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Progress Notes features doctors and medical students across the country on the frontlines of our health care system. Our views and experiences are diverse, but we share common goals and values. We speak up to move toward a future where everyone can have access to affordable, high-quality health care. Please share our posts, and follow us on Facebook and Twitter!


It's Giving Tuesday


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Dear Robert,

I am thrilled to join Doctors for America at this critical moment for the health of our nation.

As I write to you, the U.S. Senate is attempting to sneak health repeal into their tax cut bill for the wealthy and big corporations. This repeal effort would rip coverage away from 13 million people, raise premiums by double digits and slash spending for Medicaid, Medicare, SNAP, Pell Grants, housing, transportation and virtually every other service that low-income families, the disabled, and seniors depend on. The bill would starve our communities, families, and neighbors, to pay for massive tax giveaways to the one percent. A vote may come as early as this week.
 
If we have learned anything over the last year, it is that having a strong and active physician advocacy organization is essential to our work and can be successful at stopping harmful actions by this Administration and Congress. Together, we have been able to block ACA repeal and stop devastating cuts to Medicare and Medicaid. We have had some big victories in the last year but our work is not over yet. We still need your support to fight this bill which could bring great harm to our patients. 
 
Robert, -- on this Giving Tuesday, will you join Americans across the country in giving back to Doctors for America to help ensure we have the funds we need to fight for patients over politics in every corner of this country? 

Show your support for Doctors for America by donating $100, $250, $500 or $1,000.

 

In solidarity,

Jim Duffett

Executive Director 

 

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Meet DFA's new Executive Director

By Scott Poppen, MD MPA
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It is my great pleasure, combined with considerable excitement, to announce Jim Duffett as Doctors for America's new Executive Director

Jim is a seasoned, career non-profit professional who brings to DFA 30 years of leadership experience in the world of public interest advocacy. He spent more than 25 years at the helm of Illinois Campaign for Better Healthcare (CBHC), Illinois' largest healthcare coalition and one of the top statewide health coalitions in the country, building a reputation as a nationally recognized leader in health justice at both the state and federal level. In 2002 he was named Families USA’s Health Care Advocate of the Year. While at CBHC, Jim worked with then state Senator Barack Obama on Illinois' Health Care Justice Act (Health Care for All). He currently resides in North Carolina where he has worked as a consultant for voting rights efforts and Medicaid expansion. 

Jim is an excellent addition to Doctors for America. Acquiring someone with his leadership skills and experience speaks volumes about the work we have done together over the last nine years to become the nation’s leading grassroots physician advocacy organization.

A message from Jim Duffett: 

"I am ecstatic about joining your team and look forward to connecting with each of you. You are the front line leaders of DFA and for the health care justice movement. I look forward to listening and learning from you and utilizing my 30 years of grassroots organizing experience to strengthen, expand, and broaden our collaborative relationships throughout the U.S. My life has been committed to social justice, specifically health care reform. For over 26 years I lead one of the most successfully diverse statewide coalitions in the country in Illinois. I feel confident in my skills and experiences of collaboration building, developing and implementing issue campaigns, infrastructure development, messaging and framing our issues, policy knowledge, building the needed resources to achieve our goals, and most importantly, working with all of you to make a difference in the lives of your patients. And having fun and empowering individuals.

“I am looking forward to building synergy with you and others in dozens of ways as we continue to commit ourselves to affordable, accessible, comprehensive, and quality healthcare for everyone. In addition, interjecting the much needed public health perspective as it pertains to gun violence, food deserts, and the other issues that DFA has been working on. While the negative forces working to undermine our democracy, inclusiveness, fairness, and equality may at times feel overwhelming; my grandmother always told me that if there is a will - then there is a way. DFA's past, present, and future successes and goals will be achieved together because we know you have the will. Thank you all.

