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  • Video goes viral: U.S. Senate Hearing on Single-Payer System

    The U.S. Senate’s subcommittee on primary health and aging held a hearing with the theme, “What can the U.S. learn about health care from other countries?” Convened by Vermont Senator Bernie Sanders, the hearing featured discussions of health care systems in Canada, Taiwan, Denmark and France. 

    Perhaps the most memorable portion of the hearing was the debate over a single payer system, in which Canadian physician Dr. Danielle Martin faced off against North Carolina Senator Richard Burr. Dr. Martin fields Senator Burr’s questions admirably, and debunks many misconceptions about Canada’s single-payer system that Burr brings up.

    A video of the debate was uploaded onto YouTube by Senator Bernie Sanders, and has since been spread across media sites with the headlines praising Dr. Martin for “schooling”, “smacking down”, and “dropping some serious knowledge on” the Republican senator. Hopefully, the flood of media attention on this single-payer debate will ultimately help persuade Americans to support a single-payer system in the US. In her final response, Dr. Martin makes an important and perhaps disturbing observation about the current U.S. healthcare system:

    North Carolina Senator Burr: On average, how many Canadian patients on a waiting list die each year? Do you know?
    Dr. Martin: I don’t, sir, but I know that there are 45,000 in America who die waiting because they don’t have insurance at all.

    Watch the entire video here:

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  • ACA Coverage and the New Year



    Whitney McFadden
    AMSA Health Policy Chair

    As medical students, what should we expect for our healthcare system this year?

    The Department of Health and Human Services is closely tracking the number of people signing up for health insurance. This year’s resolution will be to follow how Obamacare is improving the health of our nation. First, 2.1 million Americans have signed up for private insurance in the exchanges and a new 3.9 million were found to be able to access coverage through medicaid. We do not know how many people had to change their current insurance, and how this coverage will affect doctor patient visits. In the end, we want to understand how these changes improve the health of our nation.

    How we prioritize and evaluate the measure of our national health will be a significant issue this year. Obamacare is covering more individuals and in order to measure its success, many are searching for ways to see the impact on healthcare. The National Bureau of Economic Research studied the Oregon Health Insurance Experiment published in 2011 to investigate how health insurance improves health care and outcomes. The study measured health care utilization, out-of-pocket medical expenditures, medical debt, and self-reported physical and mental health in randomly chosen low-income participants who qualified for coverage. The study found that those with coverage had statistically significant changes in their health. Participants were likely to have more healthcare utilization (hospitalizations, outpatient visits, prescription medications), less expenses, and better self-reported health. It seems these will be a few of the outcomes to follow after the ACA is in full swing.

    Listed are some of the noteworthy changes for the 2014 year:
    1. Insurance coverage will not be withheld for individuals with pre-existing conditions or premiums elevated based on age or gender.
    2. Insurance companies must share pricing and benefit information with consumers in a comparative way. 
    3. Private exchanges might be used more in the workplace.
    4. Employer mandate set for 2015 will give small companies time to prepare for covering their employees. 
    5. Price transparency. 
    6. Likely more regulations imparted by HHS.
    7. Insurance companies will begin to limit the number of healthcare providers they cover based better rates. 
    8. States will have the most impact on local price structure (i.e. Medicaid expansion). 
    We will likely see some great improvements in care as individuals access more preventive services, get connected with primary care physicians, and pay less for healthcare. However, some changes remain to be seen. Emergency room visits are not likely to drop off if we use the OHSE as a model, and some insurance plans have already increase their premiums to existing customers covering lost costs for sicker people. Following the progress of our healthcare system over the next few years will be essential to improving our health as a nation. As medical students we can help patients be aware of these changes and the effects on our overall healthcare.

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  • Mental Health Parity Act: Re-visted and Re-vamped



    By Whitney McFadden
    AMSA Health Policy Chair

    The Mental Health Parity Act and Addiction Act originally signed in 1996 and expanded by George W Bush in 2008 was established to create equity in health insurance coverage of mental health benefits. The law increased access to care, however many gaps in coverage remained and the laws were not enforced. The law established equal coverage so that co-pays could not be higher for mental health care, there were no differences in the number of visits covered, and the coverage was expanded to substance abuse treatment.

