetting the cost of care for people who do not disappear when they don’t have coverage. They instead appear for unreimbursed care in hospitals and clinics throughout the state. The state should also invest resources into the development of the electronic medical record which will in the long run have a significant impact on the delivery of care both quantitatively and qualitatively. While most larger medical institutions are on their way to creating the electronic record, smaller providers will likely need incentives to come along more quickly and develop the resources to use the electronic record in ways that will avoid duplication of services and reduce unnecessary testing and evaluation. Since 2010 no general fund dollars have been used for graduate medical education. Would you support reauthorizing general fund dollars for this purpose? Yes, I would support the use of general fund dollars for graduate medical education. I think the state must invest in the education of providers of healthcare from the technician level all the way up to physician.
SOMBRERO – August/September 2012

Stefanie Mach
AZ House Democrat
Age: 32. B.A. in international studies and Spanish from the University of Wisconsin-Stevens Point; masters in Public Policy in education from Brown University. Current Position: CEO, CM Concordia Consulting Political Experience: Democratic precinct committee person; state committee person for the Democratic Party; legislative district secretary for the Democratic Party. Campaign Website: Not Provided

Questions / Answers:
In recent years the Legislature has cut eligibility, reimbursement and services from Arizona’s Medicaid plan. How will you work to restore eligibility and services or how will you further reduce cost? Good health is the foundation of our lives. It is important for children’s development that they have access to health care (KidsCare), important for women to have access to preventative and reproductive care and critical that hospitals and clinics are not overburdened by expensive, emergency and urgent care that is oftentimes not reimbursed.
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It is just common sense that we invest a relatively small amount towards preventive care rather than wait until a problem reaches the pinnacle before addressing it. Preventative care reduces long-term cost by decreasing the spread of disease, the occurrence of chronic disease and educating the population on many health concerns. Healthy people are good for our economy because they take fewer days off of work and can work more productively. I will make health care a priority in our budget, accepting federal matching dollars to buoy these health care programs, further stimulating our economy. Since 2010 no General Fund dollars have been used for graduate medical education. Would you support reauthorizing general fund dollars for this purpose? I would support reauthorizing general fund dollars to be used towards graduate medical education. Arizona should be investing in education that prepares young people to take the high-skilled, high-wage jobs that will fuel a strong economy. Arizona has a sunrise process for various professions to use when they seek to expand the areas in which they practice. Do you favor continuing this process? I would like to consult experts like you to understand what are the advantages and disadvantages of this process. Would you deny licenses to physicians who are not board certified or who do not undergo recertification examinations? It is important to strike a balance between two interests. We want to protect the public by ensuring physicians are up-todate and competent in their field. We also want to allow experienced, skilled physicians to practice without having to go through a cumbersome, expensive process to recertify. We may need to reexamine the recertification process to make sure that it is adaptable to meet varying needs. Other issues about which you want physicians to know where you stand. After receiving third-degree burns on over sixty percent of my body many years ago, I spent a significant amount of time in and out of hospitals and clinics. My exposure to those who serve in the medical field has deepened my respect for what medical professionals do and health, in general. It is for that reason, that I intend to make health care a priority in the legislature.

returned home to Tucson and entered law school at the University of Arizona. While in law school, Ted remained heavily involved in Homeland and National Security matters. During the summer of 2008, Ted worked on Homeland Security issues at the White House. In 2009, Ted clerked for Senator Jon Kyl on the Senate Judiciary’s Subcommittee on Terrorism and Homeland Security in Washington, D.C., as well as for the Criminal Division within the United States Attorney’s Office in Tucson. Though only in his first full term, Ted has already proven himself to be an effective legislator. He introduced substantive legislation strengthening victims’ rights, securing critical funding for University of Arizona College of Medicine-Phoenix and the Arizona Poison and Drug Information Center. Ted has also taken the lead on tort reform for the Legislature, chairing the Tort Reform Working Group. Ted holds a B.A. from Yale University and a J.D. from the University of Arizona Law School. He practices law for the Tucson community at Smith & Smith, PLLC, where he is an associate. Current Occupation: State Representative, Legislative District 30; Attorney, Smith & Smith PLLC Political Experience: State Representative, LD 30 (Mar 2010-present); Chairman, LD 30 Republican Party (2009-2010); Precinct Committeeman (2007-Present). Campaign Website: vogt4arizona.com

Questions / Answers:
In recent years the Legislature has cut eligibility, reimbursement and services from Arizona’s Medicaid plan. How will you work to restore eligibility and services or how will you further reduce cost? At this time, the State of Arizona cannot afford to expand its Medicaid program (AHCCCS) without seriously jeopardizing funding for other critical programs such as education and public safety. Any expansion to AHCCCS must be based on a steady and consistent funding source. That is why I have championed and voted for policies that create a vibrant and attractive economic environment in Arizona. Growing our economy will provide additional revenue to the state that can then be use to strengthen AHCCCS. However, I realize that our economic recovery will not be accomplished overnight. That is why I helped lead the legislative effort in 2011 that now allows hospitals to draw down matching Medicaid dollars in certain circumstances that were previously unavailable. Furthermore, as the Chair of the House Tort Reform Working Group, I am working to bring about real, long-term, and system-wide cost reductions by reforming our tort system—making it more difficult to bring frivolous lawsuits that drive up the cost of care and insurance. Since 2010 no general fund dollars have been used for graduate medical education. Would you support reauthorizing general fund dollars for this purpose? Arizona’s population is both fast-growing and rapidly-aging. Ensuring that Arizona has enough physicians and healthcare professionals is essential to our future as a state. That is why I
SOMBRERO – August/September 2012

Ted Vogt
AZ House Republican
State Representative Ted Vogt is a proud veteran of the United States Air Force, serving this country for six years as an intelligence officer. After the attacks of September 11, 2001, Ted served in Afghanistan in support of Operation ENDURING FREEDOM, and throughout the greater Middle East in support of Operation IRAQI FREEDOM. Because of his outstanding performance, Ted was hand-picked to serve as the daily intelligence briefer for both the Secretary of the Air Force and Chief of Staff of the Air Force. Leaving active duty in 2006, Ted
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sponsored legislation that secured critical funding for the expansion of the University of Arizona College of MedicinePhoenix. This additional and on-going funding from the state will help Arizona meet public health challenges of the future. Arizona has a sunrise process for various professions to use when they seek to expand the areas in which they practice. Do you favor continuing this process? Yes. I believe it is prudent to thoroughly review and receive testimony from stakeholders and other interested parties when professions attempt to expand into new practice areas. Would you deny licenses to physicians who are not boardcertified or who do not undergo recertification examinations? I believe that the professional boards are in the best position to oversee and regulate their given professions. As a legislator, I have come to rely upon recommendations from the professional oversight boards on how—and in what ways— statutes need to be changed to best serve the profession and the public. Other issues about which you want physicians to know where you stand. In addition to prime sponsoring legislation for additional funding for the University of Arizona College of Medicine-Phoenix. I was also the prime sponsor of legislation enabling the State Board of Pharmacy to provide critical funding to the U of A College of Pharmacy’s Arizona Poison and Drug Information Center.

costs on to the rest of us, resulting in highter insurance premiums and hospitalization costs due to uncompensated care. Our population must have insurance options which will give them access to preventive care, lowering costs across the healthcare spectrum. It is a shame and very foolish that Arizona is the only state without KidsCare. I will work to restore eligibility by working closely with members of both parties and the governor making the argument that by doing so we save money by covering persons with preventive medical care. Cutting eligibility has and will continue to increase the work load on physicians, specifically primary care doctors, and we lower reimbursement fees further placing economic strains on our entire healthcare system including doctors, nurses, hospitals and medical centers. Since 2010 no general fund dollars have been used for graduate medical education. Would you support reauthorizing general fund dollars for this purpose? Yes. We are facing an acute shortage of healthcare practitioners. The shortage of doctors is resulting in greater workloads and people being left without care. It is imperative we address this shortage immediately if we are to provide adequate healthcare. Rural areas are particularly being negatively impacted. Arizona has a sunrise process for various professions to use when they seek to expand the areas in which they practice. Do you favor continuing this process? Yes

Bruce Wheeler
AZ House Democrat
BA, International Relations, University of Arizona, 1972; MBA, University of Phoenix, 2001. Two sons, graduated Tucson public schools, graduated from MIT and Stanford University. Member, Tucson City Council, 1987-1995. Current Occupation: Member, Arizona State House of Representatives, 2010-present. Political Experience: Candidate for re-election Campaign Website: brucewheeler2012.com

Questions / Answers:
In recent years the Legislature has cut eligibility, reimbursement and services from Arizona’s Medicaid plan. How will you work to restore eligibility and services or how will you further reduce cost? We must restore eligibility for moral and economic reasons. Accessibility to healthcare is not only a moral issue, it makes critical economic sense. 21% of Arizona’s population has no health coverage. This means that emergency personnel and hosptials must treat patients and pass the
SOMBRERO – August/September 2012 21

Would you deny licenses to physicians who are not boardcertified or who do not undergo recertification examinations? No. I have learned that some board-certification and recertification examinations are onerous, excessively expensive, unrelated to a physician’s specialty and therefore unnecessary for the physician to perform his or her responsibilities. Other issues about which you want physicians to know where you stand. I believe that the three most important issues in this campaign are education, jobs and healthcare. We must fully fund public education from K-12, universities and adult education programs to at least our 2008 levels. We must reverse the priorities of the present legislature which have resulted in Arizona ranked near the bottom in student investment and achievement. We presently allocate $7,800 per student per year, while spending over $42,000 per prison inmate per year. Allowing guns on campus is not the solution to our public education challenges. Education does matter! As a policy maker, together with statewide leaders in science, business, healthcare and sustainable energies, I will work to attract high-tech companies such as bioscience, solar, optics and aviation related industries to Arizona, adding thousands of new jobs to our state. We must revamp the loop-laden tax code with an equitable and fair code in order to properly fund education, healthcare and encourage economic development. The respected Joint Legislative Budget Committee reported that due to over 200 tax loop holes, Arizona is losing over $9 billion a year - more than the annual budget of our state! We can do better.

Questions / Answers:
In recent years the Legislature has cut eligibility, reimbursement and services from Arizona’s Medicaid plan. How will you work to restore eligibility and services or how will you further reduce cost? A cut to AHCCCS is essentially a tax increase borne by the middle class in Arizona, and I support the restoration of eligibility to AHCCCS and to KidsCare. The cost-to-benefit relationship of Medicaid has not been made clear to voters. Controlling/reducing health care costs is a larger problem, with very deep roots. Viewing the health care system as a “marketplace” is one of the most basic problems. The top priority should be quality of care of each individual patient over the long term, managed by a personal primary care physician who monitors and advises patient care. Since 2010 no general fund dollars have been used for graduate medical education. Would you support reauthorizing general fund dollars for this purpose? Of course. Once again, a program that acts as an investment has been cut for short-term gain, at long-term expense. Arizona has a sunrise process for various professions to use when they seek to expand the areas in which they practice. Do you favor continuing this process? It seems wise to carefully examine a request to expand a medical service area, to ensure that quality of care is not being exchanged for lower cost of care. Would you deny licenses to physicians who are not boardcertified or who do not undergo recertification examinations? In general, I would. But there may be extenuating circumstances in some cases, and there should be some mechanism for dealing with that. Other issues about which you want physicians to know where you stand. I support the Affordable Care Act and I also support a singlepayer health care system.

Legislative District 11
North of Ina into Pinal County. Contains most of Oro Valley, Saddlebrook and Marana. Candidates—Senate: Democrat Jo Holt, PhD, Republican Captain Al Melvina (incumbent). House—Democrat Dave Joseph. Republicans Adam Kwasman and Steve Smith.

Jo M. Holt
AZ Senate Democrat
I was born in Houston, TX, in 1952. I received my BA in Chemistry from Texas A&M Univ. in 1975 and PhD in biochemistry at Colorado State Univ. in 1982. My passion and career was research biochemistry & molecular biophysics. I was Research Assistant Professor at the Univ. of AZ in the 1980’s in the Dept. of Biochemistry, and held the same position at Washington Univ. School of Medicine in St. Louis from 1992 to 2005. My son was born at TMC, and currently works in Washington D.C. I took an early retirement in order to take care of my husband, who passed away last year from early-onset Alzheimer’s. Although I’ve always voted, I have not been personally involved in politics until I was approached last year and asked to consider running for state legislature. So, this is my first time to run for any political office. Current Occupation: Running full time for state senate Political Experience: None Campaign Website: holt4senate.com
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Albert A. Melvin
AZ Senate Republican
Al has served in the Arizona Senate since 2009. He represents the north side of Tucson and part of Pinal County. Al was born in Helena, Montana. His father was a career US Army officer, so his family lived all over the world, including Europe, the Far East and throughout the United States. During this time he became an Eagle Scout, which later helped him get into college. He graduated from high school in Fayetteville, NC which is near Fort Bragg. Al graduated from the US Merchant Marine Academy, Kings Point, NY, which is one of the five federal academies. Later, he earned his MBA from Thunderbird-The American Graduate School of International Management in Glendale, AZ. Later, he graduated from the US Naval War College, Newport, RI. Al spent 30 years in the merchant marine, including 12 years
SOMBRERO – August/September 2012

ashore in overseas assignments (Korea- 2 years, Japan- 8 years & Pakistan- 2 years) working for two large American shipping companies. Later, he worked for 10 years in California for a large Japanese shipping company. In addition, he spent 9 years at sea on US flag merchant ships. He had a parallel 30 year career in the US Naval Reserve, retiring as a Captain in 1999. One of his last active duty assignments was Squadron Commander in Diego Garcia in the Indian Ocean in 1997/8. His assignments were primarily with the Military Sealift Command and the US Transportation Command. He was fortunate to do in the military what he did in his commercial career which was managing merchant ships throughout the world. For the past ten years, Al and his wife have lived in SaddleBrooke, a golf community just north of Tucson. Prior to becoming an Arizona State Senator, he taught as an adjunct lecturer at three universities. He taught transportation and logistics courses at the University of Arizona. He taught management courses at the University of Phoenix and he taught economics and international business courses at Western International University. He owns a trade and transportation consulting LLC which is currently working on building a deep water port in Mexico. He and his wife have 16 Koi fish in a large fish pond in their backyard. They have a seven year old Basset Hound named Bradford and a one year Basset Hound named Josephine. Al’s wife is a great golfer and he is still trying to break 100. He is a member of Rotary, the Elks and two chambers of commerce. Al’s remaining goals are: • Write a book on containerization and intermodalism • Restore a Vietnam era jeep and trailer • Keep working on his golf game, so he can break 100 Current Occupation: AZ State Senator Political Experience: Four years in AZ Senate; Eight years as Republican precinct committeeman. Campaign Website: senatormelvin.com

Would you deny licenses to physicians who are not boardcertified or who do not undergo recertification examinations? Yes Other issues about which you want physicians to know where you stand. Stop ObamaCare. We need Texas-style reform. Americans should be able to purchase medical insurance across state lines.

