Introduction to Health Policy
description
Transcript of Introduction to Health Policy
NATHANIEL SCHLICHER, MD, JD
LEGISLATIVE ADVISOREMERGENCY MEDICINE RESIDENTS’ ASSOCIATION
EMERGENCY MEDICINE RESIDENTWRIGHT STATE UNIVERSITY
ATTORNEY AT LAWJOHNSON, GRAFFE, KEAY, MONIZ & WICK, LLP
Introduction to Health Policy
Why Are You Here?
Maybe… Cool Location Meet and Greet Program Paid For it
Or Maybe… Want to Make a
Difference Want to Guide Change Care about an issue
History of this Program
Where We Were
Resident Focused Track
Chair’s Challenge
Social Reception to Meet the Leaders
What We Have Added
Added First-Timers from YPS Section of ACEP
Integrated Media Training
Roundtable discussions
Today’s Speakers
1:00 – 1:40 Introduction Nathaniel Schlicher, MD,
JD
1:40 – 2:20 Health Care Economics James Eadie, MD, FACEP
2:20 – 3:00 Current Issues Jennifer Wiler, MD, MBA
Afternoon Agenda
3:00 – 4:00 Roundtable Discussion 10 Hot Topics
4:00 – 6:00 Media Training Speakers Bureau
Pre-Requisite
6:15 – 7:15 Reception Cocktails and
Networking
Objectives
What is Advocacy?
Legislative Process
Health Care Reform
Medical Malpractice Reform
Getting Involved
AdvocacAdvocacyy
PoliticsPolitics==
SPEAKING FOR A CAUSE, OFTEN FOR A VULNERABLE PERSON
Advocacy is…
US!
What is Advocacy to You?
Calling ConsultantsGetting that TestFree Care for AllHospital BoardsMedical Staff MeetingsOvercrowding SolutionsState LawsRegulationsFederal PolicyReimbursement
EMTALAWhy should we care?
$138,300 / year per ER Physician
$12, 300 / year Average Physician
On call On call SpecialistSpecialist
ss
Medical Medical HomeHome
CLOSED
CLOSED
We Need a Seat at this Table!
President Obama’s Health Reform Summit
Now Do you Care?
The Legislative Process
The Start
Bill is Introduced
Referred to Committee
Referred to a Subcommittee
Bart Gordon (HR 1188)
Energy and Commerce
Ways and Means
Subcommittee On Health in both Committees
The HearingsSubcommittee Hearings
Report out or Table it
Committee Hearings Report out or Table it
Full Chamber Considers Approve, Defeat, Refer
Back, or Table it
Second House Consideration
The Home Stretch
Compromise Amendments referred
back to original chamber
Conference committee
Presidential Consideration Sign Veto No Action Pass Pocket Veto
Health Care Reform
The Rationale46 million uninsured
1 in 3 Americans under 65 without health insurance in 2007/2008
Bankruptcy every 30 seconds from medical costs
72% of Americans favor increasing government control on costs
Obama Campaign PlanEHR 10 billion over 5
years Increased PreventionAlign incentives for
excellence – PQRIMalpractice insurer
reformCompetitive InsuranceNational Health Ins. Exch.SCHIP ExpansionEliminate Medicare
AdvantageNegotiate Drug PricesTax Credits
Moments of Pause
Expanded Pay for Performance
SGR like cuts are likely
More Medicaid or Medicare unclear
Decrease specialist utilization via incentives
Funding the Plan Stimulus Bill
17 billion for EHR 60% subsidy for COBRA 87 billion for 2 years of
Medicaid
50-65 billion / year via Tax cut rollbacks on
>$250,000 Keep the Estate Tax
634 billion over 10 years Reduced deductions Medicare Advantage gone Provider cuts
The Wrinkle
Cost: $1.5 Trillion / 10
years
Areas of Savings:PhysiciansHospitalsInsurers
Drug Companies
Hope and Change
Allocation for SGR Reversal in 10 year plan
“Restructuring” of payments to physicians
Can We Get a Bailout?
Tort Reform
Why?
Insurance Premiums $26 billion annually 12% / year growth rate
Cases more expensive 52% exceed 1 million Average verdict 4.7M
Defensive Medicine?? $70-124 billion
estimates
What are the issues?
Malpractice Caps
Statute of Limitations
Statute of Repose
Attorney Fee Limits
Expert Witness Qualifications
Where We Stand
http://www.atra.org/files.cgi/8291_Record_12-08.pdf
Data from the CBO (2004)
Caps improved costs Decreased costs of
health insurance Decreased cost of
malpractice coverage Increased insurance
premiums Increased physicians
Collateral Source Reform Limited decline
Many Issues Remain
State or Federal Issue?
Clumping of tort reform
Stigma of greed
Powerful Plaintiff Bar
Getting Involved
EMRA
35th year of existence 8457 Members 33% of all ACEP
Health Policy Committee
Legislative Advisor
Advocacy Handbook
ACEP Projects
911 Network
Speakers Bureau
Access to Emergency Medical Services Act of 2009
S. 468 / H.R. 1188 Jen Wiler
ACEP Committees
Federal Governmental Affairs Committee
State Legislative / Regulatory Committee
Medical-Legal Committee
NEMPACElection Cycle 2 years
2 million dollar goal
Ranking 1 – Anesthesiology (3.12M) 2 – Orthopaedics (2.37M) 3 – Radiology (1.70M) 4 – Ophthamology (1.69M) 5 – Emergency Med
(1.68M)
Give-a-shift Goal $1000 / attending $100 / resident
You May Be Involved But…
Rally your group / residency / friends
Give a Lecture / Journal Club on Advocacy
Become a Spokesperson
Give your Time and Money
2009 EMRA ADVOCACY HANDBOOK
Want More Information?
Thank Yous Anthony Foianini, MD,
Maine Medical Center, Portland, ME
Christopher S. Jones, MD Eastern Virginia Medical
School, Norfolk, VA
Eric Goralnick, MD Yale New Haven, New Haven,
CT
Daniel Freess, MD University of Connecticut,
Farmington, CT
George Leach MD Emory University, Atlanta, GA
Edwin F. Lopez, MD Sinai-Grace Hospital, Wayne
State University, Detroit, MI
Chet Schrader, MD Washington University in St.
Louis, St. Louis, MO
Michael Dorrity, MD MSU-Sparrow Hospital,
Lansing, MI
Erin E. Schneider, MD Oregon Health and Science
University, Portland, OR
Thank Yous Kaedrea Jackson, MD,
MPH SUNY Downstate Medical
Center, Kings County Hospital Center, Brooklyn, NY
Malika Fair MD, MPH Carolinas Medical Center,
Charlotte, NC
Stephen Tantama, MD Naval Medical Center San
Diego, San Diego, CA
Thomas Masters, MD Wright State University,
Kettering, OH
Jamie “Akiva” Kahn, MA, MSIV University of California at
Irvine, Irvine, CA
Marisa L Oishi, MD Mount Sinai School of
Medicine, New York, NY
Jawad Kassem, MD SUNY Upstate Medical
University, Syracuse, NY
Yogin Patel, MD, MBA Apollo MD, Atlanta, GA
Upcoming Advocacy Events
Advocacy Webinar – May 21st at 2pm EST Target Audience – Junior Faculty Speakers – Nathan Schlicher and Gordon Wheeler
ACEP Blog: Thecentralline.org Rotating Bloggers
Twittering with LAC Emresidents LAC09
Take Away Points
Advocacy is a core competency for us
Get involved, we need you!
Medical Malpractice Liability Reform may live
Health Care Reform Details Coming Soon! Stay involved
Thank you!