PracticeLink Magazine

FALL 2017

The career development quarterly for physicians of all specialties, PracticeLink Magazine provides readers with feature articles, compensation stats, helpful job search tips—as well as recruitment ads from organizations across the U.S.

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PracticeLink.com   FALL 2017 39 Experienced and Committed to Quality Patient Care. Get Better! ENGAGE + CONNECT NES Healthcare is among the nation's most experienced multi-hospital emergency and hospital medicine management and staffing groups. Our size and geographic reach allow clinicians an opportunity to travel to desired locations and fast-track to leadership roles. • Small to large volume EDs • Rural and inner-city locations • National footprint and in UK • Residency stipend program • Competitive rates & bonuses • Leadership opportunities • Medical Director mentorship • Paid Insurances • Travel packages • Scribes* OPPORTUNITY BENEFITS Alabama Alaska Arizona Arkansas Connecticut Georgia Illinois Indiana Kentucky Louisiana New Jersey New York Ohio Oklahoma Texas Washington West Virginia CURRENT OPENINGS CONTACT US TODAY www.neshealth-care.com 1.800.394.6376 subsidies under the Senate's Better Care Reconciliation Act would reduce federal outlays by $408 billion over 10 years. According to the Congressional B u d g e t O f f i c e , 9 m i l l i o n people received subsid ies for insurance in 2017. Instead of directly subsidizing pay ment of hea lth i nsu ra nce premiums, the Trump plan would give people tax credits when they purchase insurance. The Kaiser Family Foundation analyzed the impact of eliminating insurance subsidies and substituting tax credits and found that government costs would increase. A ccord i ng to K a iser, when insurance companies lose revenue from lack of federal subsidies for insurance, the insurance companies will raise premiums by an average of 19 percent. The increase in premiums will result in higher tax credits for those who purchase insurance, and, thus, reduce tax revenue to the federal government. Kaiser estimates that added cost to the government by shifting from subsidies to tax credits would be $2.3 billion in 2018. Cuts at NIH President Trump's proposed budget for 2018 cut $5.8 billion from the National Institutes of Health (NI h ). That amounts to an 18 percent cut of NI h 's $31.7 billion budget. Tom Price, Secretary of the Department of Health and Human Services, said the cuts will be for "indirect" costs of research, such as payments that the department makes to universities to cover the administrative costs of running research programs. Congress is likely to push back on the proposed sharp reductions in research spending. Risk pools Establishment of high-risk pools for sale of insurance is among the reforms considered by some Republicans. The pools become pa r ticu la rly i mpor ta nt i f the mandate for individuals to have i nsu ra nce is d ropped a nd i f insurance companies are allowed more flexibility on setting rates, includ ing basing rates on a n individual's pre-existing conditions. In that circumstance, the cost of insurance is likely to become quite high or not be available for some individuals. A high-risk insurance pool would be a market of last resort. If the insurance pool is funded only by the insured's premiums, people seeking insurance may technically have "access" to insurance, but they probably will not be able to afford it. If the government subsidizes the insurance pool, insurance may be affordable, but it will cost the government more money. In this scenario, the government will have closed down some programs, only to have opened others — a strategy that may or may not save money. ● JEFF ATKINSON (JAtkin747@aol.com) is a professor for the Illinois Judicial Conference and has taught health care law at DePaul University College of Law in Chicago. Win! Find your next practice— and enter to win a $500 gift card— at PracticeLink.com/Win.

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