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introtohealhpolicyppt.ppt

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introtohealhpolicyppt.ppt

  1. 1. NATHANIEL SCHLICHER, MD, JD L E G I S L A T I V E A D V I S O R E M E R G E N C Y M E D I C I N E R E S I D E N T S ’ A S S O C I A T I O N E M E R G E N C Y M E D I C I N E R E S I D E N T W R I G H T S T A T E U N I V E R S I T Y A T T O R N E Y A T L A W J O H N S O N , G R A F F E , K E A Y , M O N I Z & W I C K , L L P Introduction to Health Policy
  2. 2. 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
  3. 3. 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
  4. 4. 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
  5. 5. 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
  6. 6. Objectives  What is Advocacy?  Legislative Process  Health Care Reform  Medical Malpractice Reform  Getting Involved
  7. 7. Advocacy Politics =
  8. 8. SPEAKING FOR A CAUSE, OFTEN FOR A VULNERABLE PERSON Advocacy is…
  9. 9. US!
  10. 10. 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
  11. 11. EMTALA Why should we care?
  12. 12. $138,300 / year per ER Physician $12, 300 / year Average Physician
  13. 13. On call Specialists Medical Home
  14. 14. We Need a Seat at this Table!  President Obama’s Health Reform Summit
  15. 15. Now Do you Care?
  16. 16. The Legislative Process
  17. 17. 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
  18. 18. 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
  19. 19. The Home Stretch  Compromise  Amendments referred back to original chamber  Conference committee  Presidential Consideration  Sign  Veto  No Action Pass  Pocket Veto
  20. 20. Health Care Reform
  21. 21. The Rationale  46 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
  22. 22. Obama Campaign Plan  EHR 10 billion over 5 years  Increased Prevention  Align incentives for excellence – PQRI  Malpractice insurer reform  Competitive Insurance  National Health Ins. Exch.  SCHIP Expansion  Eliminate Medicare Advantage  Negotiate Drug Prices  Tax Credits
  23. 23. Moments of Pause  Expanded Pay for Performance  SGR like cuts are likely  More Medicaid or Medicare unclear  Decrease specialist utilization via incentives
  24. 24. 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
  25. 25. The Wrinkle Cost: $1.5 Trillion / 10 years Areas of Savings: Physicians Hospitals Insurers Drug Companies
  26. 26. Hope and Change  Allocation for SGR Reversal in 10 year plan  “Restructuring” of payments to physicians  Can We Get a Bailout?
  27. 27. Tort Reform
  28. 28. 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
  29. 29. What are the issues?  Malpractice Caps  Statute of Limitations  Statute of Repose  Attorney Fee Limits  Expert Witness Qualifications
  30. 30. Where We Stand
  31. 31. http://www.atra.org/files.cgi/8291_Record_12-08.pdf
  32. 32. 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
  33. 33. Many Issues Remain  State or Federal Issue?  Clumping of tort reform  Stigma of greed  Powerful Plaintiff Bar
  34. 34. Getting Involved
  35. 35. EMRA  35th year of existence  8457 Members  33% of all ACEP  Health Policy Committee  Legislative Advisor  Advocacy Handbook
  36. 36. ACEP Projects  911 Network  Speakers Bureau  Access to Emergency Medical Services Act of 2009  S. 468 / H.R. 1188  Jen Wiler
  37. 37. ACEP Committees  Federal Governmental Affairs Committee  State Legislative / Regulatory Committee  Medical-Legal Committee
  38. 38. NEMPAC  Election 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
  39. 39. 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
  40. 40. 2009 EMRA ADVOCACY HANDBOOK Want More Information?
  41. 41. 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
  42. 42. 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
  43. 43. 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
  44. 44. 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
  45. 45. Thank you!

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