policy

What the Government Shutdown Means to You

It turns out that as medical students, the amount of time we sacrifice to the gods that are basic sciences and clinical rotations is so great that the world of current events can pass us by. But one event that I can’t in good conscience let you ignore is the government shutdown. It’s easy to turn your textbooks into an impenetrable Fort Kickass, but the implications of this quandary reach even into the hallowed halls we construct to insulate ourselves from the outside world. First, a little background. Our country every year must pass a budget that guides our spending. Realistically, it’s like giving an 18-month-old a paint-by-numbers and expecting a masterpiece, but it gives us a place to start. A federal budget is typically proposed by the President and then Congress takes this recommendation, passes a law, and then sends a final version back to the White House for approval. And then unicorns go dancing across the rainbows of Bubblegum Canyon. Since 1997, shockingly, this happy little agreement has failed to materialize. Because of the Antideficiency Act, in the absence of a budget, all government activities must stop (turns out it’s illegal to spend government money without it being allocated, who knew?).  To avoid this, Congress relies on the well-loved stop-gap approach, in this iteration known as a “Continuing Resolution,” that provides structure for the funds and allows...

5 Easy Steps for YOU to Save Thousands of Residencies

On March 14th, representatives Schock (R-IL) and Schwartz (D-PA) introduced bipartisan legislation that aims to create 15,000 much-needed residency training positions and takes a critical look at the residency cap that has existed since the 1997 Balanced Budget Act. I happened to be in Washington D.C. for DO Day on the Hill when Congresswoman Schwartz introduced the bill, and she came to our morning debriefing to address hundreds of osteopathic medical students and physicians for our national lobbying day. She explained how the number of Medicare-funded residency slots producing licensed physicians has been capped since 1997, yet the US population has steadily grown each year (estimated to be an over 40 million increase in individuals from 1997-2013).  Additionally, with the addition of 30 million individuals added to the insurance pool by 2014 due to the Affordable Care Act, an already stretched-thin healthcare system will be faced with an ever-increasing patient load with limited resources and manpower.  Bottom-line: healthcare insurance coverage is meaningless if there aren’t enough providers to provide the actual care. The bill, The Training Tomorrow’s Doctors Today Act (H.R. 1201), currently has 10 co-sponsors and is being referred to the House Energy and Commerce and House Ways and Means committees. After doing a little digging around, I’ve found a fairly simple way to find out more about the bill and how to support it. Support the “Training Tomorrow’s Doctors Today Act” in 5 Steps   1) Read up...

Your Future, Our Fight: #SaveGME

Is it worth it? If you’re a med student, at some point between daily reading, studying for the next test, preparing for Boards, or relearning the pertinent physical findings for a Shelf, you have asked yourself this question. Well, have I got an answer for you.  It turns out that there’s a chance that after four years of medical school, X number of “years of opportunity” before that, college, and whenever you first heard the calling, you might not even have a residency…So relax! Now before you faint, a little background.  Part of Medicare’s mission, as established in 1965, is to help fund Graduate Medical Education (GME) costs.  This support comes in two flavors: Direct GME and Indirect GME.  The Direct program uses $3.5 billion each year to pay residents, compensate physician teachers, etc.  The Indirect program pays $6 billion to hospitals to offset the higher costs associated with being a teaching institution.  That’s a grand total of roughly $9 billion every year.  Still with me? Along comes the (recent) present and, amidst a confluence of politics including a desire to not look like that classmate who’ll always “get you next time”, the Budget Control Act established automatic 2% cuts across the board for every government program.  Medicare, and by extension, GME, is one of these programs. In addition to this, President Obama’s 2014 budget plans to cut $11...

I Would Suck at Being Poor and So Would You

I was thinking today how bad I would be at being poor. I’m great at being broke. I handle broke like a champion. But broke isn’t poor. Broke is temporary with better things as a possibility. Poor is generally permanent; at the very least it feels that way. Poor has no clear way out. You can’t just hang in there until things get better because probably they won’t. Being poor wouldn’t make me smarter or a better person than I am now. It would give me a different skill set, yes, but less formal education. So if I were poor, I’d most likely make all the same dumb mistakes I make now but there would be much higher stakes. Every bad choice would drive me deeper into a hole instead of merely keeping my retirement account from growing properly. I’d buy my kids toys when they opened their eyes all big and asked nicely, even when they don’t need them. Even if I knew the toys were junk and going to break soon. I’d pay extra for the backpack that will help make my son fit in at school instead of the practical one. I’d probably even get myself the occasional treat I didn’t need. And I would hate being poor. I wouldn’t be poor but happy. I’d be poor and miserable. I’d know there were better things out...

The Drug That Makes You Smarter, Or Does it?

Adderall was first created to treat impulsiveness and improve focus in people with ADHD and ADD. It has since then been used to treat several disorders, such as narcolepsy. But what are the ramifications of the drug and has its use becoming uncontrollable in our society? Source:...

Mental Health in the Poverty Stricken Population

I’ve been hanging out at the wrong Starbucks, apparently. Last weekend, I was having a nice Saturday morning coffee with a fine gentleman outside of a New York City Starbucks, enjoying the beautiful weather and the lovely conversation. All of a sudden I hear a large “BANG” behind me and I see a look of udder shock on said gentleman’s face. “That man just punched the wall [the outside wall, mind you. aka, the brick facade of the building.] right behind your head!” Fast forward a few days and I’m sitting at the very same Starbucks with a fine young lady, both of us pouring over our medical school applications. I am sitting with my back to the glass window behind me. All of a sudden I see a look of bewilderment on my friend’s face. “A homeless man was just walking by, made eye contact with me, and literally hacked a loogie and spit it at me into the window.” Have I been hanging out at the wrong Starbucks? Or is there something bigger going on here? A few days after the first incident I talked to the same fine gentleman, a doctor himself. He had one sentence that I think explains all of these situations that I’m sure I am not the first to experience: “The poor are not getting the mental health care they need and deserve.” And...

How Accountable Care Will Change America

David Sayen, the regional manager for the Centers for Medicare and Medicaid Services, discusses the shift in health insurance programs from fee-for-service to an accountable care model. Reimbursement will be based on results, as opposed to type or quantity of procedures. He explains that the relationship between health care providers and programs, like Medicare and Medicaid, will change as the United States moves closer to healthcare reform. Filmed at FutureMed, in February, 2012, at Singularity...