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  • How we pay for medical care in 2014: Paying for quality and efficiency



    Whitney McFadden
    AMSA Health Policy Chair


    Bodenheimer and Grumbach outlined in their book, Understanding Health Policy: A Clinical Approach, a view of health policy and the faults of our current healthcare system. It seems we are very familiar with the pitfalls of our current system. In order to be clear and not dwell too much on the obvious, our system struggles with overuse and underinsurance/lack of insurance that is being addressed with the Affordable Care Act. Today we pay for healthcare out-of-pocket, with individual private insurance, employment based private insurance, or government financing. Insurance plans for healthcare began in the depression due to unstable payments. Medicare was established to cover the elderly and lower income individuals. Currently physicians are paid in a multi-tier system including fee-for-service, episode illness grouping, capitation (per head fee to general practitioner and specialist), and salary.
     
    2014 will be a year of new payment methods for healthcare. The sustainable growth rate (SGR) has historically be underfunded requiring congressional intervention to avoid the reduction in payment to medical reimbursement that would make it unsustainable. This year, a bipartisan fix will change payments to value based on measure of better quality and efficiency instead of the ...

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  • Building a movement for universal health care in Illinois

    By Kathy Wollner, Rush Medical College
    and Zach Bay, Northwestern Feinberg School of Medicine
    Standard responses you get when you ask a medical student to participate in health policy advocacy:

    “The system is too complicated to try to change it.”
    “There’s nothing I can do to make the system better.”
    “I support change but I don’t think we can actually make a difference."
    “I support this but I am too busy.”

    These are the statements we hear time and again and even tell ourselves on occasion. Being both a medical student and a single-payer advocate is certainly not for the easily discouraged. In spite of these challenges, this month in Illinois twenty medical students teamed up to speak out against our inefficient, extremely expensive health care system that doesn’t even begin to take care of everyone. 

    On April 11, AMSA members from Northwestern, Rush, and Rosalind Franklin joined with colleagues from the Illinois Single Payer Coalition in support of the Illinois Universal Health Care Act (HB 311). Over the course of the day, we spoke with or distributed literature to every Representative and Senator in the state legislature. Though diverse in age, culture, race, gender and religion, we were unified ...

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  • In Support of Single Payer Legislation: Illinois

    Zach Bay and Andeonke Bambgose
    Northwestern University Feinberg School of Medicine

    We need universal health care in this country and as the recent reform process has taught us, it is not likely to happen nationally without a successful state-based example. While Vermont is well on it is way to passing legislation to create a single-payer system, in Illinois we are working to rally support for the Illinois Universal Health Care Act (HR 311).

    Health care should be treated as a human right and not a commodity. Not only is single-payer the right thing to do, it is also the most cost-effective way to cover everyone, according to the recent Harvard study for the Vermont Legislature.

    Over the past few weeks, while recruiting students to take part in our upcoming lobby day, we’ve had many conversations about why this is something we should fight for. For us, the primary answer is that it is absurd that the system treats health care as a commodity. Unlike other commodities, you can die if you don’t have adequate health care. As many as 44,789 deaths per year in the United States are associated with lack of health insurance, more than the number of ...

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  • In Support of Single Payer Legislation: Vermont

    Elizabeth Wiley, JD, MPH
    AMSA Vice President of Internal Affairs
    Last weekend, hundreds of health professions students from across the country gathered at the Vermont State House in Montpelier to rally in support of Vermont single payer legislation. The legislation, passed by the Vermont House last week and developed based on the work done by Dr. William Hsiao, would make the Green Mountain state the first in the nation to adopt single payer health care reform. In the crowd were many AMSA members and leaders.

    “Vermont could be the health care shot heard around the world.”
    --Vermont Gov. Peter Shumlin


    The rally began with Sen. Bernie Sanders (D-VT) offering inspiring words of encouragement to a standing room only crowd. Gov. Peter Shumlin then spoke to the potential for single payer passage. Several student leaders then took the stage to offer insight on why we support universal health care.

    As a medical student, it was heartening to see such an incredible number of schools represented – more than 120 institutions -- standing in solidarity with the citizens of Vermont in their effort to make history. From the University of Vermont School of Medicine to Harvard Medical School to University of ...

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