“As we enter our next decade and are witnessing a renewed activism throughout our country, please join with hundreds and hundreds of your fellow medical professionals and renew your membership to DFA or join us and become a first time contributor. Your contribution will be one of your best holiday gifts of 2017. Together we will make a difference. Happy Holidays.”

We are thrilled to have a seasoned professional like Jim at the helm of the organization at such a critical moment in our nation’s health. Together, we will continue to build and grow physician leaders to fight for patients over politics in every corner of this country.

On behalf of the Doctors for America leadership team, sending you a heartfelt thank you for your tireless advocacy. And, wishing you a happy Thanksgiving filled with time to recharge your batteries for the work ahead.

 

Sincerely,

Scott Poppen, MD MPA

Chair

 

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DFA Round Up - November 17, 2017


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TAKE ACTION

  • Tax Bill - Yesterday, the House passed its harmful tax bill. Now, the Senate is aiming to sneak ACA repeal through in its harmful plan to cut taxes for the wealthy and corporations. The Senate plans to vote on this package soon after Thanksgiving. Call your Members of Congress and tell them to OPPOSE any tax package that increases the deficit or that decreases the number of people with health insurance: (202) 224-3121 
  • Open Enrollment - Your outreach around open enrollment is working. Reports indicate that, despite Administrative sabotage, ACA signs ups are surging. Keep spreading the word ahead of the December 15th deadline about the affordable coverage options available at healthcare.gov. Find a tool kit, social media resources and tools to aid your outreach here

MEMBERS IN ACTION

Tell us about what you are up to! Email your updates and photos to DFAHQ@drsforamerica.org.

NATIONAL

In October, DFA board leaders participated in a dozen meetings in Washington, DC with coalition partners that included health advocacy organizations and national physician groups. Pictured below is Chair Dr. Scott Poppen and Board Members Ethan RomeShalini Pammal and Dr. Meghana Rao.

Also happening nationally: 

  • DFA held a membership enrollment call with hundreds of participants and then led the Provider Week of Action in partnership with Young Invincibles, Get America Covered and physician groups. 
  • DFA signed onto a letter urging Congress to fund CHIP and FQHP's which expired September 30th.
  • DFA supported a measure allowing HHS to negotiate Medicare Part D prescription price introduced by Representatives Cummings, Doggett, Welch and Senator Sanders. 

CALIFORNIA

Over 50 medical students at USC led a campaign supporting DACA recipients and urging Congress to act to protect them.

Dr Sonali Saluja, an internist at USC, joined Congressman Ted Lieu at a healthcare rally in California's 25th Congressional District where he spoke about the impact of ACA repeal on patients. 

Also happening in CA:

  • USC DFA medical students Alyssa Morse, Kyle Joyner, Santano Rosario, and Alexandra Obrembsky organized an event with Dr. Astrid Hedger on advocating for vulnerable patient populations in Los Angeles County.
  • Dr Kyle Ragins, a board member, led a physician advocacy event for Los Angles County health professionals sponsored by the Los Angeles Department of Public Health, Southern California Public Health Association, and the California Baptist University.
  • Medical students Grace Lee and Jeff Fujimoto organized the first UCLA-DFA chapter meeting on campus.

NEW YORK

DFA-NY and medical students at Mount Sinai, led by medical student James Blum, held a Day of Solidarity at Mount Sinai for DACA recipients and collected some impressive data on the impact of their advocacy, below. 

Also happening in NY:

  • DFA NY signed onto a letter sent to their Representatives asking them to oppose the budget proposal and stop Medicaid cuts.
  • Drs Bruce Rector & Katherine Scheirman joined the physician advocacy coalition letter to Mayor DeBlasio supporting the removal of a statue of Dr. Simms in New York City.
  • DFA NY participated in the 2017 NYC Regional ACA Outreach and Enrollment Summit on October 17th.

GUN VIOLENCE PREVENTION CAMPAIGN 

Dr Nina Agrawal held a press conference with Congressman Carolyn Malone in response to the Las Vegas shooting.

