Doctor David Sundwall will provide the keynote presentation at the 29th National Conference on Primary Health Care Access. The conference will be held April 16-18, 2018 at the Hyatt Regency Monterey (California).
A member of the University of Utah medical school faculty, Doctor Sundwall has served as Director of Public Health for the State of Utah.
He previously had served as Head of the United States Department of Health and Human Services’ Health Resources and Services Administration [HRSA] under Presidents Ronald Reagan and George H. W. Bush.
Previous to that, Dr Sundwall was Minority Consultant (staff member to vice-chair Senator Orrin Hatch) on the United States Senate Labor and Health Committee, chaired by Senator Ted Kennedy.
During Doctor Sundwall’s tenure at HRSA, he oversaw many progressive public health initiatives, including the rejuvenation of the National Health Service Corps [NHSC] and the creation of the NHSC Loan Repayment Program and the Ryan White Act. He is a strong advocate of legislation that advances national public health goals.
Doctor Sundwall’s presentation will discuss the policy issues and politics surrounding the Patient Protection and Affordable Care Act [ACA], still popularly known as ObamaCare. He is a critic of the characterizations of ACA by both the Republican and Democrat political establishments and their campaign operatives.
Doctor Sundwall will address the specific proposals under consideration by He will analyze the role of the state governors (a majority of whom are of the same party as the President and Congress) in proposing how ACA should be changed, as well as how Medicaid should be administered in the future.
The Coastal Research Group hosts the invitational National Conferences on Primary Health Care Access. For the 29th National Conference, we return to the Hyatt Regency Monterey. site of the 1993 and 2009 National Conferences.
The 29th National Conference will take place April 16 through 18, 2018. Invitations and registration forms will be mailed to invitees during the summer of 2017.
The theme of the 29th National Conference will be “What Appears Certain”.
The founding of the Coastal Research Group 34 years ago and the establishment of the National Conferences on Primary Health Care Access in 1990 were both based on the premise that the American health care system was in need of substantive reform.
Although there are many admirable features of American medicine and comprehensive reform has been attempted through 2010’s Patient Protection and Affordable Care Act (PPACA), very serious deficiencies still exist in how American health care is organized and financed. How these deficiencies are to be resolved and how such gains as have been made are to be protected will be the subject of discussion at the National Conference.
PPACA, to which the media have assigned the nicknames “ACA” and “Obamacare” has had a transformative impact on some aspects of the health care system. Yet, although theACA,at the time of the 29th National Conference will have been enacted for more than a half-decade, its ultimate efficacy and impact is still a source of intense debate.
Whatever its ultimate impact, the problems that brought forth the National Conferences – the geographic and specialty distribution of physicians, the lack of an appropriately functioning system of primary care, the lack of effective integration of medicine and public health – all remain concerns.
Over the past 28 National Conferences, much of the discussion has not only identified what should be changed in the health system, but has assessed the intended and unintended consequences of past federal legislation (i.e, Medicare, Medicaid and the prescription drug benefit).
These concerns are at the center of discussion of each of the National Conferences.
The Political Climate in 2017
The Patient Protection and Affordable Care Act has yet to gain the widespread popularity predicted by the legislation’s proponents. Nor has consensus yet emerged at the federal level as how to change it.
A Brief History of the Concept of Primary Health Care Resources
Over a half century ago (1964), the treatise “Health Care is a Community Affair”, called the Folsom Report, was published. The next year (1965), the two principal federal programs for funding health care, Medicare and Medicaid passed, followed in the subsequent year, by the publication of the reports of the Millis and Willard Commissions.
The three reports and two financing mechanisms have had profound results, the former on development of public and private sector policies the latter on how the structure of American health care evolved.
The reports resulted in such familiar concepts as the idea of primary and tertiary health care, programs to address geographic and specialty maldistribution of physicians, especially in rural and “inner city” areas, and creation of new primary health care personnel.
In the meantime, multiple efforts to address poverty in America at the federal level led to the creation of the Office of Economic Opportunity, which promoted such ideas as Neighborhood Health Centers.
With the change in administrations at the federal level in 1968, many of the OEO ideas were institutionalized (made politically more “acceptable”) in federal legislation supporting the Community Health Centers and the National Health Service Corps. Legislation funding the new primary care discipline of Family Medicine passed at the same time as the other “safety net” programs, that had consequences for the evolution of training the family physician.
