National Physicians Alliance

Impact of State Laws That Extend Eligibility for Parents’ Health Insurance Coverage to Young Adults

Jean Silver-Isenstadt, MD, PhD, NPA Executive Director — Fri, 17 Feb 2012 22:13:22 +0000

This week, Drs. Alex Blum, Lawrence Kleinman, Barbara Starfield, and Joseph Ross published a paper in the journal Pediatrics that suggests that the Affordable Care Act (ACA) is not only helping millions of young adults get insured – but that insurance means young Americans all across the country are more likely to get the health care they need.

The researchers used U.S. Centers for Disease Control and Prevention data before (2002-2004) and after (2008-2009) and examined 3 states that expanded coverage to young adults prior to the passage of the Affordable Care Act. The research showed that compared to 17 states without such laws, young adults in states with laws were more likely to gain their own personal physician, have regular checkups and no longer have to go without needed health care because it cost too much.

The researchers’ findings should inform our understanding of the ACA provision that mandates that private insurance companies make young adults eligible to remain on (or join) their parents’ insurance policy.

This research points out that laws that make young people eligible to join their parents’ health insurance not only allow the future workforce to gain health insurance but, ultimately, health security.

State of Emergency

Jean Silver-Isenstadt, MD, PhD, NPA Executive Director — Fri, 17 Feb 2012 22:09:34 +0000

This article was written by NPA President-Elect Dr. Cheryl Bettigole and is cross-posted from “The Medical Professionalism Blog” published by the ABIM Foundation where it was originally posted February 14, 2012.

During a recent talk at the Families USA conference, the Reverend Edward Livingston led an animated discussion regarding his groundbreaking work with the Camden Coalition of Healthcare Providers and Camden Churches Organized for People. (This work became well-known through Atul Gawande’s piece in The New Yorker, “The Hot Spotters.”) In the course of his talk, he described a simple yet critical piece of their team’s work to design a functional primary care system for frequent Emergency Department users: They asked these patients why they used the Emergency Department rather than seeing a primary care physician and used their responses to shape the intervention.

As a family doctor who is also the mother of three active boys, I am fascinated by the question of what drives people to use Emergency Departments, both for its cost implications and its effects on the lives of patients and caregivers. Through a combination of exuberant optimism, love of all sports and a certain lack of common sense, my sons have worked their way through a wide variety of orthopedic not-quite-emergencies including hairline fractures of the finger (six at last count), a mild shoulder separation, partial Achilles tears (2) and probably a few others I’ve managed to forget. Our primary care doctor is part of a Patient-Centered Medical Home and we are lucky enough to have good health insurance. Each of these conditions could and probably should have been handled without a visit to the Emergency Department, but we have struggled to figure out how to make that happen. Although our doctor has open access scheduling, this only applies if they have a slot when we call. Often by the time the child can be seen, it is too late for X-rays the same day and of course the doctor does not refer the child to an orthopedist until the X-ray results are in. All of this usually means that we are either faced with a choice between a three- or four-day sequence of medical appointments, all while the child is missing school and one of his parents is missing work or an evening visit to an Emergency Department, where exam, X-rays and splinting/casting can all be done in one place. Add to this our busy work and home schedules, and the choice to go to the Emergency Department becomes almost unavoidable.

While waiting in Emergency Department, I’ve seen countless babies and young children with head colds and other apparently minor illnesses. During my training, I cared for kids with similar minor illnesses in Emergency Department. I suspect that their parents brought them there for reasons similar to my own: jobs that don’t allow sick time for taking children to the doctor, difficulty seeing a primary care provider when a visit seems needed and, behind it all, a fear of leaving a child sick or in pain for longer than necessary because of a system that doesn’t serve our needs.

As we think about the urgency of cost containment and the potential of the Patient-Centered Medical Home, we will need to give real thought to the drivers of Emergency Department use and to finding real solutions that meet the needs of the patients who use them. We will have to ask the question that Reverend Livingston and his colleagues in Camden asked their patients: Why do you go to the Emergency Department? And we will need to begin building systems of care that respond to the answers we get.