Dr Agrawal also interviewed with Think Progress in response to the shooting.

“I think we need raise awareness that NIH and CDC can’t fund research — this seems like a no-brainer."

PRESCRIPTION DRUG PRICING, VALUE AND AFFORDABILITY CAMPAIGN 

Dr Bruce Rector participated in a panel organized by the National Physicians Alliance to discuss DFA efforts to address high drug costs and the opportunities for action in 2018.

 Please send your updates and photos to DFAHQ@drsforamerica.org.

 

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Open Enrollment: Provider Week of Action


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Open enrollment for 2018 health coverage is here and we need your help.

Administrative efforts to sabotage the law and enrollment outreach have made this enrollment period particularly confusing for millions of Americans. However, we have a secret weapon in this fight and that is you. Doctors remain the number one messengers on healthcare. That means your voice can make a big difference this enrollment period. 

Doctors for America will be partnering with physician organizations across the country to hold a Provider Week of Action on November 6-12th. Get involved and help spread the word to #GetCovered before the December 15th deadline by joining an event in your area and amplifying key enrollment information on social media. Let's make sure our patients and communities know that quality, affordable health coverage is still available. And that, thanks to financial help, most people can get plans for $50 to $100 per month. 

Take action using the resources below:

  • DFA Social Media Materials - Use these resources to help spread the word to #GetCovered before the deadline.
  • Open Enrollment 5 Toolkit - This comprehensive toolkit includes talking points, sample emails, state coalition information, a handy guide for how to help people get covered, among other resources.
  • Connector Tool - Do you know someone who needs help with a health insurance application? Enter your ZIP code below to find appointments with local application assisters.
  • Start or join an Open Enrollment team - Know someone else that's interesting in helping? You can create a team to help put up signs in your neighborhood and share resources on open enrollment.

 

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Sabotage, plain and simple

By Shalini Pammal
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The President has taken a major step toward dismantling the Affordable Care Act (ACA) with an Executive Order aimed at collapsing the private health insurance market by drawing Americans toward skimpier health insurance plans. It’s sabotage, plain and simple.

Doctors and healthcare professionals know that everyone will become sick at some point in their lives and that these junk plans will not provide patients with the coverage they need when they need it most. In fact, these plans could reject people with pre-existing conditions, have lifetime/annual limits and no limit on out of pocket costs.

It is no coincidence the timing of this order occurred just before the start of Open Enrollment. The Administration is attempting to cause confusion for Americans and discourage them from signing up for coverage on the exchange. But quality, affordable coverage is still available and we must spread the word.

Join us for an emergency call to discuss administrative efforts to sabotage the ACA and the upcoming Open Enrollment periodLearn how you can help fight back to ensure Americans get the coverage they need.

 

Doctors for America Expert Call: ACA Enrollment

Tuesday, October 17, 2017

at 8pm Eastern / 5pm Pacific

Hosted by DFA Senior Advisor Harold Pollack with special guests:

Lori Lodes, former CMS Communications Director and current leader of Get Covered America

Erin Hemlin, National Director of Training and Consumer Education at Young Invincibles

 

 

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DFA Round Up - October 6, 2017


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TAKE ACTION

Below are a few simple actions you can take to ensure our patients continue to receive the care the need. 

  • Sign this open letter and join in urging Congress to pass legislation that protects DACA recipients. This letter and submitted comments will be delivered to Congress in October.
  • Tell Congress to reauthorize funding for Children’s Health Insurance Program (CHIP), which expired at the end of September and jeopardizes access to care for 9 million children:(202)-224-3121 
  • The Administration has cut open enrollment to a mere 45 days and made deep cuts in enrollment spending. Let's work together to fill the gap by making patients aware that enrollment begins November 1 and lasts through December 15,2017, for the 2018 coverage period. Follow @GetUSCovered and visit getamericacovered.org.
  • In the wake of the mass shooting in Las Vegas, DFA gun violence leaders penned this message urging doctors and medical students to call Congress and demand action to #EndGunViolence and #EndTheBan on gun research: (202)-224-3121 

