Health Care Reform and Abortion

H.R. 3692 and abortion

What does the Stupak Amendment say?

Abortion Funding:

• No federal funds authorized or appropriated by health reform can be used to pay for abortion
• The public plan can only provide abortion coverage in cases of rape, incest, and when the life of the woman is in danger (similar to the current Medicaid restriction)
• Individuals can purchase either a private insurance plan that covers abortion in the government-run marketplace, the Exchange, or supplementary abortion coverage “abortion rider.”
• The ‘abortion rider’ is not available to anybody who purchases the public plan

Who is most likely to be impacted by the Stupak Amendment?

• Any individual choosing to purchase health insurance through the Exchange will be tied by the Stupak amendment. People eligible to purchase through the Exchange include the following groups:
• Uninsured individuals
• People with individual health plans
• People working for small business (starting in 2013)
• People working for large companies (starting in 2015)

• Medicaid recipients (status quo, abortion is currently restricted for Medicaid recipients under the Hyde Amendment except in cases of rape, incest or danger to the woman’s life).

Other points:

• The Hyde Amendment (above) has to be renewed annually
• The current language in H.R. 3692 codifies into federal law the restrictive abortion provisions, and they do not require annual approval.

What next?

• The Senate has to vote on its health reform bill, which currently does not have the Stupak amendment language in it.
• Once the Senate bill passes, it joins H.R. 3692 to Conference Committee to be merged into one bill

Want to take action?

Click here to send an e-mail to your Senators and Representatives, urging them to protect the reproductive rights of women:

http://www.capwiz.com/ams/issues/alert/?alertid=14351641&type=CO

The Stupak-Pitts amendment represents an unprecedented erosion of a women's right to choice and a dangerous expansion of the current restrictions on the use of federal funds for abortion with potentially devastating consequences for millions of low- and middle-income women.

This amendment goes further than any previous federal law to restrict access to abortion - and it's up to us to ensure it is removed before the legislation is enacted into law. It would prohibit millions of women from getting coverage for abortion in their health insurance plans, even if they pay for it themselves. This is a stunning blow to a woman’s right to choice in this country.

As physicians and physicians-in-training, we must continue to advocate for reform that will benefit all of our patients and our communities while not hesitating to speak against provisions like the Stupak amendment that will do more harm than good.

We must act now and tell our Senators and Representatives that the language in the House bill will cause women to lose coverage, that language should be changed and should not be included in the Senate bill.

Health Policy and a Pint: September 2009

September Topic: Truths about government run healthcare programs

Reid, TR “Five Myths About Healthcare in the Rest of the World”. Washington Post. 23 Aug 2009.

http://www.washingtonpost.com/wp-dyn/content/article/2009/08/21/AR2009082101778.html

Kerr, DJ and Scott M “British Lessons on Healthcare Reform” New England Journal of Medicaine. 9 Sep 2009.

http://healthcarereform.nejm.org/?p=1702

What really happens in countries that have government administered health care programs? Are these models better or worse than our current system? This month’s articles provide some an overview of how other industrialized countries provide health care to all of their citizens, and how that compares with the U .S. system.

Questions for discussion:

1. Are these models similar to the kind of health care system that you would want to work and live in? Why? What important elements would you like to see in place to meet the needs of your patients and your profession?

2. What are your greatest concerns about how health care is administered in the U.S.? Other countries? What are the most important things that a health care system should address? What are some ways that those concerns could be addressed?

3. Do you think that it’s important, as future physicians, to be well informed about the kinds of health care delivery systems in which you may find yourself working in? Have you heard some of these common myths circulating among your peers? How can you help to dispel these myths?

Want to get involved and take action?

Call your representatives in Congress and tell them what you, as a future physician, feel are the important components of healthcare reform. Enter your voting zip code at http://www.capwiz.com/ams/dbq/officials/ and get their contact information!

Want more information on Health Care Reform? Check out AMSA Health Care Reform website. It includes information on AMSA’s activities related to healthcare Health Care for all All and links to ReformsKool! , A a weekly newsletter digest on Health Care Reform background, buzz words, current issues and much more!

http://www.amsa.org/uhc/hcr.cfm

August Topic: Health Care and American Values

Brett AS. “American Values” – A Smoke Screen in the Debate on Healthcare Reform. N Engl J Med 2009;361:440-441.

http://content.nejm.org/cgi/content/full/361/5/440

In the past couple of months, many arguments have been raised for or against different health reform proposals. As Dr. Brett notes, much of the rhetoric revolves around notions of “American Values” with a number of assumptions about what those values are. In this article, Dr Brett explores some of these assumptions and discusses why they are often misleading and erroneous.

Possible discussion topics:

1. What do you feel are true American Values in relation to healthcare reform? How would you propose to incorporate those into a reformed healthcare system?

2. Dr. Brett says “suppose that ‘freedom to choose’ is indeed the paramount American value relevant to healthcare.” He explores what “choice” might mean in this context. What does it mean to you? What sort of “freedom of choice” do you feel is appropriate in healthcare reform? How can that be achieved?

3. The article describes the desired goal of healthcare reform as being “efficient, cost-effective healthcare.” What does this mean? How can it best be achieved?

4. Do you feel patients should have the freedom to choose whatever tests or treatments they want? If so, how should they be paid for? If not, how should they be rationed?

5. What type of reform do you feel will help support the values you believe should exist in a healthcare system?

What you can do:

Call your representatives in Congress and tell them what you, as a future physician, feel are the important components of healthcare reform. Enter your voting zip code at http://www.capwiz.com/ams/dbq/officials/ and get their contact information!

Want more information on Health Care Reform? Check out ReformsKool! A weekly newsletter on Health Care Reform background, catch phrases, current issues and much more!

Issue 1 Issue 2 Issue 3 Issue 4

HP&P and PNHP

Physicians for a National Health Program (PNHP) has indicated to AMSA that their members would be eager to talk to medical students at Health Policy and a Pint! To contact your local PNHP chapter, find your state on their website. This is a great opportunity to get a single-payer perspective at one of your chapter's HP&P meetings.

Coming next month... What can your chapter do to impact health policy? We'll provide easy, actionable items related to the topic so your members can get involved!

June Topic: McAllen, TX & the Health Care Cost Conundrum

In a recent New Yorker article, Atul Gawande describes McAllen, a small town in Texas, where health spending has spiraled out of control in the past two decades. Gawande characterizes McAllen as a place where the “medical community came to treat patients the way subprime mortgage lenders treated home buyers: as profit centers.” Average per capita spending is more than $15,000 in McAllen, compared to $7500 in nearby El Paso. Much of this discrepancy is attributed to the “culture of medicine” in each of these two cities.

Questions to ponder:

• What role does the “culture of medicine” play in skyrocketing health care costs and should this culture be regulated?
• What responsibility do physicians have to contain health care spending and prevent overutilization of health care services?
• How might accountable care organizations (ACOs) mitigate financial incentives for overutilization and incentivize high quality care without infringing on provider autonomy?

Resources:

Atul Gawande, The Cost Conundrum, New Yorker, June 1, 2009:

http://www.newyorker.com/reporting/2009/06/01/090601fa_fact_gawande

Fisher et al., Foster Accountable Health Care, Health Affairs, 28, no. 2 (2009): w219

http://content.healthaffairs.org/cgi/content/abstract/hlthaff.28.2.w219v1)

Fisher et al., Creating Accountable Care Organizations, Health Affairs, 26, no. 1 (2007): w44-w57

http://content.healthaffairs.org/cgi/content/abstract/26/1/w44