Legislative District 14
Includes Summerhaven, Rincon Valleyand SE Pima County, including Sahuarita and parts of Green Valley. Candidates— Senate: Democrat Patricia Fleming, Republican Gail Griffin (incumbent). House—Democrat Mark Stonebraker. Republicans David Gown and David Stevens (incumbent).

Patricia V. Fleming
AZ Senate Democrat
A proud Arizonan for over 40 years. Pat was born near her grandparents’ Missouri farm. Growing up as the daughter of a career Army Officer and an Army Civilian mother, Pat learned the importance of service to the nation and the strength that comes from its shared values, diversity and rich history.  Pat and Bob Fleming live in Sierra Vista, Cochise County, AZ. Combined, their family includes 5 children and 12 grandchildren. In 1969, Pat and her family moved to Sierra Vista where she began to make personal and professional ties to southern Arizona.  In 1981, she followed her parents’ footsteps and began working as an Army Department civilian at Fort Huachuca.  Since January 2011, Pat has been active in local community organizations, partisan, non-partisan and bi-partisan. She has been a contributing member of the League of Women Voters of Cochise County for many years. Pat has served on, and contributed to, a variety of non-profit organizations which support other members of their community. Current Occupation: Retired, Department of Army Civilian Political Experience: Arizona Democratic Party Committee Member; Cochise County Democratic Party Chair, 2007- 2008; Greater Huachuca Area Democratic Club President, 2005 – 2006; Volunteer on various partisan and non-partisan campaigns since 2002. Volunteer for various candidates, partisan and non-partisan since 2002. Candidate for Arizona House of Representatives 2006; lost by 784 votes. Candidate for Arizona House of Representatives 2008; won. Served in the House of Representatives during the 49th Legislature, January 2009 to January 2011. Candidate for re-election; lost. Campaign Website: patflemingaz.com

Questions / Answers:
In recent years the Legislature has cut eligibility, reimbursement and services from Arizona’s Medicaid plan. How will you work to restore eligibility and services or how will you further reduce cost? The Federal Government borrows 40 cents of every dollar it spends. This must stop. We have to stop borrowing from the Chinese and future unborn generations of Americans. This includes Food Stamps, Medicare, etc. We need to look at things such as the Volunteer Physicians Protection Act. Dr. Lee Vliet is familiar with this proposed legislation. Since 2010 no general fund dollars have been used for graduate medical education. Would you support reauthorizing general fund dollars for this purpose? Yes Arizona has a sunrise process for various professions to use when they seek to expand the areas in which they practice. Do you favor continuing this process? Yes
SOMBRERO – August/September 2012

Questions / Answers:
In recent years the Legislature has cut eligibility, reimbursement and services from Arizona’s Medicaid Plan.  How will you work to restore eligibility and services or how will you further reduce costs? The cuts, in all forms, were disastrous for people, and for health
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care providers. And, now we know there’s a budget surplus, at the expense of our public school system and medical care providers, because of restricting eligibility for potential AHCCCS enrollees. In essence the incumbents, as pointed out by the Sierra Vista Herald’s editorial page on July 11th, are the culprits. As the Editor  opinioned: “The shell game of cutting state financial aid to balance the budget has come home to the residents of Cochise County, who are now seeing the consequences of that fiscal policy .” To me, there’s a cost associated with having a budget surplus, i.e., people will go without preventive medical care, and children will experience over-crowded classrooms.  I will advocate for maximum federal matching funds, and no more cuts to the general fund to avoid loss of federal funding. In addition I will support restoration of eligibility standards for our poor. I will also advocate for timely claims processing, and the payment of higher percentage of actual costs to reduce under-compensation of costs to our healthcare providers. Since 2010 no general fund dollars have been used for graduate medical education.  Would you support reauthorizing general fund dollars for this purpose?   Yes.  As I did while serving in the Arizona House of Representatives during the 49th Legislature, I will continue to support funding for GME in order to better serve our rural Arizona communities. Arizona has a sunrise process for various professions to use when they seek to expand the areas in which they practice.  Do you favor continuing this process? The sunrise process, as I understand it, is asking for additional regulation in a given area…including healthcare. Whether it should be continued in statute is difficult to answer without knowing the specifics of the sunrise request…but a process asking for additional regulation at first glance doesn’t seem to be onerous. However, if it is a process that does not contribute to our governance, then it should not be one that needs to continue. Should legislation be proposed next session to change the statue, I would give it serious consideration, after seeking input from stakeholders. Would you deny licenses to physicians who are not boardcertified or who do not undergo recertification examinations? Board Certification of a physician is an action that does contribute to the quality of care provided. However, requiring Board Certification as a condition of licensure could have the effect of restricting the number of physicians who are available, and this is a problem in rural areas such as Cochise County. The common practice is for hospitals, in their credentialing process, to give the new physician a period of time to become Board Certified…in my observations it has been when the physician is scheduled for re-appointment to the Medical Staff. One issue, however, that Board Certification by the state licensing body does address directly is the physician who is not on staff and therefore not subject to peer review. In this case Board certification or re-certification might be appropriate since it does permit the peer review process to take place. Should this become an issue in terms of legislative action, I would most definitely seek the advice and counsel of medical associations. Other issues about which you want physicians to know where you stand. Arizona is in crisis. While the majority of members of the Arizona Legislature have created a climate of radical, right-wing, intolerance, they demonstrate blatant intolerance of real-life
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situations affects families and businesses. My opponent marches in lock step with special interest lobbyists and their party leadership, demonstrating that she is not willing, nor able, to address the issues that matter to most of us—creating jobs, providing quality public education which will prepare children for the future’s jobs, and seeking affordable health care solutions for families. I will work to reverse legislative support for creating nuclear waste dumps in rural Arizona, to stop putting government bureaucrats in charge of personal healthcare choices and providing tax breaks that enrich big and foreign corporations. While my opponent touts that this legislature made tough choices balancing the budget; the budget was balanced using gimmicks. My legislative track record, as a member of the House of Representatives LD25 during the 49th Legislature, is evidence that I am the one who is willing and able to fight for all of Arizona, not just moneyed special interests. Please refer to: http://www.azleg.gov/MembersPage.asp?Member_ID=7& Legislature=49&Session_ID=89 As the next senator from Legislative District 14, I intend to continue my commitment as a full-time volunteer civil servant for the people. Among my priorities is consistent emphasis on common sense solutions that address the challenges of our communities and families, and will apply my best analysis, and judgment, to any and all legislative efforts and decisions. While Arizonans have many different political views, I believe we can all agree on the importance of honest, dependable and responsive representation of OUR interests in the State legislature. I will responsibly, and respectfully, provide that kind of leadership and representation for ALL of District 14, regardless of party affiliation.

Rob Leach
AZ House Democrat
I was born in Buffalo, New York and raised outside of Cleveland, Ohio. I entered the US Army in 1989 and proudly served 20 years in the military, and retired in 2009. I spent my entire career as an Intelligence Analyst serving in a variety of places to include the Middle East, Panama, and Korea. In 2006, I was inducted into the prestigious Sergeant Audie Murphy Club for distinguished leadership. During my career, I served as a Drill Sergeant for 3 years. I earned my Bachelor’s Degree in Human Services majoring in Criminal Justice through Wayland Baptist University (Sierra Vista). My Master’s Degree in the Administration of Justice and Security was earned through the University of Phoenix graduating with a 4.0 GPA and honored as the Graduate Student of the Year by the staff and faculty. Upon my retirement, my wife Renee and I and our three dogs remained in the Sierra Vista area. I also volunteer as a Court Appointed Special Advocate (CASA) in my free time. I was appointed as a Precinct Committeeperson in January 2011 and have been a Commissioner on the Sierra Vista Parks and Recreation Commission since November 2011. Current Occupation: I am currently employed as a contractor working on Fort Huachuca teaching the Intelligence Analysts course to new Soldiers.
SOMBRERO – August/September 2012

Political Experience: I have been a Precinct Committeeperson for about 1½ years. Campaign Website: leach4ourhouse.com

Questions / Answers:
In recent years the Legislature has cut eligibility, reimbursement and services from Arizona’s Medicaid plan. How will you work to restore eligibility and services or how will you further reduce cost? I will work diligently to restore Arizona’s Medicaid plan (AHCCCS) to its funding levels prior to 2010. When asked how do you do this, well, I believe moving our corporate tax structure to a graduated system that will produce revenue at the same level prior to HB 2503 would generate approximately $538 million, which could be used to properly fund AHCCCS. Additionally, it will allow small businesses to save money, which might help them in providing healthcare for their employees. Since 2010 no general fund dollars have been used for graduate medical education. Would you support reauthorizing general fund dollars for this purpose? I fully support reauthorizing general fund dollars to support graduate medical education. Having had the opportunity to speak with rural hospital administrators, I realize how vital it is to support this program, which will help keep doctors in our rural hospitals. This money will also allow perhaps disadvantaged persons to seek employment in the medical professions. Arizona has a sunrise process for various professions to use when they seek to expand the areas in which they practice. Do you favor continuing this process? I am interested in learning more about the effects of the sunrise process. It seems like a good idea from my limited knowledge of this. However, I would seek advice from organizations like the Pima County Medical Society prior to voting yes or no for this measure. Would you deny licenses to physicians who are not board-certified or who do not undergo recertification examinations? Much like question number 3, I would refer to medical organizations for advice and counsel prior to rendering my decision. I encourage members of the Pima County Medical Society to reach out to me, and help educate myself in this area. Other issues about which you want physicians to know where you stand. As a state legislator I will not claim to be a subject matter expert in most areas. I will continuously seek advice from the people that will or could be affected by new laws. Before I make a decision I want to know both positive and negative effects of the
SOMBRERO – August/September 2012

laws. As an Intelligence Analyst for many years, I recognize the need to understand the full story from different perspectives. I will carry this practice over to Phoenix if elected as a Representative for Legislative District 14

Mark Stonebraker
AZ House Democrat
Resident of Southern Arizona for 23 years; run a small business with my wife working as a Computer Scientist Current Occupation: Computer Scientist Political Experience: Not provided Campaign Website: stonebrakerforarizona.com

Questions / Answers:
In recent years the Legislature has cut eligibility, reimbursement and services from Arizona’s Medicaid plan. How will you work to restore eligibility and services or how will you further reduce cost? Cutting eligibility for ACCCHS is a false economy. People will end up in the emergency room raising the cost for the rest of us. We are far better off making sure these people are covered at least for reasonable health care. I would strive to find some way to not pay if a health visit produces no outcome. This is difficult and is a goal only. I advocate refunding ACCCHS.

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Since 2010 no general fund dollars have been used for graduate medical education. Would you support reauthorizing general fund dollars for this purpose? Yes, it is most important that we generate health workers of all skill levels to meet the coming increase in demand by aging baby boomers. Arizona has a sunrise process for various professions to use when they seek to expand the areas in which they practice. Do you favor continuing this process? I have studied the occupational regulation structures of several states other than Arizona and find that they are quite varied. Most are much less politicized than the sunrise system in Arizona. I believe anything that can be handled in a deterministic manner derived from guiding principles rather than opinion should be so handled. I would support a careful review of occupational regulation systems applying a set of values agreed upon by the legislature for such a system in order to determine what structures and laws would best meet those values. Do we want to depoliticize it? Do we want to reduce the ability of professions to expand their area of practice? Do we want to change the method by which they may expand it to and reduce the effort involved without losing proper control of the limits of the practice? Would you deny licenses to physicians who are not boardcertified or who do not undergo recertification examinations? I would have to study this issue.

I do not have enough information on the reasons for allowing a physician to be licensed without board-certification or recertification. Perhaps the cost of continuous recertification may outweigh the benefits. However, perhaps requiring a physician to pass an exam is of good value in determining the ability of that physician to provide high quality care. This has to be examined. Other issues about which you want physicians to know where you stand. I support looking at tort reform so that the patient takes more responsibility for the decision to trust the physician to perform a procedure. I am fed up with our culture’s litigious proclivity and would like to see less frivolous tort, and more restrained awards. I also support efforts to track physician outcomes so those who have higher rates of error can be trained or put into a function that better suit their skills or perhaps physicians should be less overworked. Likewise those with exceptional rates of success may be rewarded and perhaps teach others. I fully support constant evaluation of procedures and drugs to determine if they actually produce the outcome they claim, given the patients diagnosis. For example outcome studies show that statins are of no clinical value to patients that have not already had a heart attack; therefore, they should not be prescribed for such patients. Further I believe we must not compensate on the basis of numbers of procedures but on outcomes. On that I agree with the affordable care act. n

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SOMBRERO – August/September 2012

COUNTY RACES

Pima County Board of Supervisors
Board of Supervisors District 1
Catalina Foothills from Bear Canyon to Oro Valley, north of River Road. Race is for Ann Day’s Seat. She retires this year after representing the district since the 2001 election. Candidates— Democrat Nancy Young Wright; Republicans Ally Miller, Stuart McDaniel, Mike Hellon and Vic Williams. better performance than the budgeted loss of $9.1 million that was forecasted. The current leadership of the South Campus is continuing to increase efficiencies that I hope will eventually decrease the county’s general fund support. The county’s role should be to work closely with the University and hospital management to lower costs, increase revenues, improve service and use a reasonable and sustainable county contribution to leverage state and federal money as they have with the Graduate Medical Education and the Disproportionate Share Hospital programs. The county should also continue to be responsible for providing the infrastructure needed to foster success at the South Campus much in the way that they did with the voter-approved bonds in 2006 that provided the community with the Behavioral Health Pavilion and the Crisis Response Center. What are your thoughts about the mission and scope of the Pima County Health Department? The mission and scope of the Health Department are dictated by state statutes and the policies of the Board of Supervisors. I believe the department is operating with the scope laid out for them, but the bigger issue is adequate funding. Members of the Pima County Board of Health recently raised financial concerns at the Board of Supervisor’s budget hearing I attended. The Health Department’s reserve has been swept and the health department may be required to back-fill the loss of funding for the federal Vaccine for Children program. In response, Pima County Administrator Chuck Huckelberry and his staff are currently doing a comprehensive review of the Health Department’s budget - essentially doing a zero-based budget reconstruction. The results of this review will have serious implications for the health of Pima County residents and medical professionals. I will be very involved in shaping the budgetary policy after the first of the year if elected District 1 Supervisor. Other issues about which you want physicians to know where you stand: Many of the most important health issues facing the residents and medical professionals of Pima County will be decided at the state and federal levels. I will work aggressively with our Southern Arizona delegations to develop sensible healthcare policies and advocate for greater physician education, recruitment and retention.

