Sensible steps toward a better health care system

Looking into our future, the DMU Legislative Committee is looking forward to the implementation of the Affordable Care Act (ACA). Although there is some uncertainty of what our future practices will look like with the new changes in place, we believe that change was due and will benefit our patients and future practices.

According to the American Public Health Association, this year ACA is providing $750 million to reduce tobacco use, improve nutrition, strengthen state and local health departments and increase the availability and use of immunizations to prevent some leading causes of death. Some of the funds are already being used in Iowa. One example is the Community Transformation Grant program, in which Iowa is expanding access to blood pressure and tobacco use screenings at dental practices to more than 300,000 patients, increasing referrals to the state’s tobacco quit line service and targeting a population with one of the highest stroke mortality rates.

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Health care reform’s shift from a focus on disease centered health care to holistic, preventive care parallels the focus of osteopathic medicine.

In instances like these, the ACA is starting to shift our nation’s focus from a disease-centered health care system to a greater emphasis on health and wellbeing. For us as osteopathic medical students, a great deal of our training emphasizes a holistic approach and prevention when treating patients. Prevention is a central focus when delivering quality care, no matter the specialty.

We also are excited about the ACA’s initial steps in moving forward to reduce the burden of student loans, as many of us are taking out large loans to pay for our education. According to the Association of American Medical Colleges, the ACA will allow medical residents to cap their monthly repayments based on income and offers a new public service loan forgiveness program. We feel steps like these are pertinent to the future of medical practice and prevention. When deciding what medical specialty to go into, we also must weigh how much debt we have accrued and how feasible it will be to pay it off given our income. Concerns such as these have traditionally deterred students from going into specialties such as preventive care.

We still have concerns for our future practice and patients that we would like to be addressed. Two of the most immediate concerns are the current sequestration and reduction of funding to Medicare due to the failure of Congress’ Joint Select Committee on Deficit Reduction, the so-called “super committee.” Not only will these cuts greatly affect our patients who currently rely on Medicare, but they will also greatly affect funding of graduate medical education. These cuts will directly impact residency spots for all medical students, current and future. Given the physician shortage that is expected only to increase, we hope that both Congress and the Senate can put medical school education at the forefront when they discuss health care reform.

During the “Healthy Discussion” sessions recently held on campus, our committee and DMU students spoke with our legislators on the importance of including medical school education when discussing health care reform. It was eye-opening for us students to see each representative’s willingness to become more informed about these issues by joining the Congressional Academic Medicine Caucus. The bipartisan caucus provides a forum for congressional members to engage in dialogue about the challenges and opportunities that exist with medical school education, exploring policy approaches to ensure adequate supply of quality physicians to best serve the nation’s health care needs.

From experiences like these, we realize as medical students that it is not only possible but also imperative that we make a difference in health care going forward. By taking a moment away from looking down at our books and looking up toward the future, medical students can make a difference by working alongside our legislative and health care policy officials on issues that impact health care for our patients and medical careers. Attending forums such as the Healthy Discussions, making trips to Washington to make sure our voice is heard (on D.O. Day on the Hill, etc.) and writing to our legislators are all consequential actions students can take to directly impact health care.

Des Moines University medical students do care, and we are willing to work not only for our grades but also for change that will impact our futures.

Tara Hughes, Mali Schneiter and Jessica Anne Stewart are members of the DMU College of Osteopathic Medicine Class of 2015 and members of the DMU Student Government Association Legislative Committee.

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