Graduation Competencies Patient Care Medical Knowledge Practice Based Learning and Improvement Interpersonal and Communication Skills Professionalism System Based Practice

Professionalism Principles Primacy of Patient Welfare Patient Autonomy Social Justice

Problem Cost High Uninsured Low Value Low Disparities

UP, UP, and AWAY 1998 $1,680 $3,868 $5,548 ____ 1999 $1,742 $4,000 Average annual health insurance premiums for employer plans Year Employee Employer Total % Increase 1998 $1,680 $3,868 $5,548 ____ 1999 $1,742 $4,000 $5,742 3.5 2000 $1,657 $4,694 $6,351 10.6 2001 $1,801 $5,252 $7,053 11.1 2002 $2,084 $5,870 $7,954 12.8 Source: AMA Health Care Financial Trends Report, August (Based on KFF/HRET Survey of Employer-Sponsored Health Benefits, 2002)

American Medical News, July 5, 2004

THE FIGHT FOR AFFORDABLE PRESCRIPTION DRUGS – STATE OF ILLINOIS Name Strength Quantity Canada Sample 1 Canada Sample 2 US Sample 1 Sample 2 Canada Average US Average Savings GLUCOPHGE XR 850 mg 100 $ 29.44 $ 39.71 NA $135.99 $ 34.58 $101.42 LIPITOR 40 mg 90 $187.50 $198.33 $275.97 $192.92 $ 83.06 PAXIL 10 mg 30 $ 49.95 $ 57.10 $ 74.99 $ 90.99 $ 53.53 $ 77.99 $ 24.47

FEWER PLACES FOR PATIENTS TO GO Physicians accepting all new patients: FEWER PLACES FOR PATIENTS TO GO Physicians accepting all new patients: Fee-for-service Medicare 76% 69% Medicaid 48% 37% Source: Medicare Payment Advisory Commission American Medical News, October 21, 2002

JAMA, May 19, 2004 – Vol. 291, No. 19

American Medical News, February 23, 2004

American Medical News, May 24/31, 2004

DIVERSITY Pain Meds offered less to minorities Pain Management, September 2004

American Medical News, October 20, 2003

Osteoporosis Screening African Americans have 2-3 fold Lower testing and prescription therapy Southern Med J Mag, 03 96(5), pp. 445-51

Breast Cancer Screening 28% of African American women with abnormal mammograms on breast exam have no final diagnosis at 6 months Preventive Medicine, 37, 92-101, 2003

Cause Wealth Aging Technology Demand Social Class Paperwork Litigation

American Medical News, April 21, 2003

JAMA, June 3, 1998, Vol. 279, No. 21

Source: Tillinghast-Towers Perrin, as published in a study by the Center for Legal Policy at the Manhattan Institute, “Trial Lawyers Inc., A Report on the Lawsuit Industry in America 2003” American Medical News, November 3, 2003

American Medical News, October 28, 2003

American Medical News, September 15, 2003

Limit Compensations - California 58% of death capped 41% of injury cases capped 71% of infant cases capped American Medical News, August 2, 2004

Managed Care Types of plans Types of HMO

Types of Organizations HMO PSO PPO Managed Indemnity

Types of HMO Staff Group IPA Network

Dealing with Cost • Controls • Reimbursement • Price • Regulatory • Competitive

Dealing with Cost • Controls • Reimbursement • Utilization • Management • Patient Cost Share • Supply Limits • Risk Shift

Painless Controls Set prices Prevention Waste

Prevention 1º Avert Occurrence 2º Early Detection 3º Minimize Effects

Patients give students permission to learn on them Patients give students permission to learn on them. Transform help as an obligation to help as charity.