Dr. Cheryl Bettigole is a family physician with the Philadelphia Department of Public Health where she sees patients at a city clinic and serves as the Clinical Consultant to the Office of Health Information and Improvement within the Health Commissioner’s Office.

RxDemocracy Promotes Voting – download free workplace poster

Becky Martin, NPA Project Manager — Fri, 17 Feb 2012 18:49:33 +0000

Simply put, people who have a voice–whether in the exam room, in the voting booth, or in civic and community life–tend to be healthier. And the more voices there are, the healthier our democracy becomes. This is Rx: Democracy.

The NPA is committed to advancing the civic engagement of physicians and patients through leadership development, coalition building, and voter education.

>>Click Here to Promote Civic Engagement with Rx: Democracy<<

>>Download a free 2012 Poster for Your Workplace!<<

The NPA is a founding member of Rx Democracy, a national nonpartisan network of more than 18 national and regional groups representing America’s best clinicians, health professionals and students. Together with concerned citizens’ groups, this network helps patients and those who care for them to have a voice in their health care and their community. We partner with civic organizations to provide opportunities for nonpartisan voter and civic engagement in health care settings and beyond.

If you believe that voting and civic participation are healthy activities, join our Rx: Democracy network to make sure everyone has the tools and information they need for a healthy democracy.

Learn more about NPA Civic Engagement and RxDemocracy

NPA Urgent Action Required: Call Congress about SGR

Valerie Arkoosh, MD, MPH — Fri, 17 Feb 2012 03:13:41 +0000

Today the Prevention and Public Health Fund faces an immediate threat in the ongoing negotiations to temporarily forestall the impending cut in Medicare physician payments. A significant portion of the Prevention and Public Health Fund, $5 billion over ten years, has been targeted to offset the cost of the bill. Additionally, Medicaid spending for hospitals that treat a disproportionate share of low-income patients would be cut by $4 billion.

A solution to the flawed Medicare sustainable growth rate formula (SGR) must be found but the resolution does not lie in diverting money from public health and safety net hospitals.

Time is of the essence if we want to make a difference as the vote is likely to occur in the next 24 – 48 hours.

Please call Senate Majority Leader Harry Reid (202-224-3542) House Minority Leader Nancy Pelosi (202-225-4965), and Senator Max Baucus (202-224-2651) today and urge them to protect the prevention fund and safety net hospitals.

Key points to make include:

1. Support the Prevention and Public Health Fund and oppose any efforts to reduce, eliminate or divert its funding to pay for the Medicare payment fix. Cutting a critical, overdue investment that bends the cost curve on chronic diseases is penny-wise and pound foolish.

2. It is counterproductive to cut prevention to pay for medical care. It’s the opposite approach to what is needed to help bend the cost curve. Chronic diseases are driving the increase in Medicare costs, accounting for 70 percent of all deaths and 75 percent of all Medicare spending. Instead of cutting public health funding, alternative mechanisms to fix the SGR are required.

3. Cutting funding to our safety net hospitals prior to the insurance expansions that will occur in 2014 puts these critical institutions at increased financial risk.

If you can spare 5 more minutes, call your Senators and Representative too. Use the Capitol Hill switchboard at 202-224-3121 or look up the names of your elected officials and their direct numbers here: http://www.contactingthecongress.org/

Thank you for taking the time to make your voice heard on this critical issue today!

Valerie Arkoosh, MD, MPH
President

Help Counter Industry Spin: Public Comment Period Open Now on New HHS Rules

Jean Silver-Isenstadt, MD, PhD, NPA Executive Director — Wed, 08 Feb 2012 04:00:11 +0000

One of our core efforts at the National Physicians Alliance is to restore trust and integrity in medicine by eliminating conflicts of interest between doctors and the pharmaceutical industry. An important opportunity is before us.

As part of the Affordable Care Act, the Department of Health and Human Services is working on new regulations requiring drug companies and manufactures of medical devices to disclose payments made to doctors for speaking, research, travel, entertainment, and consulting. The NPA strongly supports these regulations. As part of our Unbranded Doctor campaign, we are working to shed light on the corrupting influence of drug company payments to doctors.