Mike Hellon
Republican
Education: B.S. Business Management, 1972, AZ State Univ.; Military: USAF (Sergeant); 64-68; seven decorations including the Bronze Star. Small Claims Hearing Officer, Pima County Justice Court (1990-2012); Arizona Commission on Judicial Performance Review (Current Chairman) (2004 –Present); Arizona Judicial Council (2008-Present); Faculty Member, Arizona Supreme Court, New Judges Training Program (2004-Present; Arizona Academy (1997-Present; Pima County Merit Commission (Vice Chairman 2002-2008) (2000-2008; Pima County Board of Adjustments (Dist. 1) (1994-1997); Tucson Classics (1989-1992; Director, American Diabetes Assn. (Tucson Chapter) (1989-1992); Director, Catalina Soccer Club (1984-1988); Director, ATMA Training Foundation (1981-1984); Director, Visiting Nurse Service (President, 1978) (1976-1981) OSHA Advisory Council to Arizona Industrial Comm. (1973-1976) Current Occupation: President, Hellon & Assoc., Inc. Tucson, AZ, 1978-Present Political Experience: Arizona Co-Chair McCain for President (2008); Member, Republican National Committee (RNC) (National Committeeman for Arizona) (1992-2004); Member, RNC Executive Committee (representing the Western Region) (1997-2004; Chairman, Arizona Republican Party (1997-1999;

Questions / Answers:
Pima County subsidizes University of Arizona Medical Center South Campus with $40 million annually. Is that support sufficient? Too high? Too low? The county’s current annual general fund contribution ranges from $15 million to $20 million, not $40 million. Currently the funding level is sufficient, but the change of management from University Physicians Healthcare to the new University of Arizona entity is still a work in progress and my hope would be that county support can eventually be decreased. Previous county and independent audits identified significant problems in UPH’s management of the former Kino Hospital. I believe the University’s direct involvement is a vast improvement over both the county and subsequently UPH’s management performance. But more improvement is still needed. As of May 1, 2012, after consideration of the $10 million the county had provided in the first eight months of the fiscal year, the hospital was still showing an operating loss of $7 million. Of course, this was
SOMBRERO – August/September 2012

Nancy Young Wright
Democrat
Bio: A fourth generation south westerner and a mother of two daughters who were born and raised in Tucson. My husband, Allen, and I have been married for 30 years. My family ran a small business in New Mexico for more than 90 years. Education and interests: MFA, University of Arizona, Creative Writing; BA, Journalism, New Mexico State University
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Current Occupation: Writer, full time candidate for office Political Experience: Served three years in Arizona State Legislature in LD 26 on Tucson’s NW side. Served 10 years on the Amphitheater School Board. Volunteered on various local, state and federal campaigns. Campaign Website: nancyyoungwright.com

Humane Society of Southern Arizona spends, yet the County must also conduct all of the licensing, animal cruelty, and violation investigations. Funds for prevention could save taxpayers funds in the long run and make our community safer. Other issues about which you want physicians to know where you stand. My priorities are: Rebuilding our economy; restoring our roads; protecting Pima County’s water supplies and natural desert. I’m running to apply my 30 years of experience in the areas of education, parks, trails, citizen advocacy, budget analysis and policy development to the needs of District One. I have a deep understanding of the region’s land use, economic, recreational, and cultural needs. I will be a strong advocate for sensible policies regarding all facets of County business and for protecting our natural lands. My broad experiences in the state legislature, on the school board, as a parks and schools advocate, and as a parent will be applied to the issues before the board. I’ve learned where the resources are in the community to consult with to get things done and I am a problem solver.

Questions / Answers:
Pima County subsidizes the University of Arizona’s Medical Center South Campus with $40 Million annually. Is that support sufficient? Too high? Too low? The amount needs to be reviewed to be sure it’s current with present demands and realities. The subsidy includes 15 Million in funds for graduate medical education training of new doctors. We then receive $45 Million from the federal government, which is an excellent investment for our community. One of the most important factors for our economic growth and stability in the future is the availability and quality of our medical resources. What are your thoughts about the mission and scope of the Pima County Health Department? The Department plays a vital role in the everyday life of the health of our citizens. It may be one of the most complicated departments in the County structure due to the breadth of its scope and responsibility, and the constantly changing demands. Programs range from the oversight of the Food Safety, Behavioral Health, Emergency Preparedness, the WIC program, vital records, oral health, maintaining a resource center for Physicians, family planning, disease and infectious disease tracking and prevention, fitness and wellness promotion to running the Animal Care Center. I understand the Department has the same budget for the past 10-15 years, which makes it difficult to keep up with population growth and changing needs. In addition, cuts by the state legislature to areas such as services for the Seriously Mentally Ill have put more pressure on our local structure to meet the need. Interviews are in process for a new Chief Medical Officer and a new Director. This is a natural time for the department to review their mission and scope and see if there are programs that need updating or expanding, or if any are ineffective and need to be revised. It’s also a great time to look at efficiency measures and partnerships with other County and community agencies and departments. There may be more that the Department can do with public outreach on education and prevention if the resources can be found for these priorities. For example, the Department has worked with the library system to pilot outreach programs to help reach more people about the WIC program and about animal care issues. The library has at least one specially trained Health librarian and a health website that they created in an effort to help encourage healthy habits and give citizens the tools they need to research their health issues. This is a partnership that could be expanded. I would personally like to see the Department receive additional funding to conduct educational outreach programs on animal cruelty prevention and to operate a mobile spay/neuter van program in low income areas. The County spends $4M a year running the shelter, which is the same amount the private
SOMBRERO – August/September 2012

Board of Supervisors District 2
South of Broadway between Oracle and Wilmot. Candidates: Democrat Ramon Valadez (incumbent) and Republican James H. Kelley.

James H. Kelley
Republican
Bio: James Kelley is a native of Tucson, born here in 1961. A Navy veteran, he graduated twice from the Defense Language institute in Monterey CA majoring in Albanian and Persian-Farsi. He was a Balkan area, Middle East North Africa, Southwest Asia, and Gulf Area analyst for the Naval Security Group and the National Security Agency. He received his Bachelor of Science in Sociology from the University of the State of New York, Albany. Since leaving the service he has worked as a premium cruise line representative, telecommunications specialist, real estate broker, a substitute teacher for the Joint Technical Education District, freelance journalist and political consultant. Current Occupation: Transportation specialist for Renzenberger Incorporated, a contractor for the Union Pacific Railroad. Political Experience: Mr. Kelley has been an active, contributing, productive member of the Pima County community. He has worked extensively with Veterans issues particularly the issues of housing, drug and alcohol abuse, and PTSD. He has testified to the State legislature on redistricting issues and worked with legislators on issues of cyber bullying, internet privacy, education, and transportation. He is the former chairman of the Pima County GOP for legislative district 29 now LD-2. He is very knowledgeable about the issues facing one of the most impoverished areas of Pima County. Public health, law enforcement, employment, and transportation are but a few of the priorities that he wishes to address as County Supervisor for district 2. His goals are to remove an entrenched political incumbency that has created poverty and government dependence in District 2. Real jobs that pay a self-sustaining living wage, real roads that are the backbone of the transportation infrastructure of the arteries of commerce, and real business that produces economic engines
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for the county and are not just drains on the taxpayers. In order to pay for those mandated and necessary social services, these issues must be addressed. Mr. Kelley understands the interdependence of good mental health and physical wellness contributing to overall economic health as much as any paved road and thriving business does. Campaign Website: kelley4pima.com

Questions / Answers:
Is $40 million annually to the UMC South campus (Kino Hospital) sufficient or not? Sufficient or not, funding is based on a number of factors. What is legally mandated that the County perform with regards to its County Hospital? What is the estimated need for service of the serviced community? Are we expanding service recipients unnecessarily simply to have need for more budget dollars? Are we delivering service at the highest quality and the cheapest price? It is my hope that the members of your organization have those answers for me at budget time when I will have to make those decisions. It is not a conversation of politics, or if the service receivers are “worthy” of the service by some arbitrary moral or political standard. It is a question of medical need and what is the highest quality at the best price practices to fulfill that need. What do I believe the mission and scope of the Pima County Health Department? Protect health, prevent disease, and promote healthy living. It sounds simple. Obviously, a great deal comes under those very general aspirations. Animal control, restaurant inspections, school immunizations, social disease control (STD education and eradication), MRSA abatement, family planning, senior health, assistance to the most vulnerable economically and physically. It is a big mission. My district is probably one of the largest service populations for many of the Pima Health programs. I want to examine what is working and what isn’t, are we staffing and funding the right strategies at the right levels. These are issues that no one person can just walk in and say “Let’s reform it,” it takes deliberation with the area experts and the field representatives fighting the good fight at the street level. Other issues about which you want physicians to know where you stand. Regardless of all the politics, constitutional questions, and general discontent with the Affordable Healthcare Act, (Obamacare), the realities of our present system is driven by dollars, either for profit insurance companies, or a bloated, inefficient, and disconnected government agency is making the healthcare decisions that should vigorously be kept to the provider and the patient. If the cost of health care was decided only by provider and consumer marketplace behavior, I believe cost would come down. Unfortunately, large organizations created this monster whereby every medical product has over inflated pricing and production cost. Our task at hand is, how can we provide the best care at the cheapest price to our community? Perhaps a bonding program to create a low cost “insurance program” specific to the citizens of Pima County; one which pays the premium for up to say 12 months if found un-employed and have previously paid the premium for 12 months. A low cost plan that can be used at any county health care provider tailored to the economic realities of minimum
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wage workers. Many would say that this just another subsidy to corporations not responsible enough to offer low cost plans to their minimum wage worker. Point is we should start doing locally for ourselves if no one else will. The working poor put off seeking medical help because of economics. And once the medical issue becomes traumatic, the worker is now off production and usually becomes a greater burden on the healthcare system. Education at the street is imperative as well.

Ramon O. Valadez
Democrat
Bio: Ramón Valadez is a lifelong resident of Tucson, Arizona. He attended and graduated from Wakefield Middle School and Pueblo High School. In 1989, he graduated from the University of Arizona with a Bachelors of Science Degree in Electrical Engineering (BSEE). In 1996, Ramón was elected to the Arizona House of Representatives and subsequently re-elected 1998. While in the House, he was selected as a Flemming Fellow by the Center for Policy Alternatives (CPA) in Washington, D.C. and participated in the Program for Emerging Political Leaders at Darden College, University of Virginia at Charlottesville. Ramón was elected to the Arizona State Senate in 2000 and won re-election in 2002. While in the Senate, he was honored as the recipient of the Trailblazer Award given by the National Network of Sector Partners for his legislative work. At the end of the 2002 legislative session, the Arizona County Supervisors Association recognized him as a Legislator of the Year and the University of Arizona Alumni Association also honored Ramón as a recipient of the Public Service Award. At the end of September 2003, Ramón was appointed to serve as a member of the Pima County Board of Supervisors representing District Two. In 2006, during the successful campaign for the Regional Transportation Authority, he served as Chairman of the RTA Board of Directors. Ramón was reelected in 2004 and 2008 and currently serves as Chairman of the Pima County Board of Supervisors. Current Occupation: County Supervisor District 2 Political Experience: 1988-1989 Special Management Intern for Pima County Supervisor Dan Eckstrom; 1989-1991 Staff Assistant for US Senator Dennis DeConcini; 1991-1994 Special Staff Assistant for US Congressman Ed Pastor; 1994-1997 Special Staff Assistant for Pima County Supervisor Dan Eckstrom; 1997-2001 Member of the Arizona House of Representatives, District 10; 2001-2003 Member of the Arizona State Senate, District 10; 2003 Senior Staff Member for Arizona Governor Janet Napolitano; 2003 to present Member of the Pima County Board of Supervisors, District Two (serving as Chair of the Board since 2010). Campaign Website: Not provided

Questions / Answers:
Pima County subsidizes University of Arizona Medical Center, South campus with $40 million annually. Is that support sufficient? Too high? Too low? I have a history with the University at the Arizona Medical Center, South Campus, formerly Kino Hospital that goes back to
SOMBRERO – August/September 2012

when I was a Medical Explorer in high school. When I did my internship at that time, I remember a vibrant hospital that provided vital care for many people in our community. When I was appointed to the Board of Supervisors in 2003, I toured the hospital and was terribly saddened by what I saw. While several of the top floors were being used as a psychiatric hospital, areas that I remember well like ICU were empty of any people and looked more like a warehouse than hospital. Today, when I visit my primary care physician in the clinics at the South Campus or tour the facility, I see a hospital full of patients once again providing that vital service for our community. We have achieved this success through our partnership with the University of Arizona and the Medical Center. Our current partnership, not subsidy, will provide $15 million for each of the next two years with an additional $5 million for possible program expansion. With our investment, we generate a twoto-one and in some cases three-to-one match in federal monies through the Graduate Medical Education and Disproportionate Share Hospital programs. We are also in discussions with Tucson Medical Center for a similar partnership to generate more matching federal funds. What are your thoughts about the mission and scope of the Pima County Health Department? The mission and scope of Pima County Health Department is considerable and for the most part I believe we do a good job. Where I believe that we can improve is in the area of community outreach and involvement. A good example of this is the public health nurse in the Pima County Libraries. In this case, there is direct interaction with members of the community building relationships, providing health-related information as well as basic services. We need to learn from these experiences and expand them to include other areas including our Faith-Based community. Other issues about which you want physicians to know where you stand? For the past two years, I served as the Chair of the Leadership Team which was responsible for the successful operation of a federal grant entitled “Communities Putting Prevention to Work (CPPW).” Throughout the duration of this project, Pima County partnered with numerous community stakeholders such as the University of Arizona, YMCA, Southern Arizona Community Sports, the Boys and Girls Club, as well as other local businesses on a goal to reduce obesity and related chronic diseases by promoting improved nutrition and increased physical activity though the encouragement of children, youth, families, and seniors to maintain and improve their overall well-being. Throughout the community, individuals and families were encouraged to seek out healthy lifestyles by performing greater physical activities such as walking, running, biking and other meaningful bodily exercise. This program sponsored numerous health and wellness fairs, the planting of family/community gardens, utilization of healthier food products and sound nutritional awareness through the greater use of fresh fruit and vegetables for snacks and in meal preparation.

