Perspectives Inaugural Issue (Winter 2013)

PERSPECTIVES • WINTER/SPRING 4 Over the past several years, I have discussed the subject of health care availability for the American pub- lic multiple times in various HPD publications. However, now that the people of the United States have reelected the President, they have also helped certify the much- debated Patient Protection and Affordable Care Act— otherwise known as Obamacare. As a person who has been involved in health care for many years, I believe it’s quite evident that certain elements of the Affordable Care Act have been em- braced by the general public. These include tenets such as the closure of the controversial donut hole in Medicare Part D prescription drug coverage and the elimination of citing preexisting conditions as a means to deny health insurance coverage. I’ve mentioned the following topic numerous times, but it bears repeating: At Nova Southeastern Univer- sity, particularly within all our health care education programs, we’ve been teaching the issues of well- ness, prevention, and the medical home for many years. As a result, because we’ve embraced and in- corporated these practices within the various Health Professions Division colleges over the past decade, I think we have a dramatic advantage over many other educational institutions. One concern that has become very apparent in re- cent years is we simply don’t have enough health care providers in the United States. Based on various sets of statistics, there are approximately 32 to 34 million people who are going to be receiving health care cov- erage who weren’t covered before. You will also have, depending on which states choose to participate, an- other 12 or so million people who will become Medicaid eligible. Consequently, when you review the overall fig- ures, you’re talking about anywhere from 40 to 46 mil- lion additional people who will have the opportunity to receive health care coverage. In order to unearth the origins of the ongoing physi- cian shortage, you need to look back in time. It certainly can’t be blamed on a lack of establishing new U.S. medical schools because in Florida alone, the number continues to rise, with nine medical schools now lo- cated throughout the state. If the truth be told, the true culprit was the 1997 Budget Reconciliation Act that came out of Congress, which basically capped funding for all existing residency programs. Now that 15 years have passed since the Budget Reconciliation Act was enacted, it’s imperative to as- sess how this piece of legislation actually impacts the Affordable Care Act. This is an important point to ex- amine, especially when you consider that millions of U.S. citizens will now have the opportunity to ac- cess health care, which they will be paying for out of their pockets. Still, the question remains: Where are the physicians? Because residency programs are not funded to an adequate level, it has impacted the number of graduates who can actually gain entry into a residency of their choice. Additionally, because reimbursement rates are extremely low in many areas of the United States, those areas tend to have an insufficient physi- cian population. As a result, we’ve seen the evolution of other health care professionals that are also serving as primary care providers. And that’s why you’re going to find huge numbers of health care providers distributed amongst the areas of the country where there is a paucity of physicians. The way I see it, the medical home para- digm is paramount to the success of providing preven- tion and wellness services because it allows the physician to work in tandem with nurse practitioners, physician assistants, pharmacists, optometrists, and dentists to enhance overall patient care. What I foresee is a dramatic opportunity for insti- tutions like NSU, which are already home to a com- prehensive compendium of health-related academic programs, to place a strong emphasis on collaborating with as well respecting their fellow health care profes- sionals. That’s why NSU’s Health Professions Division has been providing interdisciplinary learning opportu- nities for its students for many years. It also explains why the various HPD colleges are housed within one complex shared by all health professions. In the world of education, it is imperative for all the health professions programs to be communicative with one another, to understand each other, and to treat each other equitably. The beneficiaries of this interdisciplinary collaboration will be the citizens of the United States. In order to create efficiency in health care, you must provide for wellness, which as we all know, starts with focusing on the critical precept of prevention. HPD Chancellor’s Message “In the world of education, it is imperative for all the health professions programs to be communicative with one another, to understand each other, and to treat each other equitably.” Frederick Lippman, R.Ph., Ed.D.