The effects of the two financing mechanisms were outsized, impacting the structure and organization of any entity that received funding from either. Neither Medicare and Medicaid were developed in concert with the policy recommendations of the Commissions, and thus a half-century of accumulated evidence suggests that the policy bases of health care financing do not synchronize with the policy bases would underlie a rational American health care system.
Issues for further consideration by the 29th National Conference
The following questions, all of which were posed for and discussed at the previous National Conferences, are posed for the faculty and invited participants for the 29th National Conference as well.
What were the changes in American Health Care intended by passage of the “ACA”? To what extent have such changes been effected, with the likelihood that the change is permanent?
Are there unintended changes that have occurred through passage of the “ACA”? Are those changes good or bad?
Because Medicaid historically has differed significantly from state to state, ACA attempted to impose a more consistent approach to the financing of Medicaid recipients between states. To what extent has this effort been successful, and where do problems still exist?
Insurance companies, which evolved historically to assess and contain risk, have been assigned by the ACA the task of advancing the “rights” of health care recipients to care (whom ACA obligated to enroll in a health plan) while charging them with the plan’s actuarial costs. Is this the best way to increase access to health care?
Has the “ACA” enhanced or impeded primary health care access in rural communities, and to “underserved” and disadvantaged populations? What is the anticipated impact of the November 2016 election on the ACA’s progress in providing care access?
What are the effects of changes being implemented in the accreditation of medical schools and postsecondary physician training programs?
How are such innovations as primary care medical homes, teaching community health centers, rural training tracks, hospital-centered community health plans, and accountable care organizations faring? Are there examples of programmatic successes (or failures) that would be of general interest?
Invitations to the 29th National Conference will be sent out in Summer 2017. Those interested in the National Conference and the Invitation Conference should e-mail the conference coordinator, William H. Burnett, at [email protected]
Mark E. Clasen, MD, Ph.D., The Third Charles E. Odegaard Lecture, March, 1996
“In [a Houston, Texas] community health center, a very ill subset of diabetic patients were getting sicker. In this group hemoglobin A1C’s were climbing, and visual and extremity complications were worsening. The physician group asked our diabetic teaching nurse, Gloria O, to break out of her prescribed protocols, and render this group of patients intensive outpatient care. Listening to her counsel her patients in a new way, I heard her use language and imagery that I had never heard her use before.Continue reading ““Access”: The 28th National Conference’s Breakout Groups – Wednesday April 12 2017”
The first event of the 28th National Conference, which opens on Monday April 10, 2017 at the Hyatt Regency New Orleans are seven breakout groups (with breakfast) with an assigned discussion topic.
THE APRIL 10, 2017 SMALL GROUP QUESTION
The following question was a breakout question for the 18th National Conference on Primary Health Care Access, held in April, 2007, three years before passage of the Patient Protection and Affordable Care Act.
Imagine the opportunity for a new discussion of the core elements of PPACA. Would the concerns suggested by the April 2007 question still be relevant today?
“You have been appointed to a citizen’s advisory group that is reporting to Congress on plans to provide health coverage for all uninsured person in the United States. You notice that most members of the advisory group are content to recommend spending whatever it takes to make the current system of care available to everyone.
“You have become concerned about the advisory group making such a recommendation without concurrently recommending reform of the health care system and new attention to the geographic and specialty distribution of the workforce. How do you articulate your concerns in ways that would help focus the public policy debate?”
The breakout group breakdown:
MONDAY APRIL 10, 2017
Group One, BEJINEZ-EASTMAN (LEAD); ALLEN (SCRIBE), North, Soto, Susman
Group Two, BOLTRI (LEAD); ERICKSON, (SCRIBE): Babitz, J.Geyman, Kahn
Group Three, R.FLINDERS (LEAD); E.GEYMAN (SCRIBE); Burnett, Fish, Gomez, Righter
Over the past 28 years, the National Conferences on Primary Health Care Access have been conducted by the Coastal Research Group, a non-profit 501(c)(3) corporation, dedicated to the advancement of the goals of family and community medicine and public health.
The National Conferences are invitational and invitations are by tradition first offered to previous National Conference registrants. Therefore, each conference consists of large majority of conferees who have attended one or more previous conferences in the series.
