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Introduction to Advocacy
Emergency Medicine Residents AssociationAdvocacy Week 2011
Created by Alison Haddock, EMRA Legislative Advisor
Objectives
•Defining Advocacy
•Healthcare Crises
•Health Care Reform
•Getting Involved
AdvocacAdvocacyy
PoliticsPolitics==
Advocacy
noun.
the act of supporting an idea or cause.
US!
Advocacy = Every Day•Negotiating with consultants•Aligning resources for our patients•Patient education•Public health efforts•Hospital boards and medical staff meetings•Solutions for crowding and boarding•State Laws•Federal Laws•Reimbursement•Regulatory Issues
Advocacy
Physician’s public role: advocacy for and participation in improving the aspects of
communities that affect the health of individuals.
Gruen RL, Pearson SD, Brennan TA. Physician-Citizens – Public Roles and Professional Obligations. JAMA. 291: 94-98. 2004.
We are the safety net.
•Average physician = $12,300 in bad debt
•Emergency physicians =
$138,300
How much does the US spend on health care each year?
$2.5 trillion
From 2000 OECD data
Basis for Health Care Reform
•Solutions to our crises▫Coverage▫Cost▫Quality
•Popular support for concept of reform
Patient Protection and Affordable Care Act (ACA): The Past•Kids on parents’ policies until 26yo
•No preexisting conditions for kids
•State-based high-risk pools
•Small business tax-credits
•Covering the Medicare “donut hole”
•No lifetime benefit limits or recissions
•Expanded quality reporting
Patient Protection and Affordable Care Act (ACA): The Future
•“Individual Mandate” in 2014•Preexisting conditions eliminated for all
•2019 Projections▫Cover 60% of the uninsured▫Cost ~4% of health expenditures▫Cut the deficit by <1%
From “What Will Happen Under Health Reform— and What’s Next?” by the Commonwealth Fund, published in May/June 2010 Columbia Journalism Review.
Patient Protection and Affordable Care Act (ACA): The Future•State insurance exchanges
▫For individuals and small businesses▫Premium subsidies▫Regulated benefits
•Cost offsets▫Cutting Medicare Advantage▫Decreased Medicare provider payments▫Taxes (tanning salons, high-income
Medicare beneficiaries, penalties)
Emergency Medicine and the ACA
•Essential Health Benefits Package
•Prudent Layperson
•EM Research
•Regionalization
(Un)Sustainable Growth Rate
-29.5%• Medicare’s flawed
formula for physician reimbursement
• Patched 5 times in 2010
• Now stable until… January 1st, 2012
SGR Solutions?
•Too expensive to fix!
•More than $369.8 billion
And there’s more!
•Access to care
•Overcrowding and boarding
•Workforce shortages
•On-call coverage
•Accountable Care Organizations (ACOs)
•The IPAB
Get Involved!
EMRA• 36 years representing
residents▫9,000+ members▫33% of ACEP
• Health Policy Committee
• EMRA-ACEP Health Policy Mini-Fellowship
ACEP• 9-1-1 Legislative
Network• Leadership and
Advocacy Conference• Ongoing advocacy
efforts from the Washington DC Office
• ACEP Committees▫ Federal Governmental
Affairs▫ State Legislative and
Regulatory▫ Medical-Legal
NEMPAC • 2 year election cycle fundraising
• Raised $1,090,166 in 2010
Physician PAC Rankings: Orthopedics (2.6M) Anesthesia (2.3M) **AMA (2.0M) Radiologists (1.8M) Emergency Medicine
(1.5M)
• Give-A-Shift!
Get involved!
Give a lecture or journal club on advocacy
Donate some of your time or $$
Speak out!
Take-Home Points
•Advocacy is a core competency…▫Bring it home to your fellow residents!
•The healthcare reform process has only just begun…
•And we need YOU to reachour goals!!!
Thank you!