 Below is a letter given to President Barack Obama on Wednesday, June 24, 2009 by Georgetown University medical students visiting the White House during a television event addressing healthcare reform.
Claiborne Childs
Student Body President
Georgetown University School of Medicine
3900 Reservoir Road NW
Washington, DC 20007
June 24, 2009
President Barack Obama
The White House
1600 Pennsylvania Avenue NW
Washington, DC 20500
Dear President Obama:
Tonight, several of my colleagues from the Georgetown University School of Medicine joined you at the White House at the invitation of ABC News. We want to thank you for hosting us.
At Georgetown, our mission statement calls us to be compassionate physicians, dedicated to the care of others and the health needs of our society. Like other future doctors nationwide, we are very concerned about healthcare reform. We are closely watching and participating in the debate regarding this critical issue.
Prior to tonight’s taping, ABC News producers invited us to submit questions for you about healthcare reform. I have included those questions in this letter. As you will see, America’s future doctors are engaged in this issue on both a personal and professional level. For example, my fellow student Jonar de Guzmán writes about his prior experience as an uninsured recent college graduate. He’d like to know how health care reform will help young graduates entering the workforce obtain and afford health insurance.
Another one of my classmates Drew Shiner is attending Georgetown through the Health Professions Scholarship Program with the U.S. Air Force. As an aspiring military physician, he is concerned with increasing preventative health care for our nation’s servicemen and women.
And finally there is the situation of my fellow student Erica Adams, who underwent heart surgery shortly before her first year of medical school. The uncovered portion of her medical expenses and the soaring price of higher education forced her to choose between books and follow-up medical care. Often, she chose the books. Erica is concerned with how changes to our system will affect the uninsured and underinsured.
While Erica’s case is uncommon, she is not alone in shouldering the burden of the costs of attending medical school. Many students will graduate with more than $250,000 in educational debt. I have been fortunate enough to receive a scholarship from the National Health Service Corp through the Department of Health and Human Services. As a recipient, I have agreed to serve as a physician in a medically underserved community in the U.S. Nonetheless, I speak for many of my classmates who want to know if the debate over healthcare reform will address the rising costs of medical education which may deter future physicians from pursuing careers in primary care in favor of more lucrative specialized care. With a larger and increasingly older population, our nation will need well-trained and dedicated primary care physicians to meet the needs of its people.
Over the coming months there will undoubtedly be intense debate regarding healthcare reform. And while there are many points of view, this marks an opportunity to change our healthcare system for the better. Thank you again for engaging us on this vital issue. We appreciate your attention to our concerns and look forward to participating in the ongoing national dialogue concerning healthcare reform.
Very truly yours,
Claiborne Childs
1. I am interested in providing medical care to all patients in need regardless of their ability to pay, but I will graduate medical school next year with over $200,000 in loans and I worry about how I will fulfill my professional and personal goals as well as meet my financial obligations. How do you plan to extend quality medical coverage to the growing number of un- or under-insured Americans while protecting health care provider compensation in light of the soaring cost of tuition?
I come from working class roots in Idaho, and getting to (and through!) medical school has been both a personal and financial struggle for me. I have a congenital heart condition for which I underwent open heart surgery in the year I started medical school. Although I have always been insured, the uncovered portion of the medical expenses has always been burdensome for me, especially as a student living on loans without parental support. I forgo regular follow-up examinations, and have in the past chosen between getting an echocardiogram and buying books. Despite the hardships I have experienced related to the high cost of healthcare, I am fortunate to even have a degree of insurance. Many people close to me, particularly younger friends and family, have no coverage at all. This means that they do not receive regular life-saving screenings or preventive health care measures, and are one medical emergency away from financial collapse. The problem extends beyond my immediate circle, and requires urgent action by those in healthcare and the government. Throughout my career I hope to contribute to the extension of quality healthcare to all in need.
Erica J. Adams
2. My question, being a graduate of the Air Force Academy and going to serve as a physician in our armed forces, is:
Having toured Brook Army Medical center and given the recent increases in reports of Post Traumatic Stress Disorder (PTSD) and loss of limbs associated with IED injuries, what kind of initiatives and programs will you implement, and where will the funding come from to ensure this generation of American soldiers aren't left to quietly endure the hardships in obtaining and affording healthcare, homelessness and forgetfulness of society that our fathers and grandfathers suffered?
Homelessness is a social epidemic as much as the number of disabled veterans is a healthcare issue.