At the 23rd National Conference in Carlsbad, California a new position of honor was created, the National Conference Scholars. Each of these is a newcomer to the National Conferences, and whose Scholarship has been sponsored by his or her institution as a National Conference participant.
Each National Conference Scholarship bore the name of a current Fellow or Senior Fellow, except for two Memorial National Conference Scholarships honoring a deceased Fellow and Senior Fellow.
The 2017 National Conference Scholars
Jeremy Fish, MD, Muir Healthcare, Walnut Creek, California, has been designated the 2017 Charles Q. North, MD, MS National Conference Scholar
Jessica Flinders, FNP, has been designated the 2017 Marc E. Babitz, MD National Conference Scholar
Ivan Gomez, MD, UCSF Fresno, has been designated the 2017 James Herman, MD National Conference Scholar
Lisa Graves, MD, Western Michigan University Homer Stryker School of Medicine, Kalamazoo, has been designated the 2017 Donald Frey, MD National Conference Scholar
Steven Harrison, MD, Natividad Medical Center, Salinas, California, has been designated the 2017 Rick Flinders MD National Conference Scholar
Kenneth LePage has been designated the 2017 J. Scott Christman National Conference Scholar
Holli Neiman-Hart, MD, has been designated the 2017 John Boltri, MD National Conference Scholar
Erik Porfeli, Ph.D., has been designated the 2017 Gary LeRoy, MD National Conference Scholar
Lisa Righter, MD, has been designated the 2017 Ana Bejinez-Eastman, MD National Conference Scholar
Emilio Russo, MD, has been designated the 2017 John Geyman, MD National Conference Scholar
Valerie Sheridan, DO, has been designated the 2017 William A. Norcross, MD National Conference Scholar
Lisandra Soto, DDS, has been designated the 2017 Samuel Matheny, MD National Conference Scholar
Jeffrey Susman, MD, has been designated the 2017 Norman B. Kahn, Jr, MD National Conference Scholar
Gina Weisblat, Ph.D., has been designtated the 2017 Allan Wilke, MD National Conference Scholar
The 2016 National Conference Scholars
Andrea Clarke, MD, Kaiser Permanente Napa, has been designated the 2016 Jimmy H. Hara National Conference Scholar
Amy McGaha, MD, Creighton University, Omaha, has been designated the 2016 Perry A. Pugno National Conference Scholar
Dennis Means, MD, Kalamazoo Family Health Center, Kalamazoo, Michigan has been designated the 2016 Donald Frey National Conference Scholar
Thomas E. Norris, MD, University of Washington Emeritus, has been designated the 2016 John Geyman National Conference Scholar
Keosha Partlow, Ph.D., Charles R. Drew University, has been designated the 2016 Ana Bejinez-Eastman National Conference Scholar
Adalberto Renteria, MD, has been designated the 2016 Hector Flores National Conference Scholar
Devin Sawyer, MD, Providence Health Systems, Olympia, Washington, has been designated the 2016 Kevin Haughton National Conference Scholar
Sunny Smith, MD, University of California, San Diego, has been designated the 2016 William A. Norcross National Conference Scholar
Sarah Woolsey, MD, has been designated the 2016 James Herman National Conference Scholar
The 2015 National Conference Scholars
J. C. Buller, MD, Associate Dean, Touro University, Vallejo, California, has been designated the 2015 Rick Flinders National Conference Scholar
Maria T. Carriedo-Ceniceros, MD, Vice President and Chief Medical Officer, San Ysidro Health Center, San Ysidro, California, has been designated the Marianne McKennett National Conference Scholar
Emily Dow, MD, Acting Chair, Department of Family Medicine, University of California, Irvine, has been designated the 2015 Joseph E. Scherger National Conference Scholar
Stan Kozakowski, MD, American Academy of Family Physicians, has been designated the 2015 Norman B. Kahn, Jr National Conference Scholar.
Steven Pollens, has ben designated the 2015 Robert Ross National Conference Scholar
JuliusAngelo Ramirez, MD, Western Michigan University School of Medicine, Kalamazoo, has been designated the Allan Wilke National Conference Scholar
Janice Spalding, MD, Northeast Ohio College of Medicine, Rootstown, has been designated the 2015 F. Marian Bishop National Conference Scholar
The 2014 National Conference Scholars
Suzanne M. Allen, the University of Washington Vice Dean for Regional Affairs, based at the WWAMI program in Boise, Idaho, has been designated the 2014 Norman B. Kahn, Jr National Conference Scholar.
