“When the meatpacking industry sells us pink slime, what really angers American consumers is the feeling of being cheated:  that the corporations’ profit is more important than the quality of their product.  We are left with a feeling of being deemed unworthy of better treatment or more dignified consideration.  We should be similarly outraged when our members of Congress try to cut corners in policymaking, especially when it comes to the health care of our fellow Americans struggling in (or near) poverty.  Turning Medicaid into a block grant system is an inadequate policy product for addressing our country’s federal deficit, and would be disastrous for the health care of millions of children, seniors, and the disabled.  Pink slime is intolerable, whether it is in our children’s school cafeterias, our grocery stores, or in the halls of Congress.”

The NPA represents supporters throughout the country, with physicians from more than 36 specialties.  We want to hear from all of you.

Please take 5 minutes to help us achieve a solid, representative response to this critical survey: Click here for survey.

We greatly appreciate your participation!

• The first call, Leading the Way to Conflict-free Medical Education, was held on February 22nd and featured discussion of AMSA’s PharmFree Scorecard.
• The second call, Dealing with Conflicts of Interest in Academic Medical Centers, was held April 18th and featured case studies illustrating the practical challenges that institutions face when developing COI policies.

Click here to listen to these calls or read summaries.
The next call is scheduled for late June.

For more information please contact Ann Woloson, NPA Director of Education at ann.woloson@npalliance.net

NPA hosts these calls in conjunction with our work related to The Partnership to Advance Conflict-free Medical Education (PACME) a joint project of the National Physicians Alliance, the American Medical Student Association Foundation, Community Catalyst, and the Pew Charitable Trusts. The project aims to create both external and internal pressure for medical schools and academic medical centers to adopt and enforce strong conflict-of-interest policies.

This partnership and related materials were made possible by a grant from the state Attorney General Consumer and Prescriber Education Grant Program which is funded by the multi-state settlement of consumer fraud claims regarding the marketing of the prescription drug Neurontin.

As we mark the second anniversary of the passage of the Patient Protection and Affordable Care Act (ACA) now is a good time to have what in medical parlance is called a “time out” and reflect on how far we have come and where we need to go.

Some states are challenging the legality of vital provisions such as Medicaid expansion and the mandate for all Americans to carry health insurance.  Candidates vying for President Obama’s job vow a complete repeal of the ACA.  Not surprisingly, polls show a confused public wondering what the health law means for them and the health plan they have now.  Despite this, the obfuscations cannot hide the reality that tens of millions of people have already been served by the initial phases of ACA.

* 54 million people with private health plans had at least one new free preventive service in 2011.
* 32.5 million Medicare seniors received at least one free preventive benefit in 2011.
* 2.5 million young adults under 26 years of age now have health insurance through their parents.
* As of this year, health insurance companies must spend 80-85% of your health insurance premiums toward health care rather than administrative costs.  It is estimated that 9 million people will even get a rebate check.

Here is a report on the impact on Californians specifically.

Lets not stop there. Here is get a glimpse of where this train is headed -because the really good stuff is just around the corner…

Click here to read the full article

This excerpt is from an article originally published in San Francisco Chronicle Blog, 3/23/2012.  It was  written by Ricky Choi, MD, San Francisco area pediatrician and NPA Board Member.

• Click here to listen to the oral arguments heard by the Court on Monday 3/26.
• Click here to listen to the oral arguments on the “Individual Mandate”
  heard by the Court on Tuesday 3/27.
• Click here to listen to the oral arguments “Severability” heard by the Court on Wednesday 3/28.
• Click here to listen to the oral arguments on ACA expansion of Medicaid coverage on states on Wednesday 3/28.

NPA members are at the Supreme Court defending
the Affordable Care Act on Monday 3/26.

Dr. Trudy Singzon, NPA Local Network Leader, San Francisco, CA

Dr. Ari Silver-Isenstadt, NPA Copello Fellow, Laurel, Maryland

Dr. Basim Khan, NPA Board of Directors

Listen to Dr. Alex Blum, NPA Vice-President of Membership, talk about the importance of the benefits in the Affordable Care Act for children with pre-existing conditions, young adults, women and seniors on the Jack Rice Show live today from Radio Row at the Supreme Court rally.

Watch Dr. Ari Silver-Isenstadt speak to Fox Business News about the Affordable Care Act from the steps of the Supreme Court today.

For a deeper understanding of the issues that the Court is considering this week, we offer the following resources—

• For a link to the written transcript of arguments:
  • Monday 3/26 – click here
  • Tuesday 3/27 – click here for part 1;  click here for part 2
  • Wednesday 3/28 – click here for part 1 on “Severability”;  click here for part 2 on expansion of Medicaid coverage in states
• A Guide to the Supreme Court’s Review of the 2010 Health Care Reform Law – Kaiser Family Foundation
• Supreme Court Watch
  
• Amicus Brief Submitted to US Supreme Court re Minimum Coverage Provision of ACA

See more photos of NPA members at the Supreme Court in the NPA Flickr Feed at the bottom of the page at this link.