    The preliminary ruling for mental health parity was established in 2010, however over 5,000 comments had to be addressed before the regulations could be put into effect. This process occurred during the introduction of the ACA and requirements for the bill were put on the back burner while the comments were addressed. Some new requirements addressed intermediate care coverage of patients who do not require hospitalization, but cannot be treated as an outpatient. Additionally, the limits on location of care were removed making insurance companies liable for payment if care was found outside the state.

    The Mental Health Parity Act is not predicted to increase health insurance costs and if implemented correctly, will provide more affordable care when patients seek mental health services earlier. This is thought to result in better outcomes, less time in the hospital, and less time lost in the workplace.

    These changes in coverage come at a time when the ACA is transforming the environment for insurance companies. These changes echo the already expanding market for coverage regardless of pre-existing conditions. This “incredibly important law, combined with the affordable care act, will expand and protect behavioral health benefits for more than 62 million Americans” says Kathleen Sebelius, U.S. Health and Human Services Secretary. The new regulations will mirror plans already in place in the ACA and emphasize the importance of comprehensive mental healthcare on our nation’s psyche.

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  • Historic Day!! #GetCovered

    Today is a historic day! People can now enroll in health care coverage in the Affordable Care Act insurance exchanges! Coverage will begin on January 1, 2014 but you must sign up by December 15th. 

    No doubt you’ve been starting to hear about the new Health Insurance Marketplace, a key part of the health care law, the Affordable Care Act (ACA). The ACA will expand coverage to millions of uninsured people through health insurance marketplaces that will be open for business on October 1st. But you probably still have questions. Like what is the Marketplace, and can you and your patients really get health insurance? Your patients will have questions too. And we’ve got answers for you and your patients.

    What is the Marketplace and where do I find it?

    Starting this fall, Health Insurance Marketplaces will help eligible patients buy new health insurance plans that fit their needs and their budgets. The Marketplace is kind of a one-stop shop for consumers to research, compare, and buy different plans. The marketplaces are not private insurance companies or government-run health plans. The Marketplace will be open from October 1, 2013 through March 31, 2014. If you sign up by December 15, 2013 you will have coverage starting January 1, 2014.

    Marketplaces are state-by-state, so find yours here.

    Have more questions? Find more information here

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  • Planned Parenthood Says New Regulations Ensure Women Can Get Birth Control at No Cost

    Planned Parenthood Federation of America today said that the revised accommodation to the Affordable Care Act’s birth control benefit will ensure that women can access no co-pay birth control as part of basic health care. Following is a statement issued by Cecile Richards, President of Planned Parenthood Federation of America:

    “This policy delivers on the promise of women having access to birth control without co-pays no matter where they work. Of course, we are reviewing the technical aspects of this proposal, but the principle is clear and consistent. This policy makes it clear that your boss does not get to decide whether you can have birth control.

    “Birth control is a basic and essential component of women’s preventive health care. Women have been fighting for access to birth control for decades, and this is a historic advance for both health care and equality. As one of the nation’s leading providers of reproductive health care, Planned Parenthood has led the charge for access to contraception for nearly a century, and we will continue to work tirelessly to ensure that women have access to birth control without hurdles or co-pays.”

    For more information, click here

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  • Today's Supreme Court Ruling

    Elizabeth Wiley, MD, JD, MPH
    AMSA National President


    What an historic day this is. For years to come we will remember this day as the first step toward achieving quality, affordable health care for all. As you know, the Supreme Court of the United States issued its decision on the Patient Protection & Affordable Care Act (also known as the “Affordable Care Act” or “ACA”). Today’s landmark decision will shape the environment in which we will practice medicine and determine how our patients receive care.

     

    The Supreme Court held that the Affordable Care Act is constitutional, and this ruling will bring health care access to millions of Americans. At the same time, the Court ruled that states may opt out of the expansion of Medicaid. This decision is deeply concerning. If fully implemented, Medicaid expansion would provide coverage to 16 million more Americans by expanding eligibility to individuals up to 133 percent of the federal poverty level, whether they are unemployed or among the so-called working poor. Clearly, as future physicians, we must continue to champion this issue and encourage states to opt in to Medicaid expansion.