Board of Supervisors District 3
Western Pima County, but catches north Tucson foothills and follows north of Grant to Swan. Candidates: Democrat Sharon Bronson (incumbent) and Republican Tanner Bell.

Tanner Bell
Republican
Tanner Bell moved to Arizona to play football for The University of Arizona. Tanner was a three year varsity letter winner and scholar athlete. He graduated with a Bachelor’s Degree in Regional Development. After graduation, Tanner worked in the financial services industry and went on to serve as the Executive Director of the Arizona Policy Institute, a nonprofit focused on government transparency. While at API, Tanner led the law suit against the City of Tucson over a gift clause violation stemming from free rent at a signature Rio Nuevo project. Today, Tanner coaches youth football and last year coached on the Tucson High School football program. Tanner is an Academic Counselor at the UofA and has served on numerous local nonprofit boards. Current Occupation: Academic Counselor- UA Political Experience: Precinct Committeeman and Executive Director of the Arizona Policy Institute Campaign Website: votetannerbell.com

Questions / Answers:
Pima County subsidizes University of Arizona Medical Center South Campus with $40 million annually. Is that support sufficient? Too high? Too low? In 2004, the Pima County Board of Supervisors entered into an agreement with privately run University Physicians Healthcare to take over and operate Kino. The initial agreement was a 10 year/$125 million to allow UPH to build up and eventually run on their own. Since the initial agreement, the Board of Supervisors has extended the deal to over $200 million. I have always agreed with the initial decision to turn the hospital over to a private entity to operate and sustain itself and I would like to see those plans come to reality. I fully support the idea of helping our most needy; however, uncompensated care at Kino has been in the $12 million/year range so I question why Kino needs $40 million a year. Further, with massive changes with the Affordable Care Act there is much uncertainty to commit that much money on a yearly basis. What are your thoughts about the mission and scope of the Pima County Health Department? From what I can see and through my conversations with individuals who work closely with the Pima Health Department, it is a very well-run part of the county that is on the cutting edge in providing valuable services in the prevention of diseases and promotion of community well-being. Other issues about what you want physicians to know where you stand. My top 3 priorities for Pima County are: Jobs and a vibrant economic climate created through developing a culture of ‘how can we help’ instead of no. With my

SOMBRERO – August/September 2012

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educational background in Regional Development it’s clear that over the past two decades our region has done a terrible job establishing a diverse economy and creating an environment where entrepreneurs, small business, and tech spin offs from the U of A are welcomed, nurtured, and supported. Building up our surrounding communities and taking the approach that a rising tide lifts all boats. In my district I’ve witnessed bitter legal and publicity battles between Marana and Pima County that ultimately undermines our ability to grow and attract quality jobs to our region. Maricopa County inherently understands that the success of any of the 24 municipalities is a win for the region. It’s time Pima County works as a partner not an advisory to our surrounding communities. Infrastructure planning through more efficient spending of the county’s resources. Pima County’s budget has ballooned from $770 million ten years ago to $1.4 billion in 2011. Our budget doubled and our population only increased 20% over the same period. Given these numbers we should have quality streets and parks to show the run up but sadly we don’t. There needs to be a complete priority shift in Pima County and no program should be rubber stamped for continuation.

The actual fund amount transferred to the Arizona Board of Regents (ABOR) to continue their operation of the Graduate Medical Education program at The University of Arizona Medical Center (UAMC) South Campus is $15 million per year, not $40 million. The $40 million figure comes from a headline. Our intergovernmental agreement with the ABOR is for a twoyear period; and for each contract year, the County has the option of increasing the amount by $5 million if there are sufficiently justified medical service expansions for the community provided by UAMC at the South Campus. I believe the funding amount is now sufficient to sustain stable financial operations of the hospital, continue and expand the physician teaching mission, and provide vital healthcare services to our community. What are your thoughts about the mission and scope of the Pima County Health Department? The scope of the Pima Health Department is evolving from that of a traditional health agency dealing with disease prevention to one of wellness education and early disease identification associated with wellness activities that individuals can undertake to improve and sustain their health. This is precisely what our healthy community initiative was about, and I expect it will continue and expand. We have a vital role in public health; not only in the traditional sense, but also in taking actions and implementing programs that improve overall community health and wellbeing.

Sharon Bronson
Democrat
Bronson earned a degree in Business Administration/ Accounting with Distinction from the University of Arizona and is a member of the Business Honorary Beta Gamma Sigma. Current Occupation: Pima County Supervisor District 3 Political Experience: Sharon Bronson was first elected to office in November 1996. She represents District 3, a sprawling district of 7,403 square miles that includes all of western Pima County, AZ and shares more than 130 miles of international border with Mexico. Since her election to the Board, Bronson has focused her efforts on economic development, job creation and balanced smart growth strategies. She served on the Blue Ribbon Commission that led to the establishment of the area’s economic development organization, Tucson Regional Economic Opportunities, Inc. (TREO). Bronson was also instrumental in the development and implementation of Pima County’s Award winning Sonoran Desert Conservation Plan. She has served as President of the County Supervisor’s Association of Arizona and President of the U.S./Mexico Border County Coalition. She has also chaired the Pima Association of Government’s Executive Committee and the local public broadcasting affiliate KUAT Communications Group’s Public Advisory Board. She serves on the Board of Directors for Tucson Regional Economic Opportunities, Inc. (TREO), is a board member of the Metropolitan Tucson Convention and Visitors Bureau (MTCVB), and is currently on the Environment, Energy and Land Use Steering Committee for the National Association of Counties, (NACO). Campaign Website: Not provided

Board of Supervisors District 4
Eastern Pima County. Candidates– Republicans Ray Carroll (incumbent) and Sean Collins.

Ray Carroll
Republican
Bio: Mr. Carroll was born in Chicago, Illinois and attended Catholic and public schools in that city. In 1980, he became a Westerner when he moved to Denver, Colorado and entered Regis University. He was graduated with honors in 1984, receiving a Bachelor of Arts Degree in Philosophy. He then moved to Tucson in 1984. Prior to his service on the Board of Supervisors, Mr. Carroll was Foundation Manager for Casa de los Niños. He also served as Chairman on the City of Tucson’s Housing Board. Current Occupation: Pima County Supervisor District 4 Political Experience: Mr. Carroll was appointed District 4 Supervisor by the 5-member Pima County Board of Supervisors. Serving as a Republican, he was elected to the position in 1998. Subsequently, he was re-elected in 2000, 2004 and 2008 without opposition. He is now in his fifteenth year on the county legislative body. Campaign Website: None provided

Questions / Answers:
Pima County subsidizes University of Arizona Medical Center South Campus with $40 million annually. Is that support sufficient? Too high? Too low?
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Questions / Answers:
Pima County subsidizes University of Arizona Medical Center South Campus with $40 million annually. Is that support sufficient? Too high? Too Low? This fiscal year, 2012-2013, the Board of Supervisors funded the
SOMBRERO – August/September 2012

Arizona Medical Center South Campus in the amount of $15 million, with a contingency amount of $5 million for specific expansion initiatives, if approved by the Board. From 2005 through June 2012, the County has had a financial commitment of $170.4 million, or approximately $24.3 million annually, not the $40 million in your question. I supported this year’s commitment. Funding from Pima County has been utilized to revitalize the South Campus supporting a significant portion of the expansion of essential services for our community. Since 2005, the South Campus has undergone a transformation from a hospital primarily providing behavioral health services to a full service hospital. A few of the changes to the hospital made possible include: the opening of a 13 bed ICU, Level III Trauma Provisional designation expanding community wide trauma service infrastructure, increased number of licensed beds, designation as a base hospital for emergency transports, and expanded services such as cardiac services which now operates a busy cardiac catheterization lab. The investment in the campus has resulted in a total licensed bed capacity of 245 beds. Each bed requires an average of 5.5 full time equivalent staff and earnings including benefits averages $60,000. The eventual increase to full operating capacity will provide more jobs at livable wages further fueling the local economy. The South Campus has been particularly helpful to my constituents in the Sahuarita and Green Valley area since they have no hospital of their own. The closer proximity of the South Campus saves precious minutes when a trip to the emergency room is necessary. What are your thoughts about the mission and scope of the Pima County Health Department? In general, I am satisfied with the mission and scope of the Pima County Health Department. Although I support a closer working relationship with the Tucson Medical Center, Carondelet and other community hospital facilities to enhance community health initiatives. In addition to offering public health clinics throughout Pima County, the Health Department offers a vast array of programs focused on improving the health of our community through educational programs and activities. It offers community nutrition programs. The Women, Infants & Children Program (WIC) provides assistance for nutritional food and other services to low-income pregnant women, new mothers, infants and children up to age five with a health risk. The Arizona Farmer’s Market Nutrition Program (FMNP) provides coupons for WIC recipients to buy fresh, unprepared fruits and vegetables from state-approved farmers, farmers markets and roadside stands. Community Networking (works with local business to promote a comprehensive approach to address tobacco and chronic disease for employees and customers), Be Well Arizona (free six-week walking program with educational classes on chronic diseases), school-based prevention (uses Coordinated Approach to Child Health Curricula), and the Youth Coalition (supports charters responsible for holding activities to promote health and tobacco/ chronic disease prevention for youth in 4th through 12th grades).
SOMBRERO – August/September 2012

In the non-medical area of the Health Department’s activities, I am concerned with the cost of permits, fees, etc. charged by the Department. As I have done with building permits and development fees in the Development Services Department, and with sewer connection fees in the Wastewater Management Department, I will be looking at reducing Health Department fees during this fiscal year. In this time of economic stagnation, business needs any help the County can provide to jump-start the economy. Other Issues about which you want physicians to know where you stand: I share the great concern of almost all my constituents about the increasing cost of health care and health insurance, very few people are comfortable about the future of health care costs in our nation. I urge your Society and others in the national medical community to work with Congress to develop common sense solutions to this problem that affects all Americans.

Sean Collins
Republican
Sean Collins has been a resident of Pima County for more than 13 years and lives with his wife Tracy and their four children in Vail, AZ. In the year 2000, he was the honored recipient of the Southern Arizona Red Cross Military Hero of the Year award. Since 2004, Sean has been managing high level Department of Defense projects while his wife handles the day to day operations of their business, a Dairy Queen close to their home. Sean holds a Masters in Business Administration, Organizational Management and Human Resources and also has a Bachelors degree in Applied Science and in Organizational Management. As an active participant in the community, Sean is currently on the Site Council at Ocotillo Ridge Elementary School, a member of the Vail Chamber of Commerce, Vice President of his Home Owner’s Association and a current Republican Precinct Committeeman. Sean was also the past President of the Cienega Rotary and a member of the Vail Community Action Board. In Vail and throughout Pima County, Sean is a dedicated supporter of Youth programs. His sponsorship of various baseball teams, football teams and local schools, help to provide the children of Pima County with many opportunities and resources. In his free time, Sean enjoys spending time with Tracy, their 4 children and granddaughter. Current Occupation: Program Manager/Functional Area Lead, Aerospace – TASC; Owner - Dairy Queen Vail, AZ Political Experience: Precinct Committeeman Campaign Website: collins4supervisor.com

Questions / Answers:
Pima County subsidizes University of Arizona Medical Center South Campus with $40 million annually. Is that support sufficient? Too high? Too Low? As a member of the Pima County Board of Supervisors, one of my most important responsibilities will be active and informed
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participation in the budget process. Pima County’s subsidy of the University of Arizona Health Care South Campus is a vital link in the health care for some of the most vulnerable citizens in our community. I welcome the opportunity to meet with the leadership of the University of Arizona Health Care South Campus personally during the budgeting process in order to be as informed on their issues as possible. As a fiscal conservative, I strongly believe that we must work within our means to properly fund the real priorities of our county and to do so you must gather all the information possible. The elimination of wasteful spending and the growing of our tax base by creating a business encouraging environment are the important steps of responsible government. Then and only then can we make thoughtful and informed decisions on the issues that Pima County needs to focus on - public safety, the health and welfare of our neighbors and roads. What are your thoughts about the mission and scope of the Pima County Health Department? The Pima County Health Department plays a vital role in our community. As a large and multifaceted department, PCHD must constantly strive to improve, streamline operations and evolve. The BOS role is to ensure the entire department has the proper tools and resources to ensure residents of Pima County an optimal level of fitness. Other issues about which you want physicians to know where you stand. Physicians and the health care industries in Pima County are some of the best and brightest in our great nation. One of the major issues in Pima County today is the perception of a hostile business environment of Pima County as a whole and specifically the current BOS. Regardless of whether you are a physician in private practice, a large health care corporation or involved in medical research, you deserve a climate that encourages business development and growth. You deserve representation on the BOS that will welcome your investment in our community. I want to personally thank you for your service to the citizens of our community. I would like to ask for the opportunity to serve you as your District 4 Supervisor for Pima County. Together we can improve the lives of our neighbors in Pima County.

Current Occupation: Pima County Supervisor District 5 Political Experience: Seeking his fourth term as County Supervisor Campaign Website: None provided

Questions / Answers:
Pima County subsidizes University of Arizona Medical Center South Campus with $40 million annually. Is that support sufficient? Too high? Too Low? I am a strong supporter of University Medical Center South Campus, the only urban Tucson hospital south of Broadway and home to one of only two trauma centers in Pima County. It also is the center of a growing health complex that includes a vital new Behavioral Health Pavilion with a mental-health emergency room, health clinics and the Pima County Health Department headquarters. The South Campus connection to UMC North, with the adjacent Cancer Center and UA College of Public Health, provides synergy that gives the county a very comprehensive service system. The South Campus is home to much-needed physician training and the array of services in and around it offers medical professionals with expanding opportunities. The health care industry is a volatile one and the federal changes that are rolling out give us even greater shortterm uncertainty that could place new demands on the county. But if we were to lose this facility, its patients would be forced into emergency rooms of the region’s other, already overburdened, hospitals and medical centers. UMC South is an essential component of the kind of public-health system that a community of our size deserves. What are your thoughts about the mission and scope of the Pima County Health Department? The most important of the Pima County Health Department’s many functions is to operate and promote programs to quickly and efficiently reduce health disparities. They particularly impact uninsured and underinsured residents of the county, many of whom are people of color and live in District Five. One striking example is the plague of diabetes, a killer disease that disproportionately afflicts Latinos, Native Americans and African Americans. The Affordable Care Act finally addresses the problem of health disparities among our various populations after many years of a significant lack of federal-government attention to it, so I look forward to improvement on this front. Other issues about which you want physicians to know where you stand. We need physicians in greater numbers to join the growing efforts to focus more on prevention of disease through diet and exercise, and to support community efforts to educate the public on this issue with health literacy programs, such as those offered by Reach Out and Read and Literacy Connections. We need them to support UMC South and to take advantage of opportunities to help serve the underserved on the urban area’s south side. These folks need better access to the work of promotoras, who instruct them on how to take better preventive care of themselves, and to early-detection services such as cervical cancer screenings and colonoscopies. n

Board of Supervisors District 5
Convoluted district that covers South Tucson, Tucson Mountain Park, but also runs between Grant and Broadway to Craycroft. Candidates– Democrat Richard Elias (incumbent) and Republican Fernando Gonzales.