The planned topics for the chat:

1. The PPACA has already enacted a number of reforms that are popular on both sides of the political spectrum (PDF link). Given that the individual reforms are popular, why has public approval of the PPACA itself lagged?
2. The individual mandate to purchase health insurance is consistently unpopular on all surveys, but is often considered necessary to expand necessary insurance coverage to all.  If the mandate to purchase insurance is removed from the PPACA, is there a way to ensure coverage or access to care?  Would any of the proposals discussed here be equally effective?
3. If the PPACA as a whole is repealed, or the Supreme Court finds the entire law unconstitutional, then the nation will face the same lack of accessible and affordable care that gave rise to the law’s reforms.  Given that the PPACA’s opponents have not proposed a plan to replace the ACA–if the PPACA is repealed, how should we address these issues of access and affordability?  Are there other plans that would lead to the same level of insurance coverage and/or access that the PPACA is attempting to reach?

Please join us and be part of this important conversation.

First, a review of what the reforms already in place as a result of the ACA:  this timeline provides a good summary, as does this timeline.   A review of these timelines shows that the ACA has already led to the following changes:

• Young adults can stay on parents’ insurance policies until age 26.
• People with preexisting medical conditions who have been uninsured for at least 6 months can access care via Preexisting Condition Insurance Plans.
• Insurance companies can no longer rescind patients insurance, and have eliminated lifetime caps on insurance benefits.
• Children can no longer be denied medical care due to preexisting medical conditions.
• Seniors have received discounts and rebates on their medication costs via Medicare Part D.
• Patients can receive many preventive care services without paying co-pays.
• Funding has been increased for community health centers and for the National Health Service Corps.
• Increased targeting of healthcare fraud.
• Insurance companies will be held accountable for unreasonable premium rate increases, and are being required to spend at least 80-85% of the premiums they receive on providing necessary medical services to beneficiaries.

These are among the ACA’s reforms that are favored by individuals on both sides of the political spectrum (pdf link).  Even before the ACA’s major reforms become active in 2014, the law is already improving the status of healthcare in America.

It can be anticipated that there will be a great deal of critical commentary about how the ACA represents a governmental overreach and that Americans resent this supposed power grab.  However, in the most recent Kaiser Family Foundation Health Tracking poll (pdf), 35% of Americans would like to see the law expanded, while 19% would like to see the law kept in its current form.  When 54% of the nation would like to leave the law as is or expand its reforms, it is hard to argue that most Americans oppose the ACA in the way that the law’s opponents would have us believe: they might highlight that 72% of Americans oppose keeping the ACA in its current form, but 1/2 of that number want the law expanded.  This underlines the disingenuous nature of the claims made against the ACA: the law’s opponents highlight those bits of data that can be presented as supporting their claims, but conveniently omit the details that undercut their claims.

Opponents of the ACA also have chosen not to propose any replacement for the law any time soon, despite the fact that the House of Representatives actually voted to repeal the law in 2011.  While the Republican Party delays action, 1/3 of Americans are struggling to pay their medical bills.  This statistic illustrates the reasons that the ACA’s reforms were so badly needed: Americans cannot easily afford necessary medical care.  The law will address this directly as the health benefits exchanges come online in 2014, but the reforms noted above stand to improve this statistic.

We will certainly hear more and more reasons that the ACA was unconstitutional, especially as the Supreme Court will be hearing arguments on the law’s constitutionality the week following the law’s anniversary.  One of the major arguments against the ACA focuses on the law’s mandate that individuals purchase health insurance or face paying a penalty.  This article nicely encapsulates arguments as to how and why the ACA and its individual mandate are both constitutional and necessary.

This is where we stand: the ACA is already benefiting Americans, many of whom are in favor of the law’s reforms or who would have preferred more expansive reforms.  The need for reform is clearly evident, and the ACA’s opponents have not proposed any meaningful answer to the current crisis in healthcare access and affordability.  Despite the law’s opponents’ fervent claims and beliefs, the law’s constitutionality can be supported in a number of ways.

If you support the ACA’s healthcare reforms, get ready, be vocal, and stand tall.  The week of March 19-23 promises to be quite active.

Dr. Arkoosh will be talking about the Patient Protection and Affordable Care Act, which will celebrate its second birthday on March 23rd.

Be sure to tune in and help spread the word!

In a recent perspective piece in the New England Journal of Medicine, John Gill and Marcello Tonelli detail the costs of this misguided policy as well as advocating for a solution, H.B. 2969, which would remove the arbitrary time limit for coverage of these critical medications.*  Overall, their estimate is that by not covering anti-rejection drugs, Medicare wastes about $200 million each year in unnecessary dialysis costs and repeat transplants.  Medicare won’t cover anti-rejection drugs after 3 years, but when the transplanted kidney inevitably fails for lack of these drugs, it will cover a return to dialysis and a second transplant.  The impact of this policy falls disproportionately on the poor and on minority populations, who are more likely to be uninsured once their 3 years of coverage is finished.  It means not only wasted money, but also a higher mortality rate among these patients, worsening health disparities, and the waste of irreplaceable transplants that should have been lifesaving.  If we are to cut costs and make our health care system both more equitable and sustainable, we cannot afford this kind of waste, both of money and of lives.

*As Gill and Tonelli state,  “H.R. 2969 represents a key opportunity to correct an irrational, needlessly wasteful policy that has harmed many U.S. patients.”  Penny Wise, Pound Foolish? Coverage Limits on Immunosuppression after Kidney Transplantation.  John S. Gill, M.D., and Marcello Tonelli, M.D., N Engl J Med 2012; 366:586-589, February 16, 2012.