Ian Sterling Tuznik, 2nd Lt. USAFR, MSC
3. I'm a half Hispanic and half Korean female from New Mexico. I grew up in a trilingual home and am the first to go to college in my family. I am devoted to continuing to serve underserved and minority populations. I worked as a public health and Veterans Hospital nurse prior to attending medical school and spent 10 years volunteering to serve the underserved communities in New Mexico, Mexico, Ecuador and India (medical and development projects locally and abroad and worked on smoke-free legislation).
My question for President Obama: By the time this plan is in place, I will be a practicing physician. I am committed to being a family practitioner in an underserved community. How will this plan allow me to have a private practice while also paying back my $300,000 medical education debt? OR Will this plan also allow me to practice as a pro-life physician?
Mary A. Vigil
4. As a healthcare provider, when I am making a treatment decision and decide to avoid getting additional tests or imaging studies because they are unnecessary, how can I be sure that the money saved will be spent more effectively for another patient? What do I tell the patient who I am denying that extra testing?
My name is J. Ryan Macdonell, I am a third year medical student interested in orthopedic surgery. I grew up in New Jersey and attended the University of Notre Dame. I am interested in orthopedic surgery and I used to work for the Notre Dame football team. I am a big fan of Bruce Springsteen.
J. Ryan Macdonell
5. My one question: Given the current economic conditions, how should our healthcare reform goals combine immediate growth of our economy–for example, the advancement of health information technology–with sustainable healthcare for our aging population?
I am a second-year medical student in the MD/PhD program at Georgetown School of Medicine, where I am an active member of our class. I have a strong interest in health information technology in increasing efficacy, decreasing cost and increasing access to and preventative aspects of healthcare. My translational research interests include tumor biology and oncology. I grew up in Maryland, graduated from UC Berkeley, and worked in biomedical and public health research in the San Francisco Bay Area before starting medical school in 2007.
Joe Murray
6. My name is Shoshana Aleinikoff and I am a first year medical student. I came to Georgetown to pursue an MD/MPH because of my interest in health policy and public health. I am particularly interested in health disparities, and I spent three years researching the longitudinal health consequences of childhood poverty in rural America (at Cornell University), as well as two years developing a health intervention project in Humjibre, Ghana. I am currently a student coordinator for our student driven Georgetown HOYA free clinic for the Homeless in SE DC. This semester I took a selective class about health care reform and the culminating project was to write our own health care reform proposal. Over the past few months I have done a great deal of thinking about health reform, and I follow the current debates closely.
There are many determinants of health that reach beyond access to insurance, or interactions with physicians: much of health wellness happens outside of the doctor’s office. For example, other determinants of health include socioeconomic disparities, nutrition, outdoor space, occupational safety, education opportunities, race, etc. How does your health care reform plan aim to work with other existing governmental organizations for a more multidisciplinary approach to wellness which would address these additional determinants of health?
Shoshana Aleinikoff
7. Thank you for extending this opportunity to the medical students. I do have a question regarding health care reform measures.
Many reform plans seek to better health care for many Americans but this is an imprecisely stated goal. What are more specific goals (e.g. lower incidences of preventable cancer death) of reform tactics that you wish to see and how will the effectiveness of those goals be measured after the reforms are taken?
I graduated from St. John's College in Annapolis, Maryland, after studying the liberal arts through primary texts of western civilization. For several years after graduating college and previous to attending medical school I worked as a pharmacy technician at a local pharmacy owned by a member of the community. While there, I saw countless instances of economics and health care intersecting. I am now interested in a career in academic medicine and clinical research.
Martin Gaudinski
8. I am a third year medical student at Georgetown, and I am interested in going into pediatrics. I have been extremely interested in, and active in, health care policy through work with the AMA in medical school and in research policy before that. (Additionally, I am Indian, and I was born in Canada and moved here during elementary school. I have seen both Canadian and American health care systems in practice). For the last 3 years, I have volunteered with a group called the Children's Health Fund; it provides mobile medical units to help disadvantaged children throughout Washington D.C. and Virginia. I am particularly interested in helping to find ways for physicians, through practice and policy, to help medically underserved children in the United States.
Medically underserved children make up a substantial percentage of our population. Recent estimates place the number of uninsured children in the United States at over 8 million. But our nation's children face more than just economic barriers to care. Children who live in rural areas often have very limited access to physicians or medical professionals. Often, children in underserved populations may have psychosocial barriers to care - children who face homelessness, chronic violence at home, or limited health literacy. These kids deserve our attention and care, so that they may reach their true potential in life. How can we help to make these children a priority to physicians and policymakers as we consider health care reform?
Thank you so much for your consideration.