Richard Elías
Democrat
In his ten years of service on the Pima County Board of Supervisors, Richard Elías has advocated consistently for the quality of life of our working families, the strength of our public services and the preservation of our beautiful Sonoran Desert habitat. His commitment to a strong local economy that provides good jobs, secure retirement benefits and affordable health care is among the many reasons District Five constituents have elected him to three consecutive terms.
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SOMBRERO – August/September 2012

NATIONAL RACES

United States House of Representatives
Congressional District 1
A huge district that runs from Marana to Page, Arizona. Democrat candidates: Wenona Benally Baldenegro and Ann Kirkpatrick. Republican candidates: Patrick Gatti, Gaither Martin and Jonathan Paton.

Patrick Gatti
Republican
I started my own business in 1977 and after 27 years I sold it to come to Arizona to be with my son and grandchildren. As with any business I struggled with receivables against payables. I was fortunate and was able to buy the commercial building I was renting, and sold that in 2008. As an experienced businessman I learned what was required to establish a yearly budget and review it often and make the adjustments required to end with a successful year. Without a budget in a business one will fail, so I just don’t see how a country is able to go for 3 + years without a budget and expect to succeed. Current Occupation: Licensed Real Estate Salesman Political Experience: While I ran my business I served on the City Council for 21 years two of which were as Mayor Pro Tem. Campaign Website: patrickgattiforcongress.com

Wenona B. Baldenegro
Democrat
Education: B.A., Barrett Honor’s College, Arizona State Univ., Summa Cum Laude; Juris Doctorate (J.D.), Harvard Law School; Master in Public Policy, Harvard University; Master’s in Law, University of Arizona; former healthcare specialist, Inter-Tribal Council of Arizona. Current Occupation: Attorney Political Experience: Co-Chair, Vince Rabago for Arizona Attorney General, 2010; National Tribal Steering Committee, Obama for America, 2008. Campaign Website: wenonaforarizona.com

Questions / Answers:
Given the US Supreme Court decision, what are your thoughts about the Affordable Care Act? For a benefit afforded few and the responsibility of many and a promise for no new taxes, we will be levied with the highest tax burden in U.S. history. The affordable Care Act must be repealed and re-written to reflect what is actually needed. Once written it should be reviewed by an independent group of active Physicians. Congress passed the Sustained Growth Rate (SGR) formula in the late 1990s to avoid voting on Medicare every year, yet now must vote every year to patch the system. How will you deal with the SGR? I would seek council from area Physicians for the best possible solution. Other issues upon which you want physician to know where you stand. As with any medical procedure, abortions should only be performed by a licensed Physician.

Questions / Answers:
Given the US Supreme Court decision, what are your thoughts about the Affordable Care Act? I support the Affordable Care Act. Arizona’s working families are concerned about rising healthcare costs and the lack of healthcare coverage. No one should ever go broke because they become ill. I support continued efforts to expand access to affordable healthcare and establish patient protections for all Americans. Congress passed the Sustained Growth Rate (SGR) formula in the late 1990s to avoid voting on Medicare every year, yet now must vote every year to patch the system. How will you deal with the SGR? I will work to update the SGR, or to find a new solution, entirely, to account for the increase in the volume and complexity of doctors’ services. Other issues upon which you want physician to know where you stand. I am a former healthcare specialist for the Inter-Tribal Council of Arizona, and healthcare is a very important issue to me. Medicare and Medicaid are very important services to the people of my district, and I oppose any efforts to cut or privatize them.

Ann Kirkpatrick
Democrat
Arizona born and raised, Ann Kirkpatrick resides in Flagstaff, and her earliest roots are found in Eastern Arizona in McNary on the White Mountain Apache Nation. Her father ran a general store and her mother was a schoolteacher. Ann graduated from Blue Ridge High School in the White Mountains and then worked her way through the University of Arizona, earning a bachelor’s degree and then a law degree there.
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SOMBRERO – August/September 2012

After earning her law degree, Ann served the people of Greater Arizona in a variety of positions. In 1980, she became Coconino County’s first female Deputy County Attorney, cracking down on criminals and protecting neighborhoods and families in Northern Arizona. She later served as Sedona’s City Attorney.  In November 2004, Ann’s neighbors elected her to the Arizona House of Representatives to represent Legislative District 2, which includes Flagstaff and the Havasupai, Hopi, Hualapai, Navajo, and San Juan Southern Paiute Nations. At the state Capitol, Ann championed fiscal responsibility and quality education.  During her 2008-10 term in the U.S. House of Representatives, Ann’s results stood out in Congress, seeing more of her bills and amendments signed into law than almost any other freshman representative. Ann’s hard work created jobs, helped small businesses, hired more border patrol agents, and protected veterans and seniors in Greater Arizona.  Ann Kirkpatrick is the only candidate who brings a lifetime of experience and results to Congressional District 1.  Current occupation: Attorney/self-employed  Political experience: Representative, United States Congress, District 1, 2009-2010 Arizona State House, Representative - District 2, 2005-7 Campaign Website: kirkpatrickforarizona.com 

Questions / Answers:
Given the U.S. Supreme Court decision, what are your thoughts about the Affordable Care Act? This law isn’t perfect, but it’s already helping hard-working families in my district in many ways. It bans some of the worst insurance-company abuses like denying coverage due to preexisting conditions, it’s making prescription drugs more affordable for seniors by closing the Medicare Part D donut hole, and it gives tax cuts to small businesses who want to provide coverage. At the same time, it enables us to keep the insurance plans and doctors we choose. And the 12 tribal communities in my district urgently needed the permanent reauthorization of Indian Health Service funding. This permanent reauthorization was a special priority of mine in Congress – I worked hard to ensure this was included in the final version of the Affordable Care Act because it is so crucial to the tribal communities in my district. We should also look for ways to strengthen the law. For example, I would like to see reimbursement rates permanently improved for rural physicians. This would make a real difference in my district.  Congress passed the Sustained Growth Rate (SGR) formula in the late 1990s to avoid voting on Medicare every year, yet now must vote every year to patch the system. How will you deal with the SGR?  Congress has an unfortunate pattern of playing politics with Medicare. The Sustainable Growth Rate formula is clearly inadequate, but we will need leadership and bipartisanship to

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find an approach with enough support to pass Congress.  Meanwhile, Medicare doctors face the threat of huge pay cuts and patients face the threat of losing access to their doctors of choice. I have a thorough understanding of physician issues (see #3 answer), and I have a record of finding common ground and getting results in Congress. If I am elected, I am committed to finding a bipartisan solution that could enact a long-term fix. I am currently watching the progress of a bipartisan bill that was introduced in May by U.S. Reps. Allyson Schwartz (D-Pa.) and Joe Heck, DO, (R-Nev.) -- the Medicare Physician Payment Innovation Act of 2012. Their bill would permanently repeal the SGR formula and prevent the looming cuts that otherwise may take place on Jan. 1, 2013.   Other issues upon which you want physician to know where you stand. As an attorney, I represented Flagstaff Medical Center and various physician groups for 22 years. I handled quality assurance, medical staff, credentialing, billing, contracts and more. I also represented Flagstaff anesthesiologists and ER physicians as well as several small physician practices. Because of this experience, I bring a unique perspective and understanding to the health care debate. I understand the ins and outs of what it takes to run medical centers and physicians’ offices.

changed my life. While IEDs exploded and guns were fired on a nearly daily basis, the time in combat offered me a new perspective on my service here at home. It made me focus on what was really important in my life, and I came home determined to continue fighting for America and our Constitution every day. I am a constitutional conservative who believes in lower taxes, less spending, small government and a secure border. As a state Representative and Senator, I wrote the nation’s first human smuggling law and voted for what, at the time, amounted to the largest reduction in government spending in Arizona history. I’m running for Congress because Arizona needs a voice for fiscal responsibility and American energy production. We need to create jobs and repeal Obamacare. But most of all, we need someone who will fight everyday for our Arizona values of hard work and independence. Back here at home, my fiancé Angie and I are looking forward to keeping ourselves firmly rooted in Arizona and starting our own family – and instilling in our children the same values that our parents made sure we’d never forget. We want the next generation to grow up in a country as safe and prosperous as the one we have enjoyed. Current Occupation: Self-employed, Public Relations Political Experience: State Representative (2005-2008), State Senator (2009-2010) Campaign Website: paton2012.com

  Jonathan Paton
Republican
As a lifelong and native Arizonan, I learned the value of hard work from my mom and dad – and a simple truth: Leaders are not kings, leaders are servants. My mom knew this well. She moved to Tuba City as a young woman and worked her way through Grand Canyon College scrubbing bathroom floors and taking care of other people’s children. She spent her life teaching kids in school and raising her children in faith. Following her example, servant leadership is at the heart of everything I do. Growing up, we didn’t always have a lot, but we always had love and faith in our home. My mother was a missionary, and my dad was a choir director before working as a chemist in the mining industry. Together, they taught me through their own example that if you worked hard in America, you could achieve anything. They pushed me every step of the way, and eventually I worked my way through college as a roofer and a dishwasher, graduating summa cum laude and with honors from the University of Arizona. I’ve been lucky to have successful careers in commercial real estate and public relations, but I’m most proud of having the chance to serve the country I love in uniform. In 1999, I enlisted in the United States Army Reserve. And in 2000, I was honored to be named “Soldier of the Year” for my battalion, brigade, and eventually for the entire 104th Division. After serving for two years as a Representative in the state Legislature, I felt called to serve my country in the darkest days of the war. So I voluntarily enlisted to serve in Iraq on the front lines as an operations officer in an intelligence unit. The experience
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Questions / Answers:
Given the US Supreme Court decision, what are your thoughts about the Affordable Care Act? Repealing and replacing Obamacare is a top priority of mine. This law raises taxes by hundreds of billions of dollars, creates over 13,000 pages of new regulations, and is creating such a terrible environment of uncertainty with American job creators that it is paralyzing the economy. It will also cost trillions of dollars over the next decade, and it fundamentally changes the nature of the patient-doctor relationship. To get America’s job creators hiring again, and to solve the crisis of rising health care costs, we must aim to repeal and replace Obamacare with free enterprise solutions that increase access to quality health care, lower costs, and keep decisions in the hands of patients and their families. Congress passed the Sustained Growth Rate (SGR) formulate in the late 1990s to avoid voting on Medicare every year, yet now must vote every year to patch the system. How will you deal with the SGR? The current political environment in Washington is creating uncertainty in many industries and hurting the American economy. The Sustainable Growth Rate formula was supposed to create stability with Medicare reimbursements to doctors, but it is a flawed formula that ties reimbursements to the overall performance of the economy. The yearly patch that Congress votes for creates a high degree of uncertainty in the medical community, and now threatens to disrupt the availability of medical care to patients. My position is that the SGR must be repealed and replaced with a permanent solution that creates long-term stability that isn’t dependant
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Other issues upon which you want physician to know where you stand. I support tort reform and will fight for that in Congress. While in the legislature, I voted for and championed the Arizona Health Care Freedom Act, which was passed by the voters in 2010. It amended our state constitution to ensure the right of individuals, doctors, and businesses to participate or not participate in any kind of health care system, and also ensured their right to pay directly for health care services. I believe those are two principles that any future federal health care reform must rest upon.

needed to care for their children at home. We improved services for families, while running one of the five most costefficient, high-quality programs in the country. As State Director I was a member of the working group that developed and implemented the Arizona Medicaid program (AHCCCS). In 2006, I began working with Gabrielle Giffords, and was honored to be named her district director in 2007. We worked hard to deliver for Southern Arizona families, particularly those who experienced problems with the federal government. This meant advocating for families who were not receiving Social Security, Medicare or Veterans Administration benefits that they had earned. It also meant bringing the voices of Southern Arizona to Congress, so that policymakers could hear directly from residents of the border area about their needs. I also worked with military leaders at Davis-Monthan, Fort Huachuca, and the 162nd Fighter Wing of the Arizona Air National Guard to protect their missions and the positive impact they have on our nation’s security as well as our local economy. I am eager to continue all this work in Congress. Current Occupation: U.S. Representative Political Experience: None prior to the 2012 Special Election Campaign Website: ronbarberforcongress.com

Congressional District 2
This is a truncated version of the district Gabby Giffords represented in 2010. Democratic candidates: Ron Barber (incumbent) and Matt Heinz, MD. Republican Candidates: Mark Koskiniemi and Martha McSally.

