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Medical marijuana plan good, but ‘recreational component’ inevitable

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Wednesday, Sept. 19, 2012
By Lorri Allen
Cronkite News

PHOENIX – Arizona’s medical marijuana system will have stronger controls than other states, but some people will still exploit it to get the drug for recreational use, the state’s top health official said Wednesday.

“Is there a recreational component to the program? Absolutely yes. Have we done everything we could to stretch our statutory authority to keep it as medical as possible? We have done that,” Will Humble, director of the Arizona Department of Health Services, said in an interview with Cronkite News Service.

In November 2010, voters passed the Medical Marijuana Act, and dispensaries are gearing up for inspections before the system launches.

Humble campaigned against the medical marijuana proposition. But once it passed, he said it was his job to execute the will of voters.

“Obviously there’s a conflict with the Controlled Substances Act at the federal level,” Humble added. “I’m certain at some point this will end up in front of the Supreme Court.”

Humble said implementing the medical marijuana system came at a cost. For more than a year, he had to dedicate six staff members to developing rules for the new law rather than addressing what he considers more pressing public health issues.

“In medical marijuana, the payoff was not profound,” Humble said.

In a wide-ranging interview, Humble also said Arizona would benefit from establishing its own health insurance exchange under the federal Affordable Care Act. The law calls for states to set up exchanges for people lacking coverage or hand that authority to the federal government.

Gov. Jan Brewer’s office is still evaluating whether Arizona should have an exchange, but the state has accepted federal grant money to plan for one.

“I believe that it’s far better to run a state exchange than to have the feds run your exchange,” Humble said. “You’ve got the ability to make decisions directly about policy inside Arizona and how you want that exchange to work. It’s also a lot easier to integrate into the whole system.”

Humble said he is glad to see the presidential campaigns debating Medicare funding because “it’s a serious problem at the national level.”

Saying Medicare’s current fee-for-service system for reimbursing doctors creates unsustainable costs while not necessarily providing better care, he expects the system to eventually work more like managed care.

“Fee-for-service has got to be crushed because it provides a disincentive to physicians,” he said.

Humble said his department has engaged the University of Arizona to study reasons behind a slow but measurable increase in families opting against immunizing their children.

In the 2010-2011 school year, parents of 3.4 percent of children between 19 and 59 months used a religious exemption to vaccinations, while parents of 0.6 percent used an exemption for medical reasons.

Humble said there’s still enough “herd immunity” to guard against large outbreaks, though he noted a recent increase in whooping cough cases in Arizona and around the country.

“We’re still OK, but we don’t have as much margin for error as we used to have,” Humble said. “Sometimes it takes outbreaks to get motivated.”

With a study released this week predicting that 59 percent of Arizona residents will be obese by 2030, Humble called obesity “the No.1 public health issue of our time.”

He said the best response to the epidemic is creative ideas that appeal to people’s self-interest. For example, companies could offer employees incentives such as discounted health care coverage for participating in wellness programs.

“It’s not hopeless,” he said, “but it’s not going to just happen on its own, either.”