Pre-Medical Student Presentation 2009-05-13

8/14/2019 Pre-Medical Student Presentation 2009-05-13

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Future Directions for theUnited States Health Care System

Heidi NelsonHeartland Health Outreach


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Heartland Health Outreach

Mission: to improve the health of disadvantaged populations- individuals andcommunities without access to health care-through the provision of culturally competent,multidisciplinary services designed to preventillness and improve physical, mental and socialwell-being, and through advocacy thatpromotes the right to access comprehensive,integrated systems of care.


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Target Populations

Homeless persons

Low-income individuals with HIV diseaseImmigrants and refugees


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Services

Primary care- medical and oral health

Mental health careTreatment for torture survivorsInterpreting services

Training and technical assistance


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What are you hearing and readingabout health care reform?

Heartland Alliance for Human Needs & Human Rights


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Challenges and Responses in

Health Care Today

Reed V. Tuckson, MD

Executive Vice President and Chief of MedicalAffairsUnitedHealth GroupMarch 27, 2009


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Challenge: escalating health carecosts due to preventable disease

Obama Administration, 5/12/09: Medicare

Hospital Trust Fund to run out in 2017, twoyears earlier than last years report

We wont get the cost of Medicare and Medicaiddown unless we get down the cost of healthcare overall.

-Kathleen Sebelius, US Secretary, HHS


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Challenge: people are makingchoices based on economics

Kaiser Family Foundation April Health Tracking

Poll: 59% of those polled say they or a familymember have delayed or skipped care in thepast year Substituting for doctor visits (42%)

Skipped dental care (36%) Did not fill a prescription (29%) Cut pills or skipped doses of medications (18%)


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Challenge: Poor or suboptimal

quality of careRegarding the Institute of Medicine Initiative,

Crossing the Quality ChasmThe first phase of this Quality Initiativedocumented the serious and pervasive natureof the nations overall quality problem including that the burden of harm conveyed by thecollective impact of all our health care quality

problems is staggering Mark Chassin, Mt. Sinai School of Medicine,1999


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Challenge: Fragmented Health CareSystem

Institute of Medicine, Crossing the Quality

Chasm, 2001

America needs care based on continuing, healing relationships


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We have to:

Be more engaged than ever beforeHave a shared visionFocus on care coordination

Push for research on what worksSeek community and population preventionstrategiesChallenge ourselves to improve quality

Tucksons Solutions to Improvingthe Health Care System


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The Obama AdministrationWhat can we expect for health system change?


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The American Recovery andReinvestment Act of 2009

What can we learn from the stimulus package

about the Administrations priorities?



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Health Care Elements of the ARRA

Quality Affordable Health Care (conference

agreement) Health information technology ($19 billion) Prevention and wellness ($1 billion) Health care effectiveness research ($1.1 billion)

Community health centers ($2 billion) Training primary care providers ($500 million) Indian Health Service ($500 million)



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A Few Details on Health IT

National Coordinators Office in HHS

Promote interoperability Promotion of studies on HIT adoption

Medicare and Medicaid enhanced rates for meaningful use of HITPromotion of electronic health record adoptionthrough federal and regional TA centersAcademic curricula on HIT



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Other health related aspects of

ARRA

Increased Medicaid federal participation rate to

provide relief to statesProvided subsidies for individuals who losetheir jobs to purchase COBRA



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ARRA themes that reveal the

Administrations policy focus

Prevention

Primary CareHealth Information TechnologyComparative Effectiveness Research



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Health Reform? Whats the Plan?

Budget plan approved in April by House and

SenateProvided a pathway for health reformlegislationBut, theres no planyet



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Policy Themes in Health Reform

Public Plan

Like Federal Employee Health Benefits Program Individuals and Businesses could Purchase Who opposes?



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Mandates

For individuals to cover themselves For businesses to cover their employees



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Tax credits



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Coverage expansions

The very poor The near elderly Young adults



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Whither Single Payer?



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What are our prospects?

Joe Antos, American Enterprise Institute, May

12, 2009In many cases, these ideas [computerizedrecords, care coordination, eliminatingduplication] have been in play for 20 yearsthese represent no sacrifices. The real money is in delivery of services. Ideally we will eliminate the services we dont need, but thatsthe debate.



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Richard Kirsch, Health Care for America Now

-Rick Scott is a tainted messenger. Hiscampaign is designed to protect health care profits.

Youtube: Americans for Health Care Now,Insurance Company Rules



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Kathleen Sibelius, May 12, 2009

-I give health reform in 2009 a 60-40 chance.



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What do aspiring medical students

need to know?

Comparative Effectiveness Research isessential to reducing health care costsElectronic Health Records have the potential toimprove quality if done rightQuality of care includes reducing disparities-first and foremost understand the patientsenvironment and resourcesConsider Health IT and Quality as career

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Pre-Medical Student Presentation 2009-05-13

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