Ron Barber
Democrat
I’ve lived here in Southern Arizona most of my life, running a small business with my wife, Nancy, and helping solve problems — whether it was heading up Congresswoman Giffords’ district operations to help people get results by cutting through federal red tape, or working for 35 years to look out for people with disabilities. I’m running for Congress to put politics aside and solve problems for the people of Southern Arizona. We need someone who will be honest, lead with civility, and who will focus on the needs of Southern Arizona. That means balancing the budget the right way, protecting Social Security and Medicare, creating jobs, supporting our military families and bases, making sure our veterans get the services they need, and securing our border. I grew up in a military family. My father was an Airman stationed at Davis-Monthan Air Force Base. My children and grandchildren all live here in Southern Arizona — and I want this to be as special a place for them as it’s been for my wife and me. Nancy and I went on our first date in 1960, and we’ve been together ever since. We raised our daughters, Jenny and Crissi, here in Tucson, they grew up to be an educator and a nurse and now they’re raising their kids here, too. We have four grandchildren: Kieran, Tillie, Ailsa and Elliot, and one on the way. Our roots here are deep and we are dedicated to serving this community we love. For 22 years, Nancy and I owned and operated a business called Toy Traders/Stork’s Nest, where families could trade and buy children’s toys, clothing, and equipment. We had two locations with 20 employees. We know what it means to meet payroll, keep the doors open, and provide good customer service. I also served our community for 32 years at the Arizona Division of Developmental Disabilities. There, I worked to get people with disabilities out of government-run institutions and back into their community where they could become employed and live full lives with their families and friends. This meant working closely with families and providing them the support they
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Questions / Answers:
Given the US Supreme Court Decision, what are your thoughts on the Affordable Care Act? The Affordable Care Act is far from perfect. However, there are key pieces of the legislation that move us in the right direction. Because of this law, in my district alone, 6,200 young people now have health insurance through their parents’ policies until they turn 26, 10,900 seniors have already received prescription drug benefits worth $6.1 million – an average discount of $560 per senior, and 102,000 seniors received Medicare preventive services without paying any co-pays or deductibles. The law also ensures that women receive fair and equal insurance coverage, and that children and adults will get the preventive services they need and cannot be denied health insurance because of preexisting conditions. Certainly, more can be done to bring down the cost of health care for individuals and for small businesses—and we should be working to fix those pieces of the law. For example, we must allow Medicare to use its purchasing power to bargain for lower prescription drug prices, as the Veterans Administration does. We should push to fix the parts of the law that should be fixed, not throw the baby out with the bath water. I am eager to hear directly from the medical community as this law is implemented, because I believe that those on the ground dealing with the impacts this law has on their patients should have an active role in evaluating what is working and what is not. Congress passed the Sustained Growth Rate (SGR) formula in the late 1990s to avoid voting on Medicare every year, yet now must vote every year to patch the system. How will you deal with SGR? SGR requires a permanent fix—we cannot continue to punt major policy decisions, like this, down the line. Not only are doctors unable to plan from year to year— patients on
SOMBRERO – August/September 2012

Medicare and Tricare remain worried that if the various cuts go through, they will lose access to their physicians. What is clear on this issue, like so many others, is that nothing but stopgap measures will be passed without true bipartisan cooperation. We will not find a solution by going to the extremes of either party. I will not vote for major cuts in TRICARE fees for doctors— doctors should know how they will be compensated for treatment, and veterans should know they will have access to care. I hope that veterans groups and groups like yours can help build bipartisan consensus on how to fix this flawed formula. I have a proven track record of working across party lines as a public servant—and I will work the same way in Washington— and look forward to doing so with your assistance and input. Other issues upon which you want physicians to know where you stand: I have pledged to protect Social Security and Medicare, and make sure that it is available to future generations. For many Americans, this is their only source of income and health care security in their senior years–and they deserve representatives who will fight to make sure it’s there for them as they grow older. My district is home to almost 100,000 veterans. I am committed to protecting and improving veterans’ access to care. Too many of our service members return home with traumatic brain injuries or posttraumatic stress disorder, the signature injuries of the wars in Iraq and Afghanistan. We must do more to accurately diagnose and treat TBIs and mental illnesses in our veterans. I am committed to continuing the fight to secure our border in Southern Arizona where too many of our neighbors are threatened each day by the illegal activities across the border. I will work to increase boots on the ground and bring more advanced technologies to our border towns and communities.

mandate and other critical provisions of the Affordable Care Act, I am concerned that the decision regarding Medicaid expansion allows states to ignore millions of our lowest income families. As a physician and state lawmaker, I am uniquely qualified to advocate for practical improvements to the health care law. Though the ruling is a reaffirmation of American values – every American should be able to see a doctor and receive basic medical care – there is more work to be done. I commend the Supreme Court for upholding a conditional individual mandate. It is important to make clear that families who would suffer excessive financial burden qualify for exemption. In addition to the mandate, crucial patient protections were upheld. As a nation, we are now assured that there will be no lifetime limits on medical services, those under 26 years old will be able to stay on family plans, prescription drug costs for Medicare seniors will be reduced, there is guaranteed access to preventive care and those with preexisting conditions will not be discriminated against. Under the current Arizona Medicaid program, many of Arizona’s most vulnerable populations will continue to be left without coverage. In 2011, Gov. Jan Brewer and the Republicancontrolled legislature slashed funding for thousands of low income adults. Without a requirement for states to include these families, hundreds of thousands of Arizonans remain in jeopardy and without access to basic health care. With new uncertainties surrounding the now optional Medicaid expansion, we must work to encourage state participation in the expansion of the program to ensure that all Americans can go to the doctor without threat of bankruptcy. Congress passed the Sustained Growth Rate (SGR) formula in late 1990s to avoid voting on Medicare every year, yet now must vote every year to patch the system. How will you deal with the SGR? The Sustained Growth Rate (SGR) formula has failed since its inception because it is set at an arbitrary level. The cost of practicing medicine continues to rise each year at a greater rate than the SGR. The American Medical Association has estimated that “[w]ithout congressional intervention, Medicare physician payments will be cut about 40 percent by 2016.” Physicians cannot afford such a steep cut in payments. If the SGR is enforced, Medicare reimbursements will not cover basic expenses of medical care; thus forcing physicians to turn Medicare patients away in order to stay in practice. We need a reasonable and realistic cost control structure that covers actual medical costs. Cliff and clawback legislation does not address this failed policy. Our health care system must prioritize disease prevention and wellness plus chronic disease management to help better control costs while maintaining a sustainable reimbursement rate. The ACA will increase Medicare primary care reimbursement and also add an annual physical/wellness exam – a good initial step. Other issues which you want physicians to know where you stand? I strongly believe no woman should be denied breast cancer treatment because of her income level. As a state legislator, I sponsored H.B. 2472, also known as Bobbie’s Law,” to increase
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Matt Heinz, M.D.
Democrat
Bio: Not provided Current Occupation: Hospital Physician, IPC: The Hospitalist Company at Tucson Medical Center; Two-term State Representative (District 29). Education: Residency and Internship, Internal Medicine, University of Arizona, 2006 MD, Wayne State University School of Medicine, 2003; Research Fellowship, Vascular Surgery, Harvard Medical School, 2000; BA, Chemistry, Albion College, 1999. Political Experience: Representative, Arizona House of Representatives, January 2009 – Present; Appropriations, Member; Health and Human Services, Member; Minority Whip, Arizona State House of Representatives, 2010; Candidate, Arizona State House of Representatives, District 28, 2006 Campaign Website: heinzforcongress.com

Questions / Answers:
Given the U.S. Supreme Court decision, what are your thoughts about the Affordable Care Act? While I applaud the Supreme Court’s ruling on the individual
SOMBRERO – August/September 2012

low income women’s access to breast and cervical cancer treatment. The bill had overwhelming bipartisan support that it was passed in this year’s state budget with a $2 million dollar earmark that’s matched by federal government at 4 times. Before “Bobbie’s Law,” a patient could not be Arizona Medicaid covered for cancer treatment if she was not screened or diagnosed by a Well Woman HealthCheck Program (WWHP) provider. Uninsured women were denied lifesaving treatment if they unknowingly walked into the wrong clinic. The law cut bureaucratic red tape and lifted age restrictions. It also allowed for more providers to qualify as a WWHP clinic, even retroactively.

the late 1990s to avoid voting on Medicare every year, yet now must vote every year to patch the system. How will you deal with the SGR? The current situation with the SGR demonstrates the difficulties of government control over markets as complex as this. It also demonstrates the need to address this complex issue with more than one tool. As noted above, a greater focus on community and preventive/wellness activities might well be successful in reducing the number of patients who require extensive and expensive tests which in part increases total costs in the system beyond the forecasts. The SGR needs to be examined as part of a re-examination of the health care system that will include discussions of the role that each individual must play in taking responsibility for their own health, and input from the health provider community. Other issues upon which you want physician to know where you stand. If elected, your representative’s office would be evaluating issues through a lens designed to filter for creating a smaller, more responsive and responsible federal government. See http://www.mark4az2.com/ifelected.htm The model found at that site might also be instructive for use in reviewing health care issues by re-orienting the starting question (and subsequent questions) to ask “Does it improve health results, and/or provide a mechanism for increasing community or individual responsibility for health issues?”

Mark Koskiniemi
Republican
Mark Koskiniemi, 48, is currently on leave of absence from the Pima County Procurement Department. He is a former chemical company executive with more than 21 years experience working in the private sector. Prior to joining Pima County, he worked for the Census Bureau in the lead up to the 2010 Census. He earned his degree in chemical engineering from the University of Delaware. This is his first run for political office. Current Occupation: Pima County Procurement Political Experience: None Campaign Website: mark4az2.com

Congressional District 3
This is a smaller version of the district Raul Grijalva represented in 2010. Democratic candidates: Amanda Aguirre, Manny Arreguin, MD and Raul Grijalva (incumbent). Republican candidates: Gabriella Saucedo Mercer and Jaime Vasques. Libertarian candidate: Blanca Guerra

Questions / Answers:
Given the US Supreme Court decision, what are your thoughts about the Affordable Care Act? While the Supreme Court upheld the constitutionality of The Affordable Care Act, serious questions remain as to what the full implementation of the Act will look like and what ultimate impacts it will have. It is unfortunate that such significant legislation was put through in the manner that it was. While there are provisions of the Act that many feel are positive developments, there are also many provisions that have little to do with improving health results for our citizens. I believe that the most positive improvements in health results can be effected through programs focused on community and individual initiatives, not requiring a massive federal program or the bureaucracy associated with it. With an aging population, increases in chronic conditions, and economic displacement, two programs currently in place in this congressional district demonstrate the power of community programs - in Pima County, the Library Nurse (http://www.library.pima.gov/about/ news/newsreleases/022312_library_nurse.pdf) and in Cochise County, the Parish Nurse program (http://www.svrhc.org/ outreach.htm#parishnurse). Local investments in these kinds of programs and other programs geared to increasing the numbers of doctors and nurses as our doctor and nurse population also ages, can be made without the need for money to have to be taken up the federal level for redistribution. Congress passed the Sustained Growth Rate (SGR) formula in
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Amanda Aguirre
Democrat
Amanda Aguirre, M.A., R.D. has served the people of Arizona as a State Representative (2003-2006) and as a State Senator (2006-2010). Her political record of successfully passing bills through the legislature is unparalleled and has earned her several awards such as “Walk the Talk” (2008), “Autism Legislative Champion” (2008), “Friend of Cities and Towns” (2009, 2010), and “Outstanding Legislator Award” (2009). Her accomplishments as a legislator have had far-reaching impacts in the areas of job creation, health care, education, science, agriculture, military support, and border security. Sen. Aguirre has been involved for more than 30 years in health care industry and is a recognized pioneer in this area. She was appointed by President Clinton to serve on the Border Health Committee in 2004. Current Occupation: President/CEO of the Regional Center for Border Health, Inc., and its subsidiary San Luis Walk-In Clinic, Inc. In 2007, Sen. Aguirre established the Health Education Career Institute, providing job opportunities and placement for over 400 individuals. Through these organizations, countless
SOMBRERO – August/September 2012

people have been able to get access to quality health care and affordable higher education. Political Experience: State Representative & State Senator Campaign Website: amandaaguirreforcongress3.com

J. Manuel Arreguin, M.D.
Democrat
My parents immigrated to the US when I was two years old. They did not speak a word of English and moved into a government housing project located in Downtown Los Angeles. It was the neighborhood where the most infamous and notorious LA Black gangs were started. Through perseverance and hard work, my parents stressed that an education would break the chains of poverty. My father worked as a janitor, my mother worked as a nurse’s aide. They both worked in these jobs for nearly 30 years. Years later, my parent’s efforts and wisdom are demonstrated by the fact that their five children are college graduates, share in four Masters’ degrees and one Doctorate. I attended UCLA for my undergraduate studies, received my medical doctorate degree form UCLA, and did my residency training at UCLA. I finished my residency in 1992. With my wife and three small children, we moved to Arizona to work in Nogales at the Mariposa Community Health Center. In 1995, I joined the El Rio Community Health Center returning to academic medicine as clinical faculty for the University of Arizona. Current Occupation: My current position is with the El Rio Community Health Center. I am also the current Chief of StaffElect at Tucson Medical Center and the previous Chairman in the department of Obstetrics and Gynecology. Political Experience: I am a novice to the Political Arena. My last public office held was high school as student body president— with an overwhelming landslide victory!!!!! Campaign Website: arreguinforarizona.com

Questions / Answers:
Given the US Supreme Court decision, what are your thoughts about the ACA? As a healthcare professional for 35 yrs., I relish the thought of rolling up my sleeves with my colleagues on both sides of the aisle to ensure affordable and accessible healthcare for our millions of working families and their children that have been uninsured or underinsured. We know that preventive care saves money in the long run and, therefore, saves tax dollars that would otherwise be spent on the rising cost of healthcare administered in emergency rooms across the country. The rising cost of medical care is the real issue with our healthcare system and it needs to be addressed. Until we can reduce the cost of healthcare, especially basic and preventive care, our system is broken and will continue to be a major burden on our families and the economy.  The Affordable Care Act is a small step toward addressing some of the issues with the current insurance system. Unfortunately, with the current dysfunctional environment in Congress, this may be the only step possible until the ineffective members of Congress are replaced. Congress passed the Sustained Growth Rate (SGR) formula in the late 1990s to avoid voting on Medicare every year, yet now we must vote every year to patch the system. How will you deal with the SGR? I believe that the SGR formula needs to be replaced with a fixed Medicare reimbursement rate for physician services. Since the SGR has been in place, physicians have suffered severe reimbursement cuts that have fluctuated annually. Unfortunately, there is no medical justification for decreasing the costs of Medicare reimbursement, but rather Congress justifies the spending cuts as an attempt to balance the government’s out-of-control spending. Other issues upon which you want physicians to know where you stand. It’s important that physicians know that the American Medical Association and Arizona Medical Association endorse me in my race for Congress. I have dedicated my life to ensuring that thousands of working families and children receive access to affordable and quality healthcare, especially along the U.S.Mexico border where the rural communities are mostly comprised of uninsured (or underinsured), low-income families. We need to invest in quality healthcare and in improving our medical facilities such as hospitals, clinics, and research centers, which all provide livable wages to our working families. I believe we need to not only create jobs in our communities, but also develop a workforce in the U.S. that can compete with other countries in order to prevent our jobs from being shipped overseas. We need to invest in education and vocational skill training, so our Country will have a competitive health professional workforce for the 21st Century.
SOMBRERO – August/September 2012