Anjuli Srivastave
9. My name is Max Freed, I grew up in DC and went to Vassar college in upstate NY. I entered medical school with the intention to do primary care, but was dissuaded by the poor working conditions: paperwork, HMOs, not enough time to listen to patients or think about each individual as a whole person, and so on.
I'm now hoping to pursue a career in cardiothoracic surgery, a field that has been shrinking due to America's love affair with stents - another new procedure proven less effective than coronary bypass but still commonly performed because of the amount of money it brings in.
Our procedural payment system has created many perverse incentives that reward intervention instead of prevention. How will your health plan reward physicians for improving health instead of intervening for intervention's sake?
Max Freed
10. I am a first year medical student from Prairie Village, KS and received degrees in Biochemistry and Genetics at the University of Kansas in 2008. My decision to pursue a career in medicine was greatly influenced by watching my uncle battle with and lose to AIDS. The stigma and hatred he faced in small town Nebraska because of the disease has instilled in me a strong desire to be a patient advocate for those I will serve in the future. Since moving to DC last fall, I've had the opportunity to be involved with local HIV/AIDS efforts and am currently working on a project to investigate youth access to testing sites. I currently serve as the student body vice president, chair of the Surgical Interest Group and am traveling to the Dominican Republic on behalf of Georgetown this
summer to provide health care to small, rural towns.
Having worked with medically underserved populations in both rural and
inner-city populations, I would like to ask President Obama how he plans to attract health care providers to these areas to help lessen the disparities in access to care that currently exist.
Ellen Stolle
11. Thank you for passing this opportunity along to us. As a medical student, I know the benefits that preventative health care can have on long term health outcomes. I agree that making health care more affordable is a step in the right direction of making such preventative care more accessible. We, however, live in a society where instant gratification often trumps long term benefit. What measures are being considered to promote health through lifestyle modification in an effort to improve health outcomes and reduce overall cost in the long run?
I am a second year medical student originally from Oklahoma. I attended Georgetown as an undergraduate where I studied economics (including government outlay programs). Thus, I have a somewhat unique view from both the side of medicine and the side of economics. I have a passion for finding efficient solutions to complex problems and I believe this issue is a prime example of such a challenge.
Tyler Pagel
12. President Obama, as a medical student I see many of my classmates going into specialty fields due to the fact that they will not be able to repay their financial obligations in primary care, yet there is a need for primary care and prevention in our country and as you said to the AMA "You did not enter this profession to be bean counters and paper pushers. You entered this profession to be healers. And that’s what our health care system should let you be." What reforms do you propose to address this financial burden and obligation that physicians are under that will allow more students to go into primary care without the financial burden in the backs of their minds?
I am a third year medical student from Georgetown University School of Medicine. Originally from Massachusetts, I went to Boston College High School then studied at Georgetown University, receiving a Bachelor of Arts in Computer Science, with minors in Biology and Psychology. During my time at Georgetown I have been a captain and former record holder of the Varsity Swim Team, worked for the Dean of International Programs at the School of Medicine and have been a member of the Student Council of the School of Medicine Class of 2010 for the past three years. I am very interested in healthcare reform and will be doing a Social Justice and Advocacy elective during the upcoming year where I hope to work with the office of an elected official actively engaged in health and social policy legislation.
Heath Walden
13. The government has given me little confidence that it can efficiently run a social program. Seeing as how at their current rate of growth both Medicare and Medicaid are projected to go bankrupt, how can we logically expect a public option, which will encompass a larger portion of the population, to contain healthcare costs?
I just finished my first year of medical school at Georgetown. I am originally from Arlington, VA. In general I hold relatively conservative views and I'm not in favor of the healthcare reform currently proposed due to the current economic state and vague details the Obama administration has given us to date.
Michael B. McCabe
14. The central premise of health care reform is based on the idea that healthcare cost is spiraling out of control. As a 3rd year medical student (and 25 year old) I have already amassed enough debt to rival an average American's home mortgage, and I still have 2 years left. I always wanted to become a physician to serve my community, neighbors, others. In a large sense I see my future career as a calling to public service. And I would gladly work for much less in the future and use that freedom to serve the areas most in need if a wasn't saddled with such tremendous debt. So my question is: As a system how can we talk about reducing costs and reimbursements when some of the central figures in healthcare are forced to face debt that averages in the hundreds of thousands of dollars? Can we look at more broadly subsidizing medical education as a component of reform to help relieve the pressure of debt on doctors and hopefully reduce downstream costs?
I just finished my second year of medical school at Georgetown. I graduated from the University of Notre Dame in 2006 and went to teach science in an inner city public school before medical school. While teaching and during my first two years of medical school I worked toward a Masters in Bioterrorism here at Georgetown, receiving a graduate certificate this past January. I have always wanted to do something good with my education and the opportunities I have had, and I see becoming a physician as a privilege and an obligation to serve your community.