ACA WEEK-AT-A-GLANCE

The Senate Finance Committee and House Energy and Commerce Committee passed a measure on Thursday to extend the Children's Health Insurance Program (CHIP) after funding expired last week. The bill approves more than $100 billion over five years for the program, which insures nearly nine million children and over 300,000 pregnant women. Though the Senate approved the bill swiftly, it was narrowly approved by the House Committee in a 28-23 vote along party lines. Democrats criticized the House Republican proposal to partially pay for CHIP by charging higher Medicare premiums to seniors earning more than $500,000. The House CHIP funding bill also modifies DSH allotments by eliminating the $2B cut for FY2018 and adding federal DSH cuts of $8B in FY2026 and FY2027 (currently set to expire in 2025). Over the past three years, Congress has passed legislation to delay reductions in Medicaid disproportionate share payments to hospitals.

Senator Bill Cassidy (R-LA) is still pushing to make revisions and garner support for his plan to repeal-and-replace the Affordable Care Act; though, the Senate has not indicated that there will be a vote on an amended bill. The Senate GOP opted not to take a vote on the Cassidy-Graham bill last week. As the open enrollment period approaches, the CBO has estimated that four million fewer people will sign up for Obamacare private insurance, given administration policies and general confusion around whether the Affordable Care Act is still in effect, following numerous efforts to repeal-and-replace the law. This has led to a surge in grassroots efforts from navigator groups and private campaigns to raise awareness for open enrollment, especially given slashed advertising funding and a much shorter enrollment period.

Meanwhile, insurers still have no commitment from the administration regarding cost-sharing reduction (CSR) payments or whether key elements of the law, like the individual mandate, will be enforced. This uncertainty has caused health insurers to aggressively increase prices next year for individual policies sold under the federal health law, with some raising premiums by more than 50 percent. The Council for Affordable Health Coverage (CAHC)—a coalition of drugmakers, insurers and others in the health sector— is also urging Congress to take several bipartisan steps to help stabilize the individual insurance markets, in particular seeking a federal reinsurance program to provide money for state-led reinsurance programs. Bipartisan market stabilization negotiations are still ongoing, though the future of a short-term plan to lower Obamacare premiums is unclear.

Lastly, following the resignation of Tom Price as Secretary of Health and Human Services, longtime HHS official Don J. Wright will be acting secretary. CMS Administrator Seema Verma is believed to be the leading choice to replace Price.

MEMBERS IN ACTION

Tell us about what you are up to! Email your updates and photos to DFAHQ@drsforamerica.org.

National

  • Dr Priscilla Wang and Medical student Michelle Lough are leading a DACA petition with 367 signatures urging Congress to find a solution for our medical students and physicians who rely on the program.
  • DFA board member Shalini Pammal was interviewed by Healthline on the impacts ending the DACA program would have on medical students and physicians across the country.
  • Doctors for America led a sign on letter opposing the SHARE Act, which would drastically weaken current laws regulating the transfer and sale of firearm silencers. Thanks to the American Public Health Association, American Medical Women's Association, American Nurses Association and the Koop Institute for signing on.
  • Gun violence campaign leaders Dr Nina Agrawal and Medical student Justin Lowenthal were both interviewed on the gun violence research ban. You can read those interviews in STAT News and ThinkProgress.
  • DFA joined 480 organizations urging Senators Murray and Alexander to take a bipartisan approach to stabilizing the individual market. 

CALIFORNIA

USC DFA group in attendance at a rally on in defense of DACA in LA the day of the announcement. 

Alyssa Morse, 4th year medical student at University of Southern California - DFA member published a letter in The Signal of Santa Clarita on the harmful effects ACA repeal would have on patients.