Please submit your thoughts for our submission to the Department of Health and Human Services supporting these new regulations.

As medical professionals we have a unique and important role to play in countering the voices of industry and parts of the medical establishment and ensuring that regulators know that many doctors support rules like these to return trust and integrity to our profession. Consider the impact these types of payments have had:

According to the New England Journal of Medicine, 94% of physicians accept gifts, payments, reimbursements or other financial incentives from the pharmaceutical industry.
Numerous studies have demonstrated that such gifts and payments directly influence medical decision-making.
It has become difficult for physicians to find and distinguish legitimate, evidence-based sources of medical information from biased, industry-influenced sources.
The very distinction between marketing and education has been blurred.

This is our house to clean.

Join us and add your support.

Join Call with Dr. Ezekiel Emanuel, Feb 7 at 9PM EST, Topic: Why You Should Care about Healthcare Cost Control

Becky Martin, NPA Project Manager — Fri, 03 Feb 2012 05:01:50 +0000

The NPA is pleased to announce its first policy call, “Why You Should Care about Healthcare Cost Control,” with Dr. Ezekiel Emanuel on Tuesday, Feb 7 at 9PM EST.

Dr. Emanuel is University Professor and vice provost for global initiatives at the University of Pennsylvania, Senior Fellow at the Center for American Progress and former special assistant on health policy to the White House. He also regularly writes in the New York Times: http://opinionator.blogs.nytimes.com/author/ezekiel-j-emanuel/

Click here to RSVP and Submit Questions for NPA’s Policy Call

Dr. Ezekiel Emanuel: “Why You Should Care about Healthcare Cost Control”

Tuesday Feb 7 at 9 PM EST/6 PM PST

Please join us!

NPA Petition to Defend Women’s Access to Care

Becky Martin, NPA Project Manager — Fri, 03 Feb 2012 05:01:33 +0000

The National Physicians Alliance is committed to eliminating health disparities and to broadening—not narrowing—access to the full range of essential health care services. This week, two powerful groups have acted to narrow women’s access to care:

1) The US Conference of Catholic Bishops is protesting the Department of Health and Human Services rule that requires employers who provide insurance to their employees to cover all FDA-approved contraceptives, as recommended by the Institute of Medicine. The rule does not require plans to cover abortions. Churches and church-affiliated secondary schools are exempt from the rule, but religiously affiliated hospitals, charities, and universities are not exempt.

2) The Susan G. Komen for the Cure foundation decided to defund Planned Parenthood (and then reversed that decision in the wake of a national backlash).

Moves like these will limit women’s equitable access to health care, and will disproportionately hurt low income women.

Please CLICK HERE to add your name to the following petition, which we will deliver to Secretary of Health and Human Services, Kathleen Sebelius.

As health care providers committed to comprehensive health care for women and to the elimination of health disparities, we stand in strong support of the Affordable Care Act’s requirement that all employers who provide insurance to their employees cover all FDA-approved contraceptives, as recommended by the Institute of Medicine.

We invite your comments below.

To learn more about this ruling and religious liberty read this excellent brief on this topic from the ACLU - “Group Health Plans and Health Insurance Issuers Relating to Coverage of Preventive Services Under the Patient Protection and Affordable Care Act”

To learn more about current state laws requiring insurance coverage for contraception read this informative brief from the National Conference of State Legislatures.

“At least 26 states have laws requiring insurers that cover prescription drugs also provide coverage for any Food and Drug Administration (FDA)-approved contraceptive. These states include: Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Georgia, Hawaii, Illinois, Iowa, Maine, Maryland, Massachusetts, Missouri, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Oregon, Rhode Island, Vermont, Washington, West Virginia and Wisconsin.“ more>>

A Physician Response to Occupy Wall Street: Occupy Health Care

Becky Martin, NPA Project Manager — Fri, 03 Feb 2012 05:00:40 +0000

Statement authored by Dr. Lisa Plymate with input from the NPA Policy Committee, 2/3/2012

We are physicians who are committed to reforming our health care system so that every person has access to affordable, high quality care. We cannot achieve this without fighting for economic and social justice. As doctors, we support many principles of the Occupy Wall Street movement. We cannot stand by; we must speak out.