Shane Kappler
15. The average medical student accumulates $140,000 in debt by the time of graduation. (Mine alone will amount to over $300,000 in total student debt.) As a result of this grim financial outlook, many students are driven towards specialization even though we already have a shortage of primary care physicians in the United States. How would your proposed healthcare reform address this situation?
Bonnie Yen
16. Mr. President, thank you for taking my question. Several studies have implicated the Family Medicine physicians providing comprehensive primary increase the quality and decrease the cost of care. Unfortunately, there are fewer U.S. medical graduates entering this specialty. Changing this reality is part of the foundation for true, comprehensive reform. Can you please cite specific examples of ideas on the table for supporting more students entering the specialty?
Mary Putnam
17. We commonly hear where healthcare needs to go as an entire industry, but perhaps we have forgotten the smaller steps for a man that lead to the giant leap for mankind. Because we are a common thread between health insurance companies, hospitals, the pharmaceutical industry, and patients, how can doctors specifically put there neck out to make a positive change and what is the government going to do to protect us on the front line? As physicians we put our patients first and so this is just another part of our duty as stewards for humanity.
My name is Michael Conti Mica, I am the president of my medical class and the president of the (AMA) American Medical Association at Georgetown University. I am a first generation Italian-American and the first person in my family to become a physician. I am from the northwest suburbs of Chicago and have lived in areas with "community supported insurance," both in Massachusetts, with the 2006 healthcare reform law, and DC with the Unity Healthcare system, but come from Chicago where that does not exist.
Michael R. Conti Mica
18. Thank you for giving us an opportunity to ask the President questions regarding health care reform.
Mr. President, how do you propose to solve the potential inefficiencies of a government backed health care system? For instances, is widely known that patients sometimes have to wait a long time to have procedures done in government sponsored health care systems such as the one in Canada because there is too much demand and not enough supply.
Also, when rotating through the veterans affairs hospital, I experiences the benefits of perhaps the best computerized medical records system in the United States. However, I was constantly hearing from other medical professionals and from personal experience that because of the "job security" experienced by the government employees, it takes a long time for things to get done for the care of our patients.
My name is Albert He, a third year medical student who is going to be applying for residencies in Emergency Medicine. I immigrated to the United States at age 10 from Beijing, China and became a naturalized US Citizen during my college years at the University of Chicago.
I consider myself moderate in terms of political leaning, fiscally conservative, and liberal on social issues.
My knowledge of the health care system overall is limited, but as I move on into residency, I definitely want to learn more. From personal experiences in dealing with insurance companies and my hospital rotations during 3rd year of medical school, I can see the various inefficiencies that exist. I think it is good that we are trying to change and hopefully improve the health care system.
Albert S. He
19. My decision to become a U.S. Air Force physician was largely motivated by a desire to care for those in harm's way. The Obama-Biden healthcare plan emphasizes greater investment in public and preventative health measures. What kinds of preventative health measures does your administration have planned for our servicemen returning from Iraq and Afghanistan?
In 2007, I graduated from the University of Scranton with a degree in Biology/Philosophy and started my first year at GUSOM in the fall. Before entering medical school, I was commissioned a 2nd Lieutenant in the United States Air Force by completing COT at Maxwell AFB, AL. Thus, I am currently attending Georgetown on a full-tuition military HPSP scholarship. Since I haven't begun my clinical rotations yet, I am unsure of a specialty but leaning towards general or orthopaedic surgery. Until moving to DC, I lived in Northeastern Pennsylvania my entire life - an area which has become drastically underserved in many medical specialties as a result of physicians fleeing PA to escape high malpractice insurance rates. There are no doctors in my immediate or extended family, although my mother was a nurse and it probably played some role in nurturing my interest in medicine. While I respect President Obama as Commander-in-Chief, I consider myself a libertarian and oppose the increasing power of the federal government over the private sector (i.e. bailout funding, GM ownership, creation of a pay czar). However, I am extremely interested in hearing his plans for healthcare being that the healthcare landscape will likely be vastly changed by the time my service obligation expires. My decision to either stay in the military or enter civilian medicine will largely be swayed by the type of practice environment that his plan would establish.
Drew Shiner
20. In what ways does President Obama plan to curtail the growing financial burden currently associated with attending medical school in the United States?
Matthew Haney
21. I am a medical student at the School of Medicine, and interested in participating in the conversation with President Obama. My question is:
"The President's proposal will offer citizen's another option in selecting their healthcare coverage. However, there are still many Americans living in poverty that simply can not afford a plan at all, public or private. What options will be available for these people?"