    In the wake of this historic decision, I would like to encourage you to MAKE YOUR VOICE HEARD on health care reform by submitting a letter to the editor of your local or campus paper. To make this easy, we have drafted some sample language that you may use, but please tailor this letter to express your perspective on health care reform.

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  • SCOTUS: Day 2

    Check out C-SPAN's coverage of the Supreme Court Hearings.

    http://www.c-span.org/flvPop.aspx?src=cspan1&msg=You+are+watching+the+C-SPAN+Networks&start=1.835&end=-1 

    Today, the Court will hear testimony regarding the individual mandate portion of the law, which requires virtually all Americans to obtain health insurance or pay a fine. The law goes into effect on January 1, 2014. The Court will consider whether the individual mandate is in fact constitutional.

    What do you think? Does Congress have the power to enact a law requiring everyone in the United States to buy health insurance?

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  • Supreme Court Hears ACA Arguments

    The Supreme Court is in the midst of hearing oral arguments to determine whether Congress can require Americans to purchase health insurance or pay a penalty. AMSA leaders went to the Supreme Court today to support comprehensive health care reform that works for patients and physicians: expanding coverage, lowering costs and upholding quality.

    Monday’s testimony focused on whether the court has jurisdiction in the case or if they must wait until the law is enacted in 2014. Tuesday's hearing will focus on the individual mandate, which requires that all Americans purchase health insurance, either through their employers or under individual plans, or pay a penalty. Wednesday’s hearing will focus on whether the law can stand if the individual mandate is eliminated. Wednesday will also include arguments over the expansion of Medicaid to subsidize an estimated 17 million more lower income Americans.

    Read more at MedPage Today: http://www.medpagetoday.com/Washington-Watch/Reform/31853

    Pictured below: AMSA President-Elect Elizabeth Wiley, Health Policy Chair Kristin Huntoon and Education and Advocacy Fellow Colin McCluney.

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  • Don't Let the Supercommittee Cut Residency Positions!

    As you have probably heard, the Congressional "Supercommittee," or the Joint Select Committee on Deficit Reduction, is scheduled to announce its recommendations to cut $1.5 trillion in federal spending over the next ten years on Wednesday, Nov. 23. The Supercommittee was created by the Budget Control Act of 2011 back in August to avert the debt ceiling crisis. Congress is scheduled to vote on these recommendations by Dec. 23. If Congress fails to adopt Supercommittee recommendations, there will be an automatic sequestration, or across-the-board cuts.

    The Supercommittee is rumored to be contemplating substantial (up to 60%) cuts to Medicare Graduate Medical Education (GME) funding which supports vast majority of residency programs in the U.S. As a result, it is critical that we, as physicians-in-training, make our voices heard on this issue. Please take a few seconds to email your members of Congress and urge them to protect Medicare GME:

    The American Medical Student Association strongly supports continued Medicare GME funding and condemns any effort to cut this funding. Massive cuts to Medicare GME will compromise patient access to care and, in some cases, may result in the closure of some residency programs. As the United States seeks to insure millions of previously uninsured Americans, it is critical that the federal government continue to invest in a robust health professional workforce to meet our nation's health care needs. Sustained GME funding is an essential element of this investment.  



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  • The State of Massachusetts

    AMSA members recently attended an event cosponsored by AMSA, CIR, Doctors for America and the Massachusetts Chapter of the ACP.

    Featured speakers included:

    Nancy Wagman of the Massachusetts Budget and Policy Center, who gave an overview of the Massachusetts budget, perception vs. reality on how Massachusetts compares to other states on taxes, and the hard, practical choices for the state budget caused by a historic drop in revenue relating to the economic recession.

    Suzanne Curry of Health Care for All talked about the impetus for implementation of national health reform at the state level, and how the combination of these factors were guiding Massachusetts’ choices in regards to Commonwealth Care, MassHealth and other safety net programs.

    Brian Rosman of Health Care for All explained how Massachusetts successful coverage expansion through their health care reform now made tackling the out of control costs and inequities of the delivery system more imperative. He gave an overview of the Governor’s proposed bill on payment reform.

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