We believe:

Health care is a human right. We are not just doctors for the 1% or for the 99%, but for everyone.

Economic and social inequalities are toxic to all Americans. These widening disparities directly affect our ability to perform our duties as doctors: to care for each patient as an individual and to improve our overall national health.

In these hard times, a rising number of people suffer from inadequate income, lack of affordable housing, a failing educational system, a polluted environment and lack of access to affordable health care, yet national policies continue to favor those who have the personal means to avoid these problems.

Too many aspects of our health care system have become corporate, and health care does not belong on Wall Street. Corporate decisions are based on shareholder profits and CEO salaries, not patient needs. A for-profit health care industry raises costs, lowers quality and reduces access. Our obligation as physicians is to work with our patients to help them receive the care they deserve.

A healthy society is built on a healthy democracy with fair treatment of all people. The rights and needs of people, not corporations, are central to the health of our democracy. The highest duty of government is to promote and protect the welfare of its people. This includes promoting conditions leading to better health, while ensuring that everyone has access to appropriate health services when needed.

Physicians must champion the ethical values of our profession by fighting for our patients’ rights. We believe we can—and must—change the health care system and our society to make them more just. As physicians and voters, we will fight for these principles in our communities and push our system to achieve what we know is right.

Add your voice below.

The Greatest Advance for Women in a Generation

Jean Silver-Isenstadt, MD, PhD, NPA Executive Director — Thu, 26 Jan 2012 15:01:30 +0000

I attended a health policy conference last week where the buzz was women. The question on everyone’s mind was: Why aren’t American women angrier that every last one of the Republican candidates for president has threatened to repeal a law that has brought the greatest advance for women in a generation? The experts had an answer: because most women don’t know about their new rights and protections. Many have no idea what’s in this health care law for us. I’m here to tell you that it’s a LOT, an astounding, tell-your-granddaughters-you-were-there LOT.

The President may have buried the lead on Tuesday night, but we don’t have to. Women know how to share good news.

Here’s the thing: family health care is one area where men readily cede decision-making and control to women—and most will even admit it. As CEOs of a family’s health care management, women are responsible for their own health care, their children’s care, their spouse’s care, and in ever growing numbers, the care of their aging parents. This means that in addition to the economic burdens and job insecurity facing American women today, there is also the terrible weight of anxiety surrounding access to reliable, affordable health care. Not to mention the overwhelming emotional burden and immediate practical demands that a family member’s illness presents to women in particular. Women are still the country’s front-line caretakers and now the law is on our side.

In his State of the Union Address, President Obama promised the country that he, “will not go back to the days when health insurance companies had unchecked power to cancel your policy, deny you coverage or charge women differently from men.”

Repeal of the Patient Protection and Affordable Care Act would do just that. Take us backwards. The ACA has moved the nation toward fairness: fairness for women, fairness for those with pre-existing medical conditions, and fairness between the health insurance choices available to members of congress and those available to millions of Americans.

Beyond the list of new benefits—such as annual wellness visits, cancer screenings, and birth control all at no additional cost—the ACA changes the very horizon for women in this country. We are no longer on our own against the insurance companies, struggling to manage family health in a system that ignores the desperate need for care coordination, preventive services, affordability, access, and security. The law now guarantees protection in each of these realms. It begins to measure the quality of our health care by the actual health and well being of our people. These are gains that we as women must actively defend.

Pass the word on to your friends, so that we may pass the power on to our granddaughters.

Under Addressing the Factors That Cause 70% of Disease

Ricky Choi, MD, MPH, NPA Board Member — Wed, 25 Jan 2012 21:48:19 +0000

While in residency, I took care of a toddler who was hospitalized following an anaphylactic reaction. During a diaper change at home the child suddenly developed lip swelling and severe difficulty breathing for no apparent reason. The child was urgently brought to the hospital by ambulance and initially treated in the emergency room…

Click here to read the full article

This excerpt is from an article originally published in San Francisco Chronicle Blog, 1/25/2012. It was written by Ricky Choi, MD, San Francisco area pediatrician and NPA Board Member.