I am a second year student at the GUSOM and current student body president. I recently received a scholarship from the National Health Service Corp through the U.S. Department of Health and Human Services. In exchange for paying my tuition and expenses, I will work in a medically underserved community after finishing residency. The debate on how to reform our system and make it more available to those that need it is very important to me, and will effect how and where I am able to practice. I believe that offering an affordable health care option is a step in the right direction, but the term "affordable" is relative. Access to healthcare for the poorest in my community must still be addressed.
Claiborne Childs
22. My question is "what kind of additional incentives might a new healthcare plan offer to graduating medical students to increase the number of primary care specialists in the United States?"
I'm the youngest child of Irish immigrants who came over in the 70s. I'm following in the footsteps of my older siblings who have also chosen healthcare professions. I grew up in Atlanta, GA and attended my state university on scholarship, then came to Georgetown for medical school. During college, I travelled to Ireland and Denmark and was able to work in their hospitals as well, to see the differences in medical care between countries.
Patrick Maher
23. The president is interested in cutting costs, but let's talk jobs. How is the president planning on addressing the shortage of trained physicians, nurses, and allied health professionals despite his commitment to cutting costs?
I grew up in Birmingham, MI. I went to high school in Detroit on 7 mile road at U of D Jesuit, and I've seen the slow decline of what was once prosperous manufacturing city firsthand. I taught 2nd grade for a year in the inner city of Detroit, and I was fortunate enough to do my Service learning this year in SE DC at HSCSN which reminded me very much of home.
Eric Oermann
24. One of the biggest problems facing Americans is a lack of preventative health care. What do you plan to do to promote preventative health care and help stop illnesses like cancer, heart disease, and diabetes before they start?
I was born and raised in central Illinois and worked as a science teacher for four years before deciding to attend medical school. I hope to become a pediatrician when I graduate.
John Hawes
25. Dear President Obama, An essential feature to healthcare reform is increasing the number of physicians pursing primary care. However, with many students being well over $250,000 in debt from the cost of their undergraduate and medical school degrees, how do you plan to make this a realistic possibility, especially when specialized physicians are making 4-5 times what primary care physicians earn?
My family was unfortunately unable to provide me with any assistance towards paying for my undergraduate or medical degrees. Though I have generously received some financial aid and scholarships throughout this time, I will still be graduating medical school well over $200,000 in debt. While I know there are ways to volunteer in rural medicine to pay back these loans, I truly believe there needs to be more options to convince indebted students to pursue primary care, especially when they can live a much more stable life pursuing a specialized field of medicine. Of my 190 classmates, I would be extremely surprised to find more than 10 applying for residencies in family medicine.
Aaron A. Laviana
26. I am a soon-to-be second year medical student. I am from a middle class family just outside of Philadelphia. Upon graduation from Georgetown I will be the first doctor in my family.
My question for the President: How would a new health care system or policy help foster more trustworthy and personalized doctor-patient relationships? In other words, how can the health care system be altered so as to allow the doctor more focus on the individual patient rather than paperwork and other technicalities?
Jonathan Grabe
27. Mr. President, it's widely known that the U.S. spends 52% more per person on health care than the next most costly nation (Norway). Health care reform is long over-due. I'm very pleased you have taken the initiative by making health care reform a top priority of your administration. How concerned are you with the Republican argument that employers will opt for the government-sponsored health insurance option over private insurance because the government option would likely be less expensive-- and they argue, of lesser quality?
Kevin Hall
28. I would ask President Obama how the new healthcare reform will ensure that medical students are encouraged to enter primary care careers. With concerns of paying off educational loans, many more students are choosing to specialize. A strong healthcare system requires a stable primary care infrastructure and in the current climate there is little reward for preventative health measures often provided by primary healthcare physicians. As a medical student who believes primary care is of the upmost importance for the nation's health, I hope when it comes time to choose my career path that I do not have to consider monetary concerns in deciding my future.
I am originally from California and I was an undergraduate at Georgetown. Both of my parents are from England and my family still lives in the UK, so I have had some experience with the idea of universal healthcare.
Megan Barber
29. My name is Jonar de Guzman and I am a first year medical student at the Georgetown University School of Medicine. Before medicine, I had a deep interest in politics. While working as a United States Senate Aide under Senator Richard J. Durbin in the summer of 1999 in Chicago, my fellow senate interns and I had the fortunate privilege to have President Obama (Illinois State Senator at the time) speak to us about his amazing life journey that lead him into politics. As the son of an immigrant Filipino, I was further motivated by Obama's speech toward a career in politics but my plans came to a halt when doctors diagnosed my father with cancer in 2001. After graduating from NYU in 2002, I decided to stay in Chicago to work until my father’s complete recovery, which unfortunately never came. My father’s struggle and eventual passing became a life changing experience that inspired me to pursue a career in medicine instead.
