Obama says: Let's keep our eyes on the Health Reform prize

So, Americans, what's the big deal?  What's at stake?  Here's from the Man at the top, his take:

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Healthcare Reform (don't miss the train!)

Dear friends & colleagues,

Health Insurance/Healthcare reform has come a long way, and it's not too late to learn what it's all about (esp. with the holidays coming up, so that you'll be able to converse about healthcare with others back home), and more importantly, to make a difference by adding your uniquely influential voice as a medical student/future physician.  For an easy & quick way to learn about/add your voice to this reform that will significantly affect us all, check these out:

1. Doctors for America is a grassroots group of 16,000 physicians and medical students.  I've pasted their latest email update for you to see (below).  Within it is this fantastic link to a poll of the "6 key reforms," which, when you click on each reform's "see how the bills address this," will give you a very clear & succinct synopsis.  Joining their listserve is easy, and the resources on their website are just as user-friendly & informative: http://drsforamerica.org/

2. Sign on to the American Academy of Family Physician's "Connect for Reform" group.  You must first register here (free for medical students) to become an AAFP member.  Then after you register, go to http://www.aafp.org/ and click on the "AAFP Connect for Reform" button to sign on.
    •    receive periodic emails with the inside scoop on Health Reform, and easy ways that healthcare professionals and students can join to help.
    •    Connect with other members, and add your voice to advocacy actions.

3. If you have any other ideas/suggestions/links for how students can join the conversation and help, or if you'd like to write any kind of healthcare-related article yourself, please email me and I can post onto DownstateCafe.blogspot.com .

Best,
Abe

from: Vivek Murthy MD, MBA
to: abraham.young
date: Fri, Dec 18, 2009 at 1:18 PM
subject: Moving Forward
Abraham -

Need your input: What's most important to you in this health reform bill?

Rank Your Priorities

 So we can take a stand together

After a whirlwind week in the health reform fight you might be wondering what all the developments mean for reform, whether a bill is still worth supporting, and what our community of physicians should fight for at this moment.

What happened:

This week, the public option and its substitute (the Medicare early buy-in provision) were both dropped from the Senate bill as Senate leadership worked to win 60 votes for the overall bill. This was quite a disappointment to our members after working for a public option for many months and considering it to be an important component of successful reform.

Aside from the public option, the Senate - unlike the House - has not included provisions to address defensive medicine. The Senate also does not include a permanent fix to the flawed Medicare payment formula (SGR); there is currently only a one year patch of the SGR.  The bill is certainly far from perfect.
 
What didn't happen:

Health reform isn't over and the final bill hasn't been written. Moreover, a lot of very important provisions are still in both the House and Senate bills. And that's because time-after-time we've spoken out for the issues we care about - expanding coverage, strengthening primary care, making premiums affordable, investing in prevention and improving quality.

As it stands, the current bill will cover 31 million more Americans, establish the strongest restrictions on insurance companies in history, and invest substantially in improving our health care delivery system - all while reducing the national deficit over 10 years. (See below for more details).

What now:

This brings us to this moment. The ultimate success of health reform depends on what we do in the next few weeks. The Senate is working to secure the 60 votes necessary to stop a filibuster on the Senate floor. Once they do so and pass a bill, the Senate and House bills will then be merged. 

While there are provisions in the bill that help doctors and patients, any of these can be weakened or stripped altogether from the final bill. So your voice is as important now as ever.  As the Senate hammers out the details over the next 24-48 hours, tell us:

We have identified 6 key reforms which are at risk. Please rank these issues according to what you believe is most important.

Your efforts have brought us to the brink of history and we hope that you will continue to fight with us to enact health reform for all Americans.

Thank you for all that you've done.
Vivek Murthy MD, MBA

President
Doctors for America

Overview of the Senate Bill
Key Element of the bill:
    •    Cover the uninsured: Expands health insurance coverage to 31 million previously uninsured Americans.

    •    Regulate the insurance industry: Prevent insurers from denying coverage based on pre-existing conditions, dropping individuals who become ill and imposing caps on health care spending. 

    •    Help people afford insurance: Subsidize insurance premiums on a sliding-scale for small businesses and the middle class.

    •    Support primary care: Investments in physician workforce expansion, including new loan forgiveness programs, scholarships and National Health Service Corps funding - for primary care.

    •    Payment reform: Payment reform that rewards value in health care delivery through new pilot programs for the medical home and accountable care organizations. 

    •    Investments in prevention and public health: Establishes fund of $7 billion dedicated to prevention and public health related activities. 

    •    Control Cost: Multiple cost control mechanisms with the potential to reduce national health care spending by $683 billion over a decade.
Reasons to keep fighting:
... to make insurance coverage affordable for all Americans.
... to ensure that enough doctors are there to take care of the newly insured.
... to secure fair pay for the hard work physicians routinely do.
... to create a truly fair insurance market via increased regulation.
... to cultivate innovation and efficiency in health care delivery.

For more information about the Senate bill and how it affects doctors, seniors, children and women – visit the DFA resource center.

--
Doctors for America is a grassroots group of over 16,000 physicians and medical students in all 50 states. Together we are committed to building a health system that works better for us and better for our patients. To contact us please e-mail info@drsforamerica.org

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Dr. Neil Calman, president/founder of the Institute for Family Health, blogs about talking with Downstate medical students

(To read the full post & other invaluable writings of Dr. Calman, visit http://neilcalman.blogspot.com/)

"On a rainy and blustery evening last week, I had the pleasure of speaking to an amazing group of first and second year medical students at Downstate Medical School in Brooklyn... My message was that patients are increasingly demanding primary care as a trusted way of negotiating an otherwise incredibly confusing and fragmented health care system. I stressed that primary care physicians must stay focused on the needs of their patients above all else and that our loyalty and responsibility towards our patients must always remain first and foremost in our minds and actions – unfettered to the maximum extent possible – by advertising and loyalties to our hospitals or peers.

...A tougher question came from a young man in the front of the room who asked how our community health care system could survive financially taking care of the number of uninsured that we currently cared for.

...I stood there proud that our organization – the Institute for Family Health – had been able to accomplish this.

Yet I missed a real opportunity to underscore the fundamental reason we need health reform in this country. People need health insurance. Our country cannot depend solely upon health centers like ours as the safety net for everything patients who are uninsured need for their care. They must have coverage to pay for all the essential health care services they need. Primary care is the front end of an entire health care system which must provide access to people for diagnostic services, treatments, hospitalizations and medicines. With people of color 2 to 3 times more likely to be uninsured in New York City providing insurance for everyone is an absolutely essential step towards eliminating racial and ethnic disparities in health outcomes. And with primary care providers already struggling to create viable practice models in underserved areas, only full insurance coverage of the people who need these providers can sustain these practices and attract new doctors to these areas. 

I am sorry I missed the opportunity to explain more to the students in Brooklyn last week about the failings of our current health care system. But I am not worried that their education will be lacking for very long. Soon the students will begin their clinical rotations in the hospital and there they will no doubt experience, first-hand, the failings of our current system to provide health care for all our people. They will see people suffering the effects of poorly treated chronic diseases – losing their legs and their kidneys to long-standing diabetes. They will see people with cancers that would have been curable if only they had been detected earlier. They will see people with advanced infections that have gone untreated for days or months and now require prolonged hospitalizations. These lessons will hit hard and perhaps some of them will understand and will choose to become the next generation of primary care physicians and the new champions for needed change in our health care system."

(To read the full post & other invaluable writings of Dr. Calman, visit http://neilcalman.blogspot.com/)

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