Introduction to Health Policy

Prepared by:Nathaniel Schlicher, MD, JD

Legislative AdvisorEmergency Medicine Residents’ Association

Why Are You Here?

• Maybe…– Have to be– Need the hours– Better than a shift

• Or Maybe…– Want to make a difference– Want to guide change– Care about health reform

Objectives

• What is Advocacy?

• Legislative Process

• SGR

• Medical Malpractice Reform

• Health Care Reform

• Getting Involved

AdvocacyAdvocacy

PoliticsPolitics==

Advocacy is…

Speaking for a cause, often for a vulnerable person

US!

What is Advocacy to You?

• Calling Consultants• Getting that Test• Free Care for All• Hospital Boards• Medical Staff Meetings• Overcrowding Solutions• State Laws• Regulations• Federal Policy• Reimbursement

Why Should We Care?

EMTALA

$138,300 / year per ER Physician$12,300 / year Average Physician

On call On call SpecialistsSpecialists

Medical Medical HomeHome

CLOSED

CLOSED

We Need a Seat at this Table!

• President Obama’s Health Reform Summit

• Ensure multiple voices are heard

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 Hearings

• Subcommittee 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

Getting Involved

EMRA

• 35th year of existence– More than 9,000 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

NEMPAC

• Election Cycle 2 years– 2 million dollar goal

• Ranking– 1 – Anesthesiology (3.12M)– 2 – Orthopedics (2.37M)– 3 – Radiology (1.70M)– 4 – Ophthalmology (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

Want More Information?

Other Advocacy Resources

• Advocacy Webinar Recorded May 21, 2009– Target Audience: Junior Faculty

– Speakers: Nathan Schlicher and Gordon Wheeler

• ACEP Blog:– Thecentralline.org

– Rotating Bloggers

• Advocacy Toolbox on ACEP and EMRA

Take Away Points

• Advocacy is a core competency for us

• Get involved, we need you!

• Medical Malpractice Liability Reform may live

• SGR Solution Not Patch is Needed

• Health Care Reform Results Coming Soon!

Many Perspectives to Keep in Mind