As a non-traditional pre-medical student in the Loyola University Chicago Post-Baccalaureate Program, I had already exhausted most of my financial aid resources after completing my undergraduate education at NYU and therefore had little money left over from loans to cover my health insurance. During the first academic year, I covered my health insurance by working at Starbucks 30 hours per week while taking classes. However, I decided to quit Starbucks to focus on school and unfortunately went without health insurance for over a year.
Among the 46 million uninsured Americans, there is a population of recent college graduates without jobs or college graduates like myself trying to pursue a higher level of education that cannot afford health insurance. So, my question for President Obama is the following:
What is your plan to help out those recent college graduates who cannot afford health insurance?
Jonar de Guzman
30. My name is Natasha Lloyd, I am currently a rising M2 at Georgetown. I was born in Chicago and later graduated from Duke University as a Psychology major. I am deeply investing in the healthcare reform and the promise it has to overhaul the current system. Having experienced being a patient as a medical student, I have first hand experience of the challenges of navigating the healthcare system.
The current healthcare system lacks continuity amongst the various organizations involved. As a result, navigation of the healthcare system is especially challenging for novice and even the most experienced patients. Insurance companies, hospitals, primary care offices, specialty office, etc. are disjointed and this complicates the patient experience. How does the current healthcare reform aim to unite all of the current groups to allow for a more cohesive system and make our heathcare system more user friendly?
Natasha Lloyd
31. Many physicians (and future physicians) believe that the more the government gets involved in health care, the possible consequences could include further rationing of care, increased administrative obligations for physicians in order to receive payment for treatment, and increased oversight and regulation of physician decisions by bureaucrats in order to minimize government spending. Given that the Obama proposed plan may potentially lead to an increase in 32 million health insurance recipients, with about $100 Billion USD increase in costs, how does the government plan to maintain cost containment without hindering the physician's ability to treat his/her patient, or overwhelming them with paperwork in order to justify their decisions and choices?
My name is Jyotsna ('Joey") Singh. I am a 23 year-old, first year medical student at Georgetown University. I was born in Mumbai, India; lived there for several years before moving to Hong Kong, then Singapore, and finally the U.S to complete my education. I supported Pres. Obamo throughout his campaign, but am skeptical of his health care plan because, though he has admirable intentions, he has yet to definitively provide the details regarding the execution of the plan.
Joey Singh
32. My sister, an American citizen who lives in Canadian, has had multiple negative health care experiences since moving there a few years ago. I have read that your plan resembles Canada’s universal, publicly funded program in many ways. How do the two plans truly differ?
I am a 30-year-old (soon to be) third year medical student from Texas. I served as president of the Student National Medical Association, class of 2011 professionalism committee, LCME faculty subcommittee member, and I volunteer with Children’s National Memorial and Food & Friends. I have a vested interest in improving access to medical services and delivery of health care to indigent and minority communities.
Apryl Martin
33. With the average medical student debt constantly on the rise in this country, what will your plan do about the disparity in pay between specialist and primary care physicians? I am finding it very difficult to even fathom going into primary care because I know that my personal debt will exceed over $240,000. While primary care loans and loan reimbursement programs help dilute the cost, they do not compare to the increase in salary that many specialties offer. I feel like the healthcare system would be dramatically improved if we encourage more people to go into primary care.
I earned by B.S. from Loyola University Chicago as well as my M.B.A. with in an emphasis in healthcare management. I interned for Senator Grassley on the Senate Finance Committee in the summer of 2008. I have lived in several places do to my father being transferred around the country for his job at General Motors. I have lived the longest in Kansas City, MO where I spent my summers working for my father's construction company, which is currently on the verge of bankruptcy.
Anthony Pereira
34. Mr. President, As a doctor in training, one of the first things I noticed while working in the hospital is how segmented a patient's medical information is. Much of a patient's information is not immediately available to the doctor as it is located in paper charts or in computer systems in other institutions. You have been a proponent of electronic medical records and have already enacted some laws incentivizing providers to go electronic. However, what is your plan to allow these electronic records to communicate with each other across institutions?
And I have one more question...
Several new health care ideas have emerged over the past few weeks including co-operatives and the Bipartisan Healthcare Plan supported by Tom Daschle and Bob Dole. Neither of these ideas contain a public option. Would you consider supporting a plan that did not contain a public option?
