- From the Governor
- Leadership Day 2013
- Member Accomplishments
- ACP Issues High Value Care Recommendations for Management of High Blood Glucose in Hospitalized Patients
- Hold the Date: Indiana Chapter 2013 Meeting
- Items of Interest
From the Governor
This month's edition of the newsletter includes an update about Leadership Day 2013, which was held recently in Washington, D.C. As always I would like to hear back from ACP members about we can be doing to bring new initiatives to the chapter. I can be contacted at email@example.com or (765) 747-4350.
J. Matthew Neal, MD, MBA, FACP
Governor, Indiana Chapter
Leadership Day 2013
ACP Services, Inc. holds an annual advocacy session on Capitol Hill. This event provides an opportunity for ACP and our members to increase our presence in Washington and bring visibility to issues of common concern. Participants receive a comprehensive orientation and briefing on ACP’s top legislative priorities and then have an opportunity to meet with legislators and the staff on Capitol Hill.
This year’s event occurred on May 21-22 and the Indiana delegation included: Matt Neal, MD (Governor); Robert Crook, MD (Indiana Chapter ACP Services President); Jeff Glant, MD (Resident, IU Hospital Ball Memorial Hospital); Brandon Dickey, MD (Treasurer, Indiana Chapter); Christina Doan, DO (Resident, St. Vincent Hospital); Eric Robinson, DO (Resident, St. Vincent Hospital). We met with a total of seven members of Congress or their staff (two Senators, five Representatives).
Efforts that the Indiana delegation focused on included:
1. Eliminate Medicare’s Sustainable Growth Rate (SGR) and transition to better payment systems.
2. Ensure full funding for essential health programs. Congress should consider the trillions in across-the-board sequestration cuts, which do not take into consideration the importance or effectiveness of any particular program or activity, with a fiscally-responsible alternative that addresses the real cost-drivers in health care, as proposed by ACP, with emphasis on outcomes and value-based medical care.
3. Reform and sustain graduate medical education (GME) financing; re-align the program with the state’s workforce needs. Primary care is in short supply in Indiana, and investment in GME will help preserve funding for our future physicians.
ACP Issues High Value Care Recommendations for Management of High Blood Glucose in Hospitalized Patients
The summary of this article can be found here: http://www.acponline.org/pressroom/hvc_high_blood_glucose.htm. The full article can also be accessed on that page and is free until June 30, 2013.
Hold the date for the 2013 Indiana Chapter Meeting!
November 15-16, 2013
The Marten House Hotel & Lilly Conference Center
Items of Interest
Interns May Devote Only 12% Of Their Time To Patients.
In the New York Times (5/30, Chen) “Well” blog, Pauline W. Chen, MD, writes that a “dramatic decrease in time spent with patients compared with previous generations appears to be linked to new constraints young doctors now face, most notably duty hour limits and electronic medical record-keeping.” A study recently published in the Journal of General Internal Medicine found, “for example, that interns now spend almost half their days in front of a computer screen, more than they do with patients, since most documentation must be done electronically.” When the study authors “calculated the amount of time spent face to face with patients, the researchers found that interns were devoting about eight minutes each day to each patient, only about 12 percent of their time.”
“Partisan Gridlock” Preventing Any ACA Alterations.
On its front page Monday, the New York Times (5/27, A1, Weisman, Pear, Subscription Publication) reported on the “partisan gridlock” that is preventing lobbyists and other interested parties from making any alterations to the Affordable Care Act, even ones that could make it better, meaning that “a landmark law that almost everyone agrees has flaws is likely to take effect unchanged.” The article added that as full implementation draws closer, “some businesses say that without changes, it may be their undoing.”
Journalist Jamelle Bouie responds to the New York Times piece in the Washington Post (5/28, Bouie) “Plum Line” blog. He writes, “without the political leeway necessary to make adjustments to the Affordable Care Act, the ride to implementation may be bumpier than expected.” He continues on to surmise that this is likely “the point behind GOP opposition to changing the law.” Bouie concludes, “Rather than pine hopelessly for an end to the Affordable Care Act, Republicans would be better served by reforming the law to suit their substantive priorities on health care”.
Some Insurance Plans Could Be Canceled Under ACA.
The AP (5/30, Alonso-Zaldivar) reports that individuals who purchase their own health insurance may find that their policies are canceled because they “aren’t up to the basic standards of President Barack Obama’s health care law.” The AP describes the discontinuation of plans as one of the “bumps in the road” as the ACA is implemented and notes that it “doesn’t seem to square with one of the president’s best known promises about his health care overhaul: ‘If you like your health care plan, you’ll be able to keep your health care plan.’” However, supporters of the law believe “consumers won’t object once they realize the coverage they will get under the new law is superior to current bare-bones insurance.”