"I am a 3rd year medical student at the Keck School of Medicine of USC. My family and I are also your constituents in Valencia. I have spent most of my short medical career caring for patients at LAC+USC Medical Center, which is responsible for serving the low-income communities of East Los Angeles. Before Obamacare the majority of my patients were uninsured, and now because of your vote they have the most to lose."

Dr Pam Dyne a UCLA emergency medicine physician, spoke at a rally in Rep. Knight's district urging against ACA repeal.

NEW YORK

Medical student James Blum led DFA Mount Sinai students standing in solidarity with DACA.

DFA - New York co-sponsored and participated in a "Funeral March" in Times Square in NYC against the latest ACA repeal bill on Sept 23. 

Drs Bruce Rector and Katherine Scheirman joined @NYDocs coalition partners and planned a coordinated strategy to stop Graham-Cassidy.

OHIO

Dr Don Nguyen penned a piece in the Dayton Daily News, on the Graham-Cassidy-Heller Senate Bill.

“As a pediatric specialist, I worry about the funding for children on Medicaid. This new bill proposes per capita capping, block-granting Medicaid as funding to the states. This is a very bad idea — it will cut payments to children’s hospitals and providers and gives no consideration to how many children or disabled nursing home recipients this lump sum can cover. It will devastate children’s care, and therefore is completely unacceptable. It would repeal the important Medicaid expansion, which has been credited with saving lives of hard-working Americans and of opiate-addicted and mental-health patients.”

MASSACHUSETTS 

Drs Umbereen Nehal, Anish Mehta, and Stephanie Friend participated in a roundtable discussion with Senator Markey to discuss the impact Graham-Cassidy would have on their patients. 

 

Prescription Drug Value, Pricing, and Affordability

Maryland’s price gouging law is under threat by the pharmaceutical industry. Medical students Justin Lowenthal and Hussain Lalani worked to help with the passage of the law.

The California Legislature passed Senate Bill 17 that requires pharmaceutical companies to disclose the costs of price increases to the state. DFA-CA supported the bill while in the Legislature.

 

 

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Las Vegas

By Justin Lowenthal, MD/PhD student
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On the evening of October 1, 2017, the deadliest mass shooting occurred in US history. These were our friends, neighbors, patients, and colleagues who were senselessly massacred. We are grateful to first responders, tasked with  protecting thousands from gunfire. We thank health care providers at local hospitals doing their best to save lives  ravaged by bullets.

  • 59 - the number of lives lost in Las Vegas on Sunday night
  • 500+ - those injured by a single man armed with a cache of powerful and deadly weapons
  • 42 - the number of firearms found in the hotel room and the home of the shooter

The reality is that too many physicians struggle to save too many lives lost to the devastating effects of gun violence every day. This is not about a lone shooter in Las Vegas or in Newtown Connecticut. This is about a public health crisis as urgent as Ebola virus or drunk driving. Unless we do something now to keep our children and families safer from gun violence, the death toll will continue to rise and more Americans will suffer the loss of loved ones. We must mourn but we should not be quiet.  

  • 93 - the number of lives that gun violence claims on an average day
  • 33,000 - annual deaths attributable to gun violence
  • 114,994 - people in America are shot in a year

How many more lives must we lose? As health care providers, we can save lives by tackling gun violence through effective public health approaches: investigating the causes of such tragedy and helping to develop solutions that lead to policy changes. As health care professionals and public health researchers, we use well funded evidenced-based research to save lives from car accidents and other traffic fatalities; reduce smoking-related illnesses; and prevent heart disease, diabetes, cancer, and other major health challenges.

We call on Congress to #EndTheBan on the CDC and the NIH from conducting federally funded scientific research on gun violence. We call on Congress to appropriate funds to the CDC and the NIH to conduct this life saving research, just as we do for other preventable injuries in the United States.  

As physicians and medical students, we are united in standing with thousands of healthcare professionals in every state in this country to say enough is enough. We must stop the carnage of gun violence. We call on Congress to take action now.