Brett Sperry
35. My name is Sean Levy and I am currently a rising fourth year student at GUSOM. There has been a lot of discussion in the hospitals this year about the shifting focus of physicians' responsibilities in our health care delivery system today. Many are proposing that in the years to come, physicians will provide more of a solely technical role, performing procedures and providing prescriptions among other things, while other health care practitioners, become more responsible for the traditional elements of the doctor-patient relationship, including communication and counseling. How will your administration work with Congress to ensure that the doctor-patient relationship that is so crucial to good health care is maintained in this changing environment?
As for myself, I grew up on Long Island and went to the University of Pennsylvania, gaining degrees in neuroscience and classical studies. Beginning at the age of 16, I worked as a counselor at Camp Hope in upstate New York each summer, a camp for children living with HIV/AIDS from Harlem Hospital's Pediatric Clinic. This work really encouraged me to consider a career in medicine, and since coming to Georgetown, I've been blessed with the opportunity to act as one of the six coordinators that, together with Drs. Levy and Moore, formed the HOYA Clinic in 2007-8, a student-run free clinic that provides care for homeless families at DC General Hospital here in the District. I intend to pursue a career in Internal Medicine or Med/Peds and hope to work as a primary care physician in the future, providing care to those that need it most.
Sean Levy
36. You have proposed cutting billions of dollars to Medicare and Medicaid to help pay for your healthcare reform plan. In addition to providing health insurance for senior citizens and disadvantaged families, Medicare and Medicaid also help to finance graduate medical education. How will these proposed cuts affect payments to teaching hospitals to cover costs related to resident training?
I have just completed my first year of medical school at Georgetown University where I also received my Bachelor's degree. I'm originally from Merion, Pennsylvania, and I play the oboe in the Georgetown University Orchestra. In between college and medical school, I conducted genetics research at both the National Institutes of Health and Duke University. This summer, I will be spending a month in Xela, Guatemala learning Spanish and working in a medical clinic.
Charlotte Jenchura
37. My name is Sheanita Howard and I would like to submit a question to President Obama. Currently, I am a third year medical student (rising 4th year) at Georgetown. I graduated from The University of Memphis, (Memphis, TN) where I received a B.S. in Biology and B.A. in Sociology. Upon completion at Georgetown, I plan to go into Pediatrics.
Despite having insurance, many Americans, specifically those with chronic medical conditions, are faced with the difficulty of paying high co-pays on prescription medications and medical services, President Obama how do you envision implementing a plan that would make co-pays affordable to those that are on multiple medications and requiring long-term health care follow-up?
This question is close to home due to the fact that my father, who is diabetic and with other med conditions, is currently paying $60 for at least 2 medications/ month (not including other medications that he take). Likewise, my mother was unable to complete physical therapy (which she needed at least 3 time/wk) for back problems due to high copays.
Sheanita R. Howard
38. My name is Rishi Surana and I am a rising 3rd year MD/PhD student here at Georgetown. I have just finished my second pre-clinical year and will be beginning work towards my PhD next month. My question is as follows: "Given the complexity and relative unknown consequences of overhauling our healthcare system, how will your healthcare proposal allow for addressing and efficiently adapting to unforeseen problems that may arise once enacted?"
Rishi Surana
39. As a medical student interested in family medicine, it seems to be that many are discouraged from ceritan specialties as well as patient populations due to the incredible amount of financial burden that awaits us when we finish training. I am curious as to if the president would consider offering incentives such as partial loan forgiveness to doctors who have finished their residency training, but would like to work in an undeserved urban or rural population?
Lauren Waltersdorf
40. My name is Irini Kolaitis. I am a 3rd year medical student from California. I am interested in pursuing a career in Pediatrics or Med-Peds. My question for the president is as follows: These days, a typical medical school student graduates from medical school with a debt well in excess of $100,000. The magnitude of the debt and the low pay of physicians in primary care makes young doctors opt out of primary care even if they were contemplating a career in primary care when they enrolled in medical school. What can you do to change this situation?
Irini Kolaitis
41. I understand the main objectives of the new health care reform include creating a government-sponsored health insurance program that is available to all Americans, ending discrimination against those with pre-existing conditions, increasing use of preventative health services, and using modalities like EMR to make the business of medicine more efficient and less costly. However, with improvements in place, if a patient lives in a rural area and does not have physical access to sufficient health care then how can they fully benefit from all these changes? Are there any measures in this reform to increase the availability of health care and technology to underserved areas with increase need?