Eileen Chaing, CFO of the Family Health Center, Kalamazoo, Michigan, has been designed the 2014 Marianne McKennett National Conference Scholar.
Desiree Cox-Maksimov, MD of Eden Healthcare Consulting Ltd and the University of Exeter, United Kingdom, has been designated the 2014 Jimmy H. Hara National Conference Scholar.
Cheryl Dickson, MD, Associate Dean for Community Health and Health Equity has been designated the 2014 Robert Ross National Conference Scholar.
Walter Mills, MD, of Natividad Medical Center, Salinas, California, has been designated the 2014 Perry A. Pugno National Conference Scholar.
Caryn Slack, MD, of the Utah Department of Health, Medicaid Division, Salt Lake City, has been designated the Michael D. Prislin National Conference Scholar.
The 2013 National Conference Scholars
Michael Fine, MD, Director of Health, State of Rhode Island, has been designated to be the David N. Sundwall National Conference Scholar, named for the former Head of the Health Resources and Services Administration, United States Department of Health and Human Services.
Robert Bowman, MD, A. T. Still University School of Osteopathic Medicine or Arizona, has been designated the Mitchell Kasovac National Conference Scholar, named for an Emeritus Professor of the A. T. Still University SOMA.
Denise Crawford, of the Kalamazoo Family Health Center, has been designated the Virginia Fowkes National Conference Scholar, named for the Senior Research Scholar Emerita, Stanford University School of Medicine.
Mark D. Goodman, MD of Creighton University School of Medicine, has been designated as the Gary F. LeRoy National Conference Scholar, named for the Associate Dean of Student Affairs and Admissions, Wright State University Boonshoft School of Medicine.
Colin Kopes-Kerr, MD of Peach Tree Health Care, Marysville, California, has been designated as the Perry A. Pugno National Conference Scholar, name for the Vice President, Education, of the American Academy of Family Physicians.
Carol Levitt, MD, of Generations Family Health Center, Danielson Connecticut, has been designated as the Cynthia G. Olsen National Conference Scholar, named after the Acting Chair of the Department of Family Medicine at Wright State University Boonshoft School of Medicine.
Eugenie Lewis, MHSA, LCSW, has been designated as the Allan Wilke National Conference Scholar, named after the Chair of the Department of Family and Community Medicine of Western Michigan University School of Medicine.
Carol Wilson Saffold, MD . of the Family Health Center, Kalamazoo, Michigan, has been designated the Ana Bejinez-Eastman National Conference Scholar, after the Associate Program Director, Family Medicine Residency, Presbyterian Intercommunity Hospital of Whittier, California
Elizabeth Schlegel, Ph.D., MBA, of the Ross University, Dominica, West Indies, has been designated the Marc E. Babitz National Conference Scholar, after the Director of the Division of Health Systems Improvement of the Utah Department of Health.
The 2012 National Conference Scholars
David Squire, then a member of the Utah Medical Education Council, received the F. Marian Bishop Memorial National Conference Scholar position, named after the late Chair of the Department of Family and Preventive Medicine at the University of Utah and President of both the Society of Teachers of Family Medicine and the Society of Teachers of Preventive Medicine.
Danielle Renaud, Ph.D., received the Thomas C. Brown Memorial National Conference position. Dr Brown was a major figure in the development of family medicine curricula in several California resident programs.
Sally Bachofer, MD, of the University of New Mexico, received the Charles Q. North National Conference Scholar position, named for the former clinical director of the United States Indian Health Service.
Benjamin Fredrick, MD, of Penn State University/Milton S. Hershey College of Medicine, received the Mark Clasen National Conference Scholar position, named for the emeritus Chair of Family Medicine at Wright State University, Dayton.
Frederick Schwartz, DO, of the A. T. Still College of Osteopathic Medicine, Mesa, Arizona, received the J. Jerry Rodos National Conference Scholar position, named for the former Dean of the Midwestern University College of Osteopathic Medicine.
Ramiro Zuniga, MD, of the San Joaquin General Hospital, French Camp (Stockton), California, received the John Geyman National Conference Scholar position, named for the Emeritus Chair of Family Medicine at the University of Washington.