Questions / Answers:
Given the US Supreme Court decision, what are your thoughts about the ACA? The presidents ACA was a good first step in establishing a working document. Extending dependents coverage to age 26, the broadening of pharmaceuticals covered for seniors and protecting patients with prior medical conditions are positive areas we can all agree on. However, the issue of cost remains. The issue of what the ACA will mean for patients and doctors is very vague. The massive influx of new patients, rightly expecting excellent care will be very overwhelming. The unparalleled upcoming physician shortage is not being dealt with. The exclusion of medical liability reform is concerning. The unresolved infamous sustainable growth rate formula, and formation of committees like IPAB to deal with physician compensation are all gut wrenching unresolved issues. Given the historical record of this Congress, it makes me very concerned that these unresolved issues will not be appropriately dealt with in any timely fashion. In short, although I favor the ACA, amendments need to follow. I believe medical doctors and patient voices need to be present at the negotiation table. Congress passed the Sustained Growth Rate (SGR) formula in the late 1990s to avoid voting on Medicare every year, yet now we must vote every year to patch the system. How will you deal with the SGR?
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There needs to be repealed once and for all. The current doc-fix is only about deferrals and always temporary. The 2010 Congress delayed scheduled cuts five times! It will cost $31 billion to stop the doc-fix over the next decade. With more and more physicians opting to leave Medicare for numerous reasons, the SGR formula is yet another invitation to leave medicine. Representatives Allyson Schwartz and Joe Heck, DO have put forth bipartisan legislation that will fully repeal the SGR formula while setting clear paths for comprehensive reforms of Medicare payment and delivery system. Briefly, this piece of legislation includes: • Permanent repeal of the SGR formula • Positive annual payments for physicians, • Ensures patient access to preventative care, care coordination and primary care services, • Puts forth accountability for testing and evaluating new payment and delivery models, • Allow physicians to participate in programs committed to quality and efficiency, • Accurately uses models that accurately reflect cost and value of providing health care in coordinated models. Other issues upon which you want physicians to know where you stand. The Platform: My top priorities are to help Southern Arizona families by creating and protecting jobs, ensuring healthcare reform is patient focused and physician respected, and preserving families through compassionate, workable immigration reform. Fighting the Congressional Paralysis: Another issue is to fight Partisan Political gamesmanship. Our current Congressman owns the distinction of the most Leftist member of Congress. That does not represent the majority of us. His partisanship doesn’t allow him to dialogue with any of his colleagues. That’s why he is 0 for 28 on sponsored bills passed this year alone!!! The Economy: Our economy is on life-support. We need a Congress that will address real diagnosis, not simply attend to symptomatic relief. I am a moderate Democrat. Being fiscally conservative, I pledge to seriously look at how we can reduce spending. Being socially compassionate, we need to empower, not entitle. Finding workable solutions is the agenda. Medical Liability: Medical liability must be on the negotiation table. My opponent received one of his largest financial campaign contributions from the Trial Lawyers Association. Ethics and Integrity: These virtues must return to Washington DC. Unless we change the personal, we will never have a culture change in DC. My oldest just graduated from Fire Academy in Dallas, Texas. At graduation, these were the final words coming from the commanding Lieutenant. The Dallas FD motto: Be Humble and Always remember, You are Second. That’s why our first responders unselfishly went up the towers on 9/11. That motto is the message I intend to bring to Washington DC.

Raul M. Grijalva
Democrat
Raúl has a thirty-year record of exceptional public service and he, his wife Ramona, and their three daughters Adelita, Raquel, and Marisa, have a lifelong commitment to improving quality of life in the Southern Arizona community. Raúl is an outspoken leader for a new middle class tax cut and more investments in new areas of job creation and economic growth. Raúl voted in favor of the Patient Protection and Affordable Care Act, the most significant overhaul of American health care policy in decades. He remains committed to fighting Republican attempts to repeal it or de-fund parts of the bill that improve health care delivery and affordability and ensure that peoples’ livelihoods are not undermined by excessive bottom-line thinking in the health insurance industry. Raúl believes in keeping promises the government has made to the American people. As far as he’s concerned, the relationship between public service and public support is a fundamental part of American life: you give to your country, and your country gives back. That’s why he’s such a strong supporter of continuing to fully fund Medicare, Social Security and support for veterans. Current occupation: Member of Congress, U.S. House of Representatives (AZ-07) Political experience: United States House of Representatives, Arizona District 7 Representative, 2003-present; Pima County Board of Supervisors, Chairman, 2000-2002; Pima County Board of Supervisors, Member, 1989-2000; Tucson Unified School District Governing Board, Chairman, 1980-1986 ; Tucson Unified School District Governing Board, Member, 1974-1986. Campaign Website: standwithraul.com Given the US Supreme Court decision, what are your thoughts about the Affordable Care Act? The Supreme Court’s decision was historical as it upheld a minimum level of health care for Americans. It was a needed decision that allows us to move forward on many improvements to our health care system. These improvements will begin to move our health care system towards one that focuses on primary and preventative care instead of costly sick care. It is an opportunity to build on what is working, move away from what is not and to provide a medical home to millions of Americans. Patients will have more say over their care as insurance bureaucrats dictate less. Uncompensated care cost will go down allowing our health care system to operate more efficiently. Our health care workforce can be broadened and diversified. This can all happen but there is much work to do. The ACA provided large amounts of flexibility and control to the states; the reforms to improve access to care must be upheld to the furthest extent possible. The ACA is not a final solution to our broken health care system, but one can be improved upon and one that is a momentous step beyond the status quo. Congress passed the Sustained Growth Rate (SGR) formula in the late 1990s to avoid voting on Medicare every year, yet now must vote every year to patch the system. How will you deal with the SGR? I have supported patches to the SGR so that doctors that see our Medicare beneficiaries are able to provide needed care. However, short term patches are not a solution. I have urged my colleagues to seek a permanent fix to the outdated and flawed formula that
SOMBRERO – August/September 2012

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provides a cloud of uncertainty over Medicare doctor’s heads. As co-chair of the Progressive Caucus, I authored alternative budget resolutions that include paying for a permanent fix to the SGR. I support proposals that will attract desperately needed professionals to primary and preventative medicine. The longer we wait to act the more expensive the problem becomes. I believe passing a permanent solution is about setting priorities. I will continue to demonstrate that this fix can be a priority and I will continue to build a coalition of members of Congress that attest to this understanding. Other issues upon which you want physicians to know where you stand. • I have led federal efforts to fight Medicaid provider cuts and eligibility cuts in Arizona. • I introduced HR 3542 which restores enhanced Medicaid rates to help struggling states while creating jobs. • I have repeatedly called for an end to the freeze on KidsCare program and successfully urged Center for Medicare and Medicaid Services (CMS) to include additional enrollees in final approval of Arizona’s new Medicaid waiver. • I support and regularly write letters of support for health care funding and pilot programs provided in the ACA to be brought to my district. • I have co-sponsored 236 health care related bills in the 112th Congress such as Health Insurance Review Act and Preserving Access to Life-Saving Medication Act.

We need to stand firm on what percentage of growth to allow for a period of five years. After each five year cycle, review the plan for any revisions or tweaks required. Its annual vote is so the political parties can use it as leverage against each on other matters. Other issues upon which you want physician to know where you stand. I am healthy. My family has been in the medical profession for many generations. I have two brothers that are MDs and other family member who are nurses and therapists. I’m the black sheep who preferred law.

Gabriela Saucedo Mercer
Republican
Gabriela Saucedo Mercer was born and raised in Mexico. She immigrated to the USA in 1986 (Legally) And on July 3rd 1991, Gabriela became a Naturalized Citizen. She is married to Ted Mercer. Gabriela has three grown children, Juliana Mercer, Christopher Mercer, Stephen Mercer and a grandson Zane Mercer. She left the work force in the Aerospace Industry in 1992 in order to raise her three children and continue her education. In 2008 Gabby decided that she could no longer watch the country she loved fall so far from the roots that drew her here and decided to get involved in her community. She volunteered her time, talent and treasure to help candidates that upheld her core values get elected into office. She was drafted by policy makers to craft legislation, she has held positions of leadership within the Republican party in Pima County. She can no longer stand on the side lines and be a cheerleader, she has decided to run herself. Her strength shows through each day as she stands up for what she believes in. Her courage to no longer remain idle and watch as the country she vowed to support flirt with extreme government controls, is what sets her apart from the rest. Her passion for making a difference propelled her to run for the United States Congress where she believes she can make a difference and uphold the values she believes makes our country so great. Current Occupation: Campaigning full time and on my spare time I am an Independent distributor of health and wellness products for Isagenix, International Political experience: Elected Precinct Committeeman 2010present. Member at Large for the Pima County Republican Party Executive Committee. First time running for office (not a career politician) Campaign Website: saucedomercer.com

Blanca Guerra
Libertarian
A Naturalized citizen, I was educated in Tucson and after high school, I enlisted and proudly served in the United States Air Force where I was privileged to work at Headquarters 1ST STRAD, Vandenberg Air Force Base CA as part of America’s nuclear deterrence team. After leaving the military, I became a paralegal and have spent decades focusing on helping those less fortunate and who can’t afford legal counsel. I enjoy my small ranch near Robles Junction; I’m a proud mother, and even prouder grandmother; I am 52 years old and a LIBERTARIAN. Current Occupation: Paralegal Political Experience: Not provided Campaign Website: guerraforcongress.com

Questions / Answers:
Given the US Supreme Court decision, what are your thoughts about the Affordable Care Act? I would support the REPEAL of Affordable Care Act. This mandate will enable the biggest insurance companies to control the insurance industry. Current regulations will not allow for small businesses to start up, leaving the big conglomerates to control the premiums. It will also put the insurance companies in a position to cap the incomes of the independent medical professionals. Congress passed the Sustained Growth Rate (SGR) formula in the late 1990s to avoid voting on Medicare every year, yet now must vote every year to patch the system. How will you deal with the SGR?
SOMBRERO – August/September 2012

Questions / Answers:
Given the US Supreme Court decision, what are your thoughts about the Affordable Care Act? The US Supreme Court’s decision does not change my mind about the need to repeal the Affordable Care Act. I believe that free markets solutions are the best answer to improving our healthcare in the United States.
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Congress passed the Sustained Growth Rate (SGR) formula in the late 1990s to avoid voting on Medicare every year, yet now must vote every year to patch the system. How will you deal with the SGR? I believe that the SGR as currently configured should be scrapped and re-tooled. It is counter productive to progressively reduce physician reimbursements. Possibly a better approach to increasing Medicare cost would be to focus on reducing waste, fraud and abuse in the system. Other issues upon which you want physician to know where you stand. When elected I will fight for the consumer to have the freedom to choose their own healthcare and allow them to preserve the

doctor/patient relationship relative to medical decisions. I also believe in promoting competition across state lines for medical insurance plans. I will also promote legislation to achieve tort reform.

Jaime Vasquez
Republican
Bio: Not provided Current Occupation: Owner Artisan Iron Works Political Experience: Candidate for State Senate in 1992 against John Huppenthal. Campaign Website: Jaimevasquezforcongress.com

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Questions / Answers:
Given the US Supreme Court decision, what are your thoughts about the Affordable Care Act? The Supreme Court decision on Obama Care has made problems worse. The law will add $1.7 trillion in new government spending over the next ten years. The money will come from Medicare and Taxes. Fewer people will be insured, the entire Law is filled with ineffective programs. Congress passed the Sustained Growth Rate (SGR) formula in the late 1990s to avoid voting on Medicare every year, yet now must vote every year to patch the system. How will you deal with the SGR? I need to sit down with the Doctors and chat . I represent the Doctors , as a Businessman I realize the problems every business has to deal with on a daily basis. The SGR formula seems like an obstruction by the way the law is set up. Other issues upon which you want physician to know where you stand. Jobs creation and the economy are on the top of my agenda. I am in favor of SB1070, because I am a strong believer in the rule of law. I consider myself to be a Conservative Reagan Republican. Please look me up on Jaimevasquezforcongress and Facebook.

arry Kirschner is recognized as an AV Preeminent® attorney by his peers for his 30 years of legal work in Tucson including as a partner at Waterfall Economidis since 2003. As a member of the firm’s Litigation Practice Group, Barry represents disabled persons whose claims have been denied or terminated by disability insurance carriers. Successful verdicts, settlements and administrative appeals come from knowing how to approach the problem effectively with clear, convincing and honest medical assessments by treating physicians. When an insurance company inappropriately relies on a doctor who has never seen the patient, Barry supports the treating physician to ensure his or her opinion is not over ridden by the insurer. Barry practices law with the conviction of a man who has dedicated his life to helping others. Passion like that cannot be duplicated and is part of what makes Barry a preeminent lawyer.

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44 SOMBRERO – August/September 2012

NATIONAL RACES

United States Senate
This race is to replace Sen. Jon Kyl who is retiring after serving since 1994. Democrat Richard Carmona, M.D. is running unopposed. Republicans: Wil Cardon, Jeff Flake, Bryan Hackbarth and Clair Van Steenwyk.

Wil Cardon
Republican
Wil is a business owner, a fifth-generation Arizonan, a husband and father of five. He is a true conservative who is willing to step away from his successful business ventures to serve the people of Arizona. Wil grew up in his family’s business, where as a young man he worked on the construction crew and made change at the family’s gas stations. He attended Brigham Young University and graduated from Stanford University for his undergraduate degree and earned an MBA from Harvard. He came back to Arizona to be part of the family business where he has created hundreds of jobs and a debt free business that has thrived by investing in our community. Current Occupation: President and CEO of the Cardon Group Political Experience: Precinct Committeeman Campaign Website: wilcardon.com

I support a permanent reform to the SGR so that physician payment rates are not subject to annual cuts, as well as taking a hard look at our Medicare system as a whole. We need a system that can be sustained and with more people coming into the system, with less revenue to go around it is obvious why the system is failing. What Congress and the President did in 2010 was simply a delay of the inevitable. By choosing not to adjust the rate, or find real solutions to both the number of Medicare patients coming into the system and the decrease in GDP for our country we are going to be faced with an even larger problem. It is no longer acceptable to turn a blind eye on our nation’s problems as past politicians have chosen to do. We need elected official who are willing to make the tough choices that will enact change rather than concerning themselves with what will get them the most votes in the next election. Other issues upon which you want physicians to know where you stand. Jobs and the Economy- As a businessman, I understand firsthand how excessive government regulations are strangling the private sector and stifling job growth. This has to change. Until we get government off the backs of business, we will not see significant economic improvement and that is unacceptable. We need people in Washington who have real world business experience and understand what businesses need to be successful. We must send people to Washington who have balanced budgets and created jobs. Securing the Border- For too long, the federal government has allowed millions of people to stream into our country illegally. This has drained our resources, and increased incidents of crime and drugs. Our border must be secured now. We cannot incentivize people to break the law by offering amnesty or lower tuition. As a country we must demand that our federal officials finally respect the rule of law and make sure that it is enforced. After our border is secure, and the law is being upheld, we need a legal immigration system that works. It is a daunting process to become a citizen. I have seen this first hand, as 5 of my 6 adopted siblings are from Brazil and our family has been through this process with them. I will work hard to be part of the solution to a functioning legal immigration system.