My name is Mary Egbuniwe, I am a first generation Nigerian-American from Greenville, SC. As a rising 4th year medical student, I plan on entering a residency in Ob-Gyn with interests to later sub-specialize in Reproductive Endocrinology. My future career plans include using my training as and Ob-Gyn in underserved areas of Nigeria.
Mary Egbuniwe
42. I will be starting my 3rd year as a medical student at Georgetown in just a couple of weeks and just completed my Step 1 licensing exam two days ago. I grew up in a small city in Western Michigan. I attended the University of Michigan ('02-'06) and received a Bachelors of Science & Engineering in Biomedical Engineering. I then spent a year doing basic research for the National Institute of Allergy & Infectious Disease, NIH, in Rockville, MD before matriculating at Georgetown. I took a selective course in my first year of medical school on health care policy and was able to hear directly in a small group setting from a number of the top minds in health care policy. I continue to be very interested in the changes that lie ahead for health care as both my professional life and the lives of the millions of un-insured stand to be affected by any legislation Congress may pass on the issue. I disagree with President Obama on some key issues related to health care reform and would be thrilled to hear his plan explained first hand.
My question for the President is as follows:
How do you propose moving forward with medical liability reform, if, as you said at AMA recently, you are not for caps? Are you still for affirmative defense? If so, who sets the quality metrics/standards, the federal government or the specialty medical societies?
David Christianson
43. Why not adopt a single payer system or how is your proposed plan better or more efficient in guaranteeing health care for all Americans than a single payer system?
I am an African American Female from Alabama. I am a rising 4th year medical student. I am interested in a combined Internal Medicine/Psychiatry program. I eventually would like to become a Medical Director of a Hospital system or community health center in an urban or inner city area. While at Georgetown, I have served as :
GUSOM Executive Council President of the student body 08-09
Co- President of the American Medical Student Assoc 07/08
SNMA Regional Politcial Advocacy Liasion 07/08
Lbby Day 06/07 for the Healthy Places Act- with AMSA and Obama (a co sponsor of bill) came and spoke to our group
Tracey L. Henry
44. Thank you for giving us Georgetown students such an exciting opportunity.
While the estimates vary regarding exactly how many million uninsured Americans could afford insurance but decide to save their money and remain uninsured, all parties involved in the health care debate can agree that it is a significant percentage. So, what, if any role, should the government play in insuring those individuals who are voluntarily uninsured?
My name is Jeff Mullin, I am a rising fourth year medical student at Georgetown University. Before matriculating to Georgetown, I studied at the University of Notre Dame, where I was the first student ever to earn a BS and a MBA in four years. My MBA studies were geared toward the health care field. I grew up in a single parent household in Pittsburgh with my one older brother. Currently, he works as a self-employed laborer, who has decided to save the 50-100 dollars a month on health insurance; hence, my question.
Jeff Mullin
45. Every year medical school tuition costs are rising and this is making more and more medical students anxious about paying off their loans that exceed $300,000 for some students. Many of us are interested in primary care or academic medicine/research and with this accumulation of debt, many current doctors are warning us of the difficulties of paying off these loans. This may lead to many of us forgoing our passion in primary care or academic medicine and choosing a more specialized field of private medicine in hopes to alleviate our accumulation of debt through better compensation. How will you be able to help medical students interested in primary care and academic medicine/research with this ever increasing debt and rising medical school tuition costs?
Humair Quadri
46. My question is "How are newly graduated physicians, who are upwards of $300,000 in school loan debt, expected to repay their loans in a system where our pay will be salaried/limited by the confines of a system trending toward socialized medicine?"
I am a 4th year student (just finished 3rd year), grew up in Wisconsin and Indiana and went to Wellesley College outside of Boston, worked as a speech writer at the National Science Foundation, am a former Fulbright scholar to Germany before coming to Georgetown SOM. My mother is Chinese who moved to the states for college; my father is 3rd generation German/French/Norwegian.
Thanks,
Andrea Spiker
47. Everyone knows there's a shortage of primary care doctors in medicine right now, and with a national insurance program, we'll need even more. However, I will soon graduate with a quarter of a million dollars in debt, and primary care is notorious for poor reimbursement and patient overload. In what ways will your reform alleviate the burden of debt on medical students so that the fields we choose start to line up with the needs of the American people?
About me: I'm 26 and grew in Baton Rouge, Louisiana, where I learned to make a mean gumbo. My dad is a scientist, and my mom works at Kmart, and I have 2 brothers. I'm a huge LSU fan (They're in the college world series right now!). I moved to DC for college and a Masters degree at American University. I also worked at an OB/GYN for a year as a medical assistant, and I recently finished my second year at Georgetown Med.
Thank you!
Erin Reigh
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