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  • The Physicians’ Proposal

    By Brandon Sandine
    AMSA Health Policy State and Local Policy Coordinator

    It’s a simple proposal! And amidst the growing financial and human burden that our current healthcare system induces, it’s the most equitable and economically sensible proposal of all. Everybody in, nobody out. This was the idea that two emphatic physicians concluded some 25 years ago would help alleviate the growing health insurance disparity, and the problems that are associated with lack of insurance, in our country.

    Today the ranks of Physicians for a National Health Program (PNHP) are significantly larger than it was 25 years ago. Yet their realization is still the same. Our country desperately needs to improve access to medical care, for all of its residents, by implementing a universal health insurance program. While national healthcare reform has recently occurred, primarily through The Patient Protection and Affordable Care Act (ACA), approximately 30 million Americans will still remain uninsured. As such, it is imperative that the single-payer agenda passes into legislation.

    At the recent PNHP annual convention this was exactly the focu of discussion. Content at the convention introduced new and old members to changes that the ACA will have on their clinical practice, to how would the House of Representatives Bill 676 - single-payer health insurance - function in our country. For me, an aspiring future physician, it was profoundly influential to see primary care physicians, cardiologists and neurosurgeons all in one room agreeing that their career had fell short of their ideological expectations. Yet, they all knew that a national single-payer healthcare model would significantly decrease the problems most often cited, and increase their personal satisfaction in being apart of healthcare in America.

    This year’s convention was a short reprieve from the daily stresses of the classroom. However, I left with newfound empowerment. Past PNHP president Dr. Claudi Fegan led the concluding remarks from the convention with our paradigmatic slogan, “EVERYBODY IN, NOBODY OUT!”

    If you would like to learn more about Physicians for a National Health Program check out this link. For further information on H.R. 676 read this

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  • Is Healthcare a Right Yet?

    By Vanessa Obas
    AMSA Health Policy Committee - National Policy Coordinator

    Beneath the haze of the government shutdown, the Affordable Care Act (ACA) finally began its open enrollment for government-subsidized health insurance, and the implementation of the law has proven as difficult a road as its passage. In recent weeks, low and middle-income individuals and families experienced technical difficulties and outages with the federally-organized website that has hindered many from enrolling in insurance plans. What’s more, many states, like my home state of Florida, have tried their hand at impeding plan enrollment in their opposition to the ACA. For instance, personnel have been trained to help Americans understand the health care law and navigate the marketplaces. However, in Florida, these navigators have been banned from working on the grounds of county health departments, restricting access to the already-limited number of navigators in the state.

    The passage of the ACA demonstrated that the U.S. accepted what many developed countries had recognized long before: health care as a right not a privilege. Yet, the obstacles created by states like Florida, and the shortfalls of the federally-run website, serve as reminders of the still-existing difficulty in achieving healthcare access for all. The success of open enrollment matters to millions of Americans – insured and uninsured. Many will find themselves needing to drop their existing, inadequate health care plans by January and enroll in plans that meet the newly established minimum standards of coverage. And, of course, there are the millions of Americans looking to the marketplace as their opportunity for less-expensive health care coverage. We can only hope the issues with enrollment will be addressed as even more citizens will need coverage during this period of open enrollment.

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  • Government Shutdown

    Katie Ni
    Health Policy Education and Outreach Coordinator

    On October 1st, the debt ceiling crisis and the federal government shutdown took center stage in a showdown between members of Congress. Unable to agree on the budget for the 2013-2014 fiscal year, Congress initially used the Affordable Care Act (ACA) as ransom. Up to the last hours of the fiscal year, the Democrat-dominated Senate repeatedly rejected proposals from the Republican-dominated House that would in any way defund or change the ACA’s funding. Ultimately no agreement was reached culminating in the current shutdown.

    AMSA supports the Affordable Care Act, health care reform that includes comprehensive coverage, and improved access for the uninsured in the United States. We applauded the Supreme Court decision to uphold the law over a year ago and believe that the ACA is officially law. Continuous efforts by the Republican party to derail the ACA are fruitless, and serve only to disrupt the economy and the daily life of Americans. The shutdown has furloughed millions of federal employees, disrupted government operations, and has threatened to damage the recovering economy. Congress’ failure to decide on a budget is harming the very constituency these legislators are employed to serve.