Sincerely,

Justin Lowenthal, Medical Student (MD/PhD) at Johns Hopkins University

Nina Agrawal, MD

David Berman, DO

Sanjeev Sriram, MD, MPH

 

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ACA repeal defeated (again)!

By Shalini Pammal
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The latest bill to repeal the Affordable Care Act has failed to get the support it needed for a vote! Thank YOU for your calls, tweets and activism. Your advocacy has made a difference in the lives of millions of patients.

It is time for Congress to listen to the doctors, nurses, hospitals and patient groups calling for them to put patients over politics and begin working in a bipartisan manner to reduce health care costs and increase coverage. If Congress remains committed down the path of repealing coverage, let this be a notice that when we fight for our patientswe fight to win.

From the bottom of my heart, thank you.

In solidarity,

Shalini Pammal

Board Member

 

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ACA vote set

By Shalini Pammal
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Senate leadership has announced they will plan to bring the Graham-Cassidy-Heller bill to the floor next week.

The stakes are high for millions of patients currently benefiting from life-saving coverage. This bill causes 32 million people to lose health insurance, converts the traditional Medicaid program to a per capita cap, ends the Medicaid expansion and allows states to gut key consumer protections for people with pre-existing conditions. In short, this bill is a lethal prescription for health care and we cannot allow this version of care to become reality.

The vote is set but this is far from over. Let's make sure Congress knows that doctors and medical students stand in unified opposition to this latest repeal effort.

Here are three things you can do over the next few days to help kill this devastating bill.

SPEAK UP
Calls are a top priority. We need to drive as many calls as possible into Senate offices ahead of the vote, especially if you live in a target state. We also need to start driving calls into the House of Representatives.

  • Find contact information for target state Senators (AK, AR, AZ, CO, IA, KS, LA, NC, ND, NV, ME, OH, SD, TN WI, WV) 
  • Contact your Representative and Senator by dialing 202-224-3121.
  • If you are in a blue state, click here to use this tool to make calls to allies in red states to encourage them to get involved.

SHOW UP
Members of Congress will be back home in their districts over the next few days. This is the perfect time to visit them and make your voice heard. Request a meeting with your member of Congress or connect with partners for events on the ground.

USE OUR TOOLKIT
The following tool kit contains resources gathered from our partners across the country. Find talking points, background and resources to help you engage in your district and online.

We have a short window to make an impact but I know what is possible when we come together and elevate our voices for what is right. Let's join together to defeat ACA repeal one more time-- for the millions of patients in your care.

In solidarity,

Shalini Pammal

Board Member 

 

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Action Alert: ACA repeal threat grows


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Congress is back in Washington and back to their old tricks of trying to repeal the Affordable Care Act. Senate leadership has reiterated that repealing the ACA will be a priority before the end of the month and they are, reportedly, closing in on the votes they need to get it done. We need your help to stop this effort in it's tracks. 

The new repeal bill, known as Cassidy-Graham-Heller, is nothing more than a last-ditch effort to repeal the ACA. It would cause virtually all of the same devastating impacts as previous repeal bills already rejected by the Senate, such as:

  • cutting health coverage and raising premiums and out-of-pocket costs for millions
  • slashing Medicaid, converting the traditional Medicaid program to a per capita cap, and ending the expansion
  • allowing states to gut protections for people with pre-existing conditions

Doctors and medical students have made it clear it's time to move on from repeal. We expect Congress to work in a bi-partisan manner to stabilize the health insurance marketplaces, protect children’s health, and take steps to help patients afford the coverage they need. It's time to put an end to repeal attempts once and for all.

Join us in calling for Congress to put patients over politics. Tell your Senator to #ProtectOurCare and oppose the Cassidy-Graham-Heller bill: 202-224-3121. And, use this helpful toolkit to make your voice heard on social media. 

 

Yours in service, 

Scott Poppen, MD MPA

Chair

 

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