Questions / Answers:
Given the US Supreme Court decision, what are your thoughts about the Affordable Care Act? Regardless of the Supreme Court decision, ObamaCare is wrong. It is bad for our medical system and bad for our country as a whole. It must be repealed immediately. This massive expansion of government hurts small business, stifles economic growth and infringes on the freedom of every American. Under ObamaCare, millions of American’s are at risk of loosing their employer based healthcare. We need to move toward market based healthcare reform; reform that lowers costs, improves quality of care for patients and protects all Americans’ freedom to make decisions about their own healthcare. I oppose ObamaCare and if elected, will fight tirelessly until it is repealed. Congress passed the Sustained Growth Rate (SGR) formula in the late 1990’s to avoid voting on Medicare every year, yet now must vote every year to patch the system. How will you deal with the SGR? The Sustained Growth Rate formula must be reformed. We cannot continue to cut the rates that physicians are getting paid every year. As the number of people qualifying for Medicare increases annually, while our economy continues to stagnate, clearly the current system cannot sustain itself.
SOMBRERO – August/September 2012

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Richard Carmona, M.D.
Democrat
Born to a poor Hispanic family in New York City, Dr. Richard Carmona experienced homelessness, hunger and bleak prospects for a future education and economic opportunity. The child of parents who emigrated to the United States and struggled with alcoholism and substance abuse, Rich learned tough early lessons about economic disparities and social injustice – an experience he has never forgotten, and one that has given him an understanding of how culture, health, education and economic status shape our country. Like his siblings and many of his friends, Rich dropped out of high school. With few skills and little education, he enlisted in the Army and went to Vietnam. Military service gave him discipline and a drive to succeed that he still carries today. In order to apply for Special Forces and become a combat medic, he earned his high school equivalency degree. Rich left the Army a combat-decorated veteran, with two Bronze Stars, two Purple Hearts, a combat medical badge and numerous other decorations to mark his service. When he returned home from Vietnam, Rich became the first member of his family to earn a college degree. Through open enrollment reserved for returning veterans, he attended Bronx Community College and earned an Associate of Arts degree. Later he went California, worked as a registered nurse while he earned a bachelors of science degree at the University of California, San Francisco, and three years later, Rich completed his medical degree – receiving the prestigious gold-headed cane as the school’s top graduate. Trained in general and vascular surgery, Dr. Carmona also completed a National Institutes of Health-sponsored fellowship in trauma, burns, and critical care. A Fellow of the American College of Surgeons, Dr. Carmona was recruited jointly by the Tucson Medical Center and the University of Arizona to start and direct Southern Arizona’s first regional trauma care system. He, his wife Diane and their children relocated to Tucson. Dr. Carmona would later become chairman of the State of Arizona Southern Regional Emergency Medical System, a professor of surgery, public health and family and community medicine at the University of Arizona, and the Pima County Sheriff’s Department Surgeon. While continuing his medical career, Rich’s call to service led him to the Pima County Sheriff’s Department in which he has served for more than 25 years as a deputy sheriff, detective, department surgeon and SWAT Team Leader. In 1992, he rappelled from a helicopter to rescue a critically injured paramedic stranded on a mountainside when their medevac helicopter crashed during a snow storm, receiving national media attention. In the course of his service, Rich received the National Top Cop Award and was named the National SWAT Officer of the Year, as well as numerous other awards and decorations. In 2002, Carmona was nominated by the president and unanimously confirmed by the United States Senate to become the 17th Surgeon General of the United States. As Surgeon General, Carmona focused on prevention, health disparities and emergency preparedness to protect the nation against
SOMBRERO – August/September 2012

epidemics and bio-terrorism. He also issued a groundbreaking report on the dangers of second-hand smoke among many other Surgeon General communications. While very successful as Surgeon General, he unfortunately also experienced the divisive politics that continue to plague Washington today -- where the desire to score political points has become more important than solving problems, creating jobs or providing for those in need. That experience guides his current mission to become Arizona’s next senator and change how Washington works. In 2007, Dr. Carmona testified before Congress that political appointees had put partisan politics ahead of science -especially when it came to the public’s health -- in hopes that shining a light on how the administration operated could bring change. He testified: “The job of surgeon general is to be the doctor of the nation, not the doctor of a political party.” Knowing he stood up and did the right thing, Rich returned to Tucson and became vice chairman Canyon Ranch, a nationally renowned health and wellness company. He also serves as president of the nonprofit Canyon Ranch Institute. While Rich also resumed his service as a Pima County deputy sheriff, he became the first Distinguished Professor of Public Health at the University of Arizona’s Mel and Enid Zuckerman College of Public Health, Professor of Surgery and Professor of Pharmacy Practice. Current occupation: Vice-Chairman, Canyon Ranch and CEO, Canyon Ranch Health; President, Canyon Ranch Institute; Distinguished Professor of Public Health, University of Arizona College of Public Health, Professor of Surgery and Professor of Pharmacy Practice; Pima County Sheriff’s Department, Surgeon and Deputy Sheriff. Political experience: This is my first run for political office, however, from 2002-2006 I served as the 17th Surgeon General of the United States. Campaign Website: richardcarmonaforarizona.com

Questions / Answers:
Given the US Supreme Court decision, what are your thoughts about the Affordable Care Act? I’ve worked within our health care system as a paramedic, nurse, trauma surgeon, hospital administrator, university professor and as the 17th Surgeon General of the United States. I’ve seen the inefficiencies and problems first hand, but I also subscribe to the belief that every American should have access to a basic set of health care benefits.” “Both Democrats and Republicans got it wrong. The fact is, we don’t have a health care system, we have a sick care system. More than 75% of the $2.8 trillion we now spend in health care costs annually go towards treating chronic diseases, much of which are preventable. We each need to be more responsible for our personal health choices -- that alone would cut health costs dramatically. The Affordable Care Act does contain laudable first steps that help address health disparities, but it also has major flaws. Until we have leaders courageous enough to deal seriously and apolitically with a costly and ineffective business model, we won’t make the reforms needed to cut costs, encourage prevention and adopt healthier lifestyles.
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The health and fiscal security of our nation is on the line, but neither side is willing to shed special interest politics to fix it. We need to drop the politics, solve the problems and move forward before the rising cost of inaction bankrupts our country. Congress passed the Sustained Growth Rate (SGR) formula in the late 1990s to avoid voting on Medicare every year, yet now must vote every year to patch the system. How will you deal with the SGR? Americans of all political persuasions are fed up with the “kick the can down the road” attitude of the current Congress. I believe that Congress must work with the medical community to eliminate the current formula and find a permanent solution – not just another temporary “fix.” Other issues upon which you want physician to know where you stand. Arizona physicians are currently confronting significant cuts in state health care spending, serious uncertainly around the Affordable Care Act, and many of the challenges that have plagued doctors for decades: increasing costs; an ever-morecomplex health care system; and relationships with insurance companies that have become increasingly adversarial, with deleterious consequences to patient care. On top of these pressures, they face state and federal governments that too often see draconian, across the board payment cuts as the best way to control health care costs. As an independent-minded doctor who was called to public service positions by Democrats and Republicans, I am committed to working with both parties as well as experts in the medical community and patient advocates to find common sense solutions to these issues and end the partisan gridlock that has paralyzed the current Congress. As a soldier, a physician, and a businessman, I have demonstrated the ability to bring people together and work toward a common goal, and I plan to bring that sense of mission to the United States Senate. Vitriolic, partisan rhetoric solves no problems. My immediate focus will be on building a coalition of reasonable, moderate people in the U.S. Senate willing to solve problems and start making progress on the important issues facing physicians and all Arizonans.

with several Food Company’s in Ca. His clients in the Food Business were; Wal-Mart, Sam’s Club, Costco, Kroger, and Albertsons to name a few. He has also had a property development management business and antique businesses. Van and his wife Jean also operated a Christian Outreach on LA s’ Skid Row, Hollywood Boulevard, while also running a Christian Coffee/Halfway House, with an Outreach to a small village in Mexico. All of this was all done while they both worked full time jobs that supported the work. Vans’ radio career began in Ca. He’s been on the air since 2004 in Ca., Id., FL, and now in Phoenix with his Political Talk Show; Crossroads with Van on KXXT 1010am / blogtalkradio.com. He interviews office holders and candidates about issues and provides additional commentary. Van and Jean have sponsored candidate forums through the last election cycle as well as promoted events for others. Van has been asked to run for office before, but believed that his outreach work and political activity was enough, however when a group of conservatives asked him this year to run for the open US Senate seat, Van and Jean after thought and prayer decided to come out of retirement to be the Christian Constitutional Republican Candidate for the Office, where Compromising Values isn’t acceptable. I believe it’s time for business practices to be brought to government and All Government must be in compliance with Constitution or dissolve it, whether depts., agencies or laws. We hope you’ll join us in our endeavor to bring Our Republic Back. Current Occupation: Political talk radio show host; retired food industry executive. Political Experience: None Campaign Website: vanforussenate.com

Questions / Answers:
Given the US Supreme Court decision, what are your thoughts about the Affordable Care Act? Unconstitutional, needs to go back to Supreme Court on grounds wasn’t passed properly thru the house, also now that it’s been declared a Tax all those who were exempt now must be taxed no exemptions possible from a tax. Congress passed the Sustained Growth Rate (SGR) formula in the late 1990s to avoid voting on Medicare every year, yet now must vote every year to patch the system. How will you deal with the SGR? Move all elements to sustainability and begin setting up a Health Savings plan for future generations to take the fed out of it. Other issues upon which you want physician to know where you stand. I support the Constitution and want it restored and followed thereby removing most of the power of the Federal Government from our lives. Please check the site, and watch the videos. n

Clair Van Steenwyk
Republican
Van grew up in Bellflower, Ca. in a loving Christian Family where the values of being responsible for your actions mattered, as he believes most were taught in homes and schools at that time. Van began his political involvement in 1956 campaign of President Eisenhower by handing out small pocket size Presidents books and has been active to one degree or another ever since. Presently Van and Jean are PCs and State Committeemen. Van began his working career at the age of 9 and has worked in many industries since. Van entered the food industry in the 1970s where he worked his way up to an Executive Position
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SOMBRERO – August/September 2012



SOMBRERO – August/September 2012 49

PCMS News

that hundreds of local military members in the Navy and Marines stay healthy and ready for mobilization. His first stop was Camp Pendleton, then to Fort Dix for training. Although some of that training will help prepare him for the war wounds he can expect to see, from traumatic brain injuries to amputations, Dr. Lavor has had extensive experience in trauma surgery, having served as a member of the trauma team at TMC, where he was also chairman of the Department of Surgery. He will remain in Afghanistan September through April. The mobilization, his first, comes after Dr. Lavor’s efforts to help get TMC’s new Wound Care Center up and running, which helps manage chronic and non-healing wounds caused by diabetes, circulatory problems and other conditions. The advanced wound care center at the El Dorado facility, which opened March 5, houses two new hyperbaric chambers and five treatment rooms in the 4,700 square-foot facility. Dr. Lavor applauded his family’s support, particularly his wife’s. “At our stage in life, we were looking more toward retirement than at a mobilization, so it’s a sacrifice for her and for the family.” Commander Ross Orvik, CO of the Navy Operational Support Center in Tucson, said it’s an honor to see Dr. Lavor head out to assist the troops. He noted that as an experienced surgeon, Dr. Lavor “brings a lifetime of experience from the battlefield and the operating room. There will be soldiers, sailors, airmen, Marines and even Afghan civilians who will owe their lives to Mike and his shipmates. We wish him the best for a safe deployment and a speedy return!” Dr. Lavor’s vascular, general and endocrine surgery practice is Saguaro Surgical, P.C., 6422 E. Speedway Blvd. Suite 150. The group includes Michael Probstfeld, M.D., Matthew Namanny, M.D., Layla C. Lucas, M.D., and Sarah Ducharme, M.D. All are Fellows of the American College of Surgeons.

U. Colorado dedicates Fulginiti Pavilion

University of Colorado photo

The University of Colorado Anschutz Medical Campus reports that it will dedicate the Fulginiti Pavilion for Bioethics and Humanities Aug. 27. As Sombrero readers will know, the surname is that of Associate Member Dr. Vincent A. Fulginiti, former chancellor and professor emeritus of pediatrics at the University of Colrado Health Sciences Center. He is also a UofA College of Medicine professor emeritus of pediatrics, who founded that department at the college and headed it from 1969 to 1985. He is internationally recognized as an expert on the adverse affects of the smallpox vaccine, and was recently honored by Pima County Medical Foundation for his achievements in furtherance of medical education.

Dr. Lavor takes mission to Afghanistan
By TMC Communications
Dr. Michael A. Lavor, general surgeon with long standing ties to Tucson Medical Center, said he was surprised to find out in January that he would be serving his country by going to another. “Honored,” was his immediate reaction after discovering he would be would be headed to Afghanistan as a member of the U.S. Navy Reserve, to care for the troops there. “It’s a very rewarding experience for me,” said Dr. Lavor, adding that many Tucsonans don’t realize there’s a significant naval presence in Tucson. Dr. Lavor served in the U.S. Navy for 12 years as a Corpsman, and went back into the Reserve two years ago. “I just felt it was important to give something back,” he said, adding he enjoys the teaching and training opportunities that come with being in the rotation. As an officer in charge of the medical unit locally, he helped ensure
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UA Medical Center physician office opens in northwest
University of Arizona Medical Center—La Cholla Physician Office has opened at 6261 N. La Cholla Blvd., Suite 131, near where North La Cholla Boulevard and West Orange Grove Road meet, the university reports. The facility offers neurology, neurosurgery and pain management services by university specialists, including neurologists Scott Sherman, M.D. and Bruce Coull, M.D., and pain management specialist Steven Galper, M.D. It was established to meet a growing need in the northern part of the city, said Jeff Gooding, R.N., the office’s nurse manager. Patients who might benefit from a visit to the La Cholla Physician Office include those with migraines, chronic pain, stroke, fibromyalgia, or seizure disorders, Gooding said. The newly renovated 3,500-square-foot facility includes eight exam rooms and a procedure room for minor, outpatient procedures. It has a staff of five, plus more than 20 physicians from The University of Arizona Health Network who will be seeing patients each week at the office, which is open Monday-Friday, 8 a.m. to 5 p.m. Appointments may be made by calling 694.3940. n
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Y EA R S
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SOMBRERO – August/September 2012