Experts From Across Political Spectrum Weigh In On ACA’s “Complexity.”
On the “Room for Debate” section of the New York Times (5/30, Subscription Publication) Opinion Pages, several notable commentators weigh in on the source, severity, and implications of the Affordable Care Act’s complexity. Asking, “Is Obamacare Too Complicated to Succeed?” the introduction to the debate notes that, on the other hand, the law’s problems could be due to its “its opponents creating obstacles and preventing changes that would allow it to work?”
First, in a piece titled, It’s Complicated, But Far Better Than Nothing (5/30, Subscription Publication), Kevin Pho, a primary care doctor and MedPage Today blogger, explains the law’s complexity by noting that “to pass, it had to be contorted to satisfy a number of special interest groups.” Still, he concludes, “Despite Obamacare’s complexity and the rocky implementation expected, its very existence is a success.”
Next, in a piece titled The Only Real Problem Is Political (5/30, Subscription Publication), Dean Baker, economist and co-director of the Center for Economic and Policy Research, acknowledges the law’s complexity, but ultimately blames Republicans for trying to do “everything possible to make the situation worse.” He concludes that “there will be many who want to celebrate the glitches as implementation proceeds, but serious people will be focused on making the law better so we can effectively provide care at the lowest possible cost.”
J.D. Kleinke, a medical economist, author and entrepreneur, in a piece titled Fighting Obamacare, but Just to Fight Obama (5/30, Subscription Publication), echoes this point, noting that “howling over every hiccup in implementation is the last chance opponents have to undermine the law.” He concludes, “Rooting against Obamacare is rooting against its namesake’s legacy.”
Anthony Wright, executive director of Health Access California, in a piece titled It’s Working In California (5/30, Subscription Publication), blames not the ACA’s complexity but the entire health system’s. He then uses his state’s health insurance exchange Covered California, set up under the law, as an example of “a huge step toward a simpler and more straightforward system.”
Jonathan Oberlander, professor of social medicine and health policy and management at the University of North Carolina-Chapel Hill, writes in Hurdles That Past Programs Did Not Face (5/30, Subscription Publication), that the ACA faces several problems Medicare never had to, most of these stemming from “partisan intransigence.” Still, he writes, complexity “does not...mean failure,” and if implementation succeeds, “the Obamacare model can work.”
Donald Susswein, former tax counsel to the Senate Finance Committee, writes in a piece called Some Gaps Are Deliberate, Not Flaws (5/30, Subscription Publication), that the law’s “Achilles’ Heel” is that both the individual and employer mandate penalties are too low, meaning many will opt out of coverage, paying the fines instead.
To this point, Deborah Chollet, senior fellow at Mathematica Policy Research, writes in a piece titled One Complication That Could Create Problems (5/30, Subscription Publication) that “some large employers will self-insure, which often would push the least healthy employees into the insurance exchanges.” This could in turn raise the prices on the exchanges.
Michael F. Cannon, the director of health policy studies at the Cato Institute, argues in a piece called The Obstacle Is That Americans Don’t Want It (5/30, Subscription Publication) that, while it is entirely complex, the “main reason Obamacare is encountering obstacles is simple: the American people do not want it.” He continues, “The law will not be undone by its complexity; it will be undone by the democratic process and the will of the people.”
David Himmelstein and Steffie Woolhandler, professors at the City University School of Public Health at Hunter College and visiting professors at Harvard Medical School, argue in A Simpler, Better Solution (5/30, Subscription Publication) that the “obvious solution” to the complex Affordable Care Act is a single-payer system. In the mean time, the ACA is “a giant workaround, wasting time and money and ruining lives.”
Communities look beyond Healthcare Providers in Their Efforts to Stay Healthy.
About four years ago, Nick Macchione had an idea to expand the ACO concept in a way that would involve a much broader range of stakeholders working together to improve the health of an entire region. (View article from MODERN HEALTHCARE)
Tavenner Confirmed as CMS Administrator.
Marilyn Tavenner was easily confirmed Wednesday as the first permanent CMS administrator since 2006. (View article from MODERN HEALTHCARE)
Indiana Chapter Governor:
J. Matthew Neal, MD, MBA, CPE, FACP, FACE
(765) 747-4350; Fax (765) 751-1451
4319 West Clara Lane, PMB #288
Muncie, Indiana 47304