    The government shutdown has other serious consequences for the health of the public. The CDC is has been unable to track the annual flu outbreak, or continue monitoring other disease trends. The FDA has reduced its number of food inspectors, leaving some foods, particularly foreign imports of seafood, uninspected and to be sold to an unsuspecting public. The Consumer Product Safety Commission cannot recall faulty or dangerous products on the market and the NIH has been unable to admit patients on research protocols.

    Congress is currently at a political impasse. While actively creating legislation to address the debt ceiling and end the shutdown, having both parties agree will be the main challenge for our congressional representatives these next few weeks. On Saturday, the House unanimously passed H.R. 3223, providing backpay for furloughed federal employees. Republican crafted H.R. 3273 was introduced to create a committee with a purpose of ending the shutdown with appointed members by the House and Senate. The Debt Reduction and Economic Growth Working Group has the potential to help, but more immediate solutions will be needed to end the shutdown. AMSA believes Congress’s refusal to end the shutdown remains unacceptable, bears no benefit to the parties involved, and should not involve dismantling the Affordable Care Act.

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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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  • Are You Ready? The Health Insurance Marketplace is Coming

    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.

    How should I talk with my patients about this?

    AMSA has put together a white coat card to help you get the necessary facts at your fingertips.

    Download & Print the AMSA White Coat Card for Students.

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  • U.S. Medical Students Willing to Contribute to Health Care for All

    Even after the improvements in coverage due to the Affordable Care Act, over 23 million in the United States will likely remain uninsured, and tens of thousands may die needlessly. A recent survey of U.S. medical students, published in PLoS, published last month, suggests the coming generation of physicians believes in health care for all, and is willing to do their part to achieve this goal. The survey, which included nearly 900 medical students at ten U.S. medical schools, reported that over 86% of medical students agreed or strongly agreed that healthcare should be provided to all regardless of ability to pay. Two thirds (66%) of students indicated they were willing to sacrifice future time and money to provide that care, and nearly three quarters (72%) indicated a preference for a publicly-funded healthcare system.

    In a departure from previous studies that have shown a decline in student empathy over the four years of medical school training, these survey also found that this willingness to sacrifice in order provide care increased with increasing student age and years in medical school, and was also correlated with choosing a primary care career focus.

    There was no consensus about whether "a publicly-funded national health program would solve the United States health care problems," (approximately 1/3 agree, 1/3 neutral, 1/3 disagree), while only 19% supported private health insurance (19% vs 35% neutral, 46% against).

    These results point out an encouraging trend among future students, and the authors suggest a need for increased training in social medicine at medical schools to promote underserved care.

    Read the entire survey here.

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  • One step forward two steps back

    Whitney McFadden
    AMSA National Health Policy Coordinator

    Ran Tao
    AMSA Associate National Health Policy Coordinator

    The pace of progress is slow and incremental undermining of the ACA have begun. The Energy and Commerce Committee passed a piecemeal bill last week (H.R. 1206) to amend an important component of the ACA regulating insurance company profits. 

    The new bill adds another layer of complexity to the medical loss ratio (MLR), a measure created by the ACA to monitor the percentage of premiums spent on medical coverage vs. administrative overhead. Currently the ACA mandates insurance companies to have a MLR of 80%, that is 80 cents of every dollar must be spent on medical claims and improving quality of care. However, the infrastructure of insurance companies is a delicate balance, one that rests on making enough profit to pay administrators and insurance brokers alike.

    The original ACA policy proclaimed insurance broker and agent commission covered by the 20% allocated for administrative costs. It takes no expert to see that this shift in money balance will greatly restructure insurance company administration and force them to look critically at the business model. In the meantime, the house has decided to take on this burden and change the policies initially created to protect the patient. Insurance broker commission will no longer come from the 20% dedicated to administrative costs. This will shift the burden of cost to the other 80%, taking more money away from actual healthcare and putting it back in the pockets of the company itself.

    The question then becomes, how much value does the ACA place on protecting patient premiums for medical care? If the solvency of insurance companies depends on changing this 80/20 balance, then we must either re-evaluate our definition of MLR or the way we are providing health coverage.

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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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