How in depth are we supposed to know Obamacare for the interviews?

[PremedSurvivor]

A common question I've heard gets asked is "What would you change about the healthcare system?" but since there has been a major overhaul recently, would that question be directed more towards "what would you change about the affordable care act?" ?

Also how in depth should we be able to discuss this?

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[Soulstice]

A common question I've heard gets asked is "What would you change about the healthcare system?" but since there has been a major overhaul recently, would that question be directed more towards "what would you change about the affordable care act?" ?

Also how in depth should we be able to discuss this?

Pick any singular aspect as long as you can discuss it well. More often I think the question comes in the form of "What's your take on it?" ... Which is also a VERY broad question but narrow in on an aspect or two and go from there, describing the ACA's take on it, the pros/cons of it, and your interpretation or consensus opinion.

 

[Sardinia]

There have been some interesting articles re: reimbursement of the 340B program.

 

[NickNaylor]

A common question I've heard gets asked is "What would you change about the healthcare system?" but since there has been a major overhaul recently, would that question be directed more towards "what would you change about the affordable care act?" ?

Also how in depth should we be able to discuss this?

I would know the basics: what the major provisions are (e.g., individual mandate, state-based exchanges, changes in how pre-existing conditions/children are covered), what problems those changes try and address, and your evidence-based opinion on why you think those provisions are a good idea or not. No one is expecting you to know everything - healthcare economists still disagree on whether or not the ACA will be effective - but I would focus on understanding as best as you can the failures of our current healthcare system and how the ACA addresses those issues.

 

[as1212559]

I would start by not referring to it as Obamacare. Past that, follow the advice above. You don't need to know crazy amounts about it, and you might not ever be asked about it.

 

[NickNaylor]

I would start by not referring to it as Obamacare.

A good point, though in fairness Obama himself doesn't mind the informal name. I agree though that those who support the ACA generally take "Obamacare" as a pejorative, so you may offend some with that term.

 

[PremedSurvivor]

Thank you, this is some great advice 🙂 I also didn't realize some people might take offense to calling it "Obamacare"; I'm just too lazy to type out the Patient Protection and Affordable Care Act.

 

[NickNaylor]

Thank you, this is some great advice 🙂 I also didn't realize some people might take offense to calling it "Obamacare"; I'm just too lazy to type out the Patient Protection and Affordable Care Act.

It's one of those ridiculous politically correct things to do. Unfortunately that kind of nonsense can matter depending upon who you run into on the interview trail. I would refer to it as the ACA ("A-C-A") to prevent offense in a professional setting.

 

[13132]

I read this book (http://healthcarehandbook.wustl.edu) and it gave me the preparation I needed and then some.

 

[Tipp]

Khan Academy also has a decent really basic review of the ACA. Its on the Khan app under Humanities>American Civics> PPACA or "Obamacare".

 

[Temerit]

Calling it Obamacare is just lazy and very informal. Just go with ACA.

 

[Body Habitus]

I read this book (http://healthcarehandbook.wustl.edu) and it gave me the preparation I needed and then some.

Thanks for pointing this book out, I've been looking for something like it and it seems very well reviewed.

 

[BlueLabel]

An interesting/related question I got at my last interview: "Do you think healthcare is a privilege or a right?"

 

[karayaa]

An interesting/related question I got at my last interview: "Do you think healthcare is a privilege or a right?"

How did you answer it?

 

[Omppu27]

An interesting/related question I got at my last interview: "Do you think healthcare is a privilege or a right?"

Did you really get asked this? That surprises me...

 

[TheWeeIceMan]

You don't need to know the ACA