In the 2012 legislative session, AMSNY advocated at the federal level in support of:
- National Institutes of Health (NIH)
- Graduate Medical Education (GME)
- Title VII Health Professions Programs
- Medicare Residency Slots
- Medical Malpractice Reform
National Institutes of Health (NIH)
As the primary federal agency responsible for conducting and supporting medical research, NIH provides the foundation that drives scientific innovation. NIH has been critical to improving the nation’s health by funding research that improves treatments, develops cures, and provides a better understanding of the diseases that affect our population. NIH alone now accounts for two-thirds of all federal support for research and development in colleges and universities. Much of what has been accomplished in the past half century to improve health can be directly or indirectly attributed to the bipartisan investment in NIH. Over the last 15 years, cancer rates have fallen 11.4 percent among women and 19.2 percent among men, saving more than 650,000 lives. In addition, NIH-supported research has led to dramatic reductions in deaths from coronary heart diseases and stroke through the development of minimally invasive techniques to prevent heart attacks and through highly effective drugs that lower cholesterol, control high blood pressure, and break up artery-clogging blood clots. Funding for biomedical research is necessary to advance science that will ultimately develop treatments and cures for chronic diseases and conditions.
Graduate Medical Education (GME)
Providers are already absorbing $155 billion in reductions as part of the Affordable Care Act (ACA) and any further cuts would only result in a more handicapped health care system. In recent months, a number of proposals aimed at reducing the federal deficit and modifying entitlements have been offered and may be under consideration as Congress and the Administration work to address the federal deficit and reach an agreement on a budget for FY 2013. Provisions that would reduce GME funding have been part of several proposals and are of great concern to New York’s medical schools and teaching hospitals. It is vital that teaching hospitals receive the support necessary to maintain training programs and to protect residency slots, allowing medical schools to preserve or increase class sizes and grow the physician workforce.
Title VII Health Professions Training Programs
As the nation’s health care system undergoes rapid and dramatic changes, and as approximately 32 million more people will be eligible for health insurance, an appropriate supply and distribution of a diverse health care workforce has never been more essential to the public’s health. The health professions programs, authorized under Title VII of the Public Health Service act, are critical components of the nation’s healthcare safety net. Title VII grants support students who otherwise would not be able to afford a medical or other health professions education. Funding for Title VII programs in the Labor, Health and Human Services, and Education Appropriations Bill, must be restored. AMSNY strongly supports funding of the Title VII health professions training programs at $280 million in the FY 2013 budget.
Medicare Residency Slots
The 1997 Balanced Budget Act capped the number of residents for which hospitals could claim Medicare payment based on the residents employed at each hospital in 1996. The cap has remained at the 1996 level, even though the United States population has increased by 17 percent since then. With the new health reform legislation, it is estimated that an additional 32 million Americans will have health insurance and will be eligible for medical care. This will add pressure to an already overburdened physician workforce. As such, many medical schools are increasing their class sizes and several new schools are opening. These additional students will need to be placed in residency positions to complete their training, creating the need for more Medicare residency slots to accommodate the increasing number of students graduating from medical school. The Path Act legislation would phase in an additional 1,000 Medicare-supported graduate medical education (GME) training positions in each of the three successive cost reporting years.
Medical Malpractice Reform
H.R. 5, the Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2011, reported out of the Energy and Commerce Committee, is one step towards addressing rising malpractice costs, but other reform measures that will lower costs, increase access, and improve patient safety must also be considered. An out of control tort system and unaffordable insurance are affecting access to care as physicians leave states with high insurance costs or stop providing services that expose them to higher risks of lawsuits. Particular areas of concern include obstetrics, neurosurgery, and emergency medicine. In addition to the rising costs of insurance, physicians practice “defensive medicine” by providing additional care that serves only as liability protection in the event of a lawsuit. Estimates place the national costs of defensive medicine at between $50 billion and $100 billion per year. If real and comprehensive medical malpractice reform is implemented, it could save the NYS academic medical centers millions of dollars annually, as well as save New York State as much as $305 million annually.