End to Premarital Tests Asked : Medicine: CMA seeks state approval to end syphilis, rubella blood testing. Doctors say benefits are minimal.

In a move to slash health care costs, the California Medical Assn. Monday said it wants to eliminate state requirements for premarital blood tests to detect German measles and syphilis.

Premarital testing has not been effective in detecting these diseases and is costing California residents and insurers $20 million a year, said Dr. Val W. Slayton, who co-authored the proposal to eliminate the testing, which was adopted by CMA delegates meeting here.

“We are misplacing our resources,” Slayton said. He said vaccinations for rubella have become so pervasive that last year, only three babies born in California had contracted German measles from their mothers. And none of those cases would have been prevented with premarital rubella testing, he added.

Similarly, he said, state health officials estimate that only 37 to 52 cases of syphilis were diagnosed from 250,000 premarital blood tests administered for the disease in 1992, the last year for which there are statistics.

Slayton said although about 7,000 new cases of infectious syphilis are diagnosed in the state each year, most are not found among people seeking premarital blood testing but among a high-risk group composed of intravenous drug users, prostitutes and persons who carry the virus that causes AIDS.

Proponents of doing away with the premarital testing requirement also noted that 40% of couples already bypass the requirement by filing for “confidential marriages” and an additional 20% of California residents get married in other states that don’t require blood tests. In addition, they noted that 30% of babies in California are born out of wedlock, making premarital testing moot.

However, the elimination of required premarital health screening was opposed by some physicians at the CMA’s annual weeklong meeting, who said instead the law should be revised to encompass the high-risk groups. Some physicians said through testing they had discovered women who needed to be immunized against rubella. “It is a low case rate because we give the shots,” one physician said.

But the opposition’s arguments were criticized as “anecdotal,” by those wanting to dump the testing requirement, noting that already 36 other states have done so.

In other action, CMA leaders also said they would lobby the state Legislature to remove the requirement for women seeking sterilization to sign special consent forms in addition to the regular surgical consent form. The special form requires a three-day grace period after signing, and a 30-day grace period for women on Medi-Cal. Dr. David Priver, who authored the proposal, said the most onerous aspect of the current law is that some women who want to be sterilized during a Cesarean section instead must wait and endure a second operation.

However, Dr. Judith Leong Mates, chairman of a scientific committee that recommended against the proposal, said she expected opposition from women’s groups who will argue that special consent procedures are necessary to prevent unwanted sterilization being performed on poor women, especially those who do not speak English. Mates said the CMA previously had tried to change the consent law regarding sterilization, and its public image had suffered.

The CMA leadership softened a proposal that it support therapeutic use of marijuana for people with diseases such as AIDS and cancer, saying it would do so only “if controlled studies prove efficacy” of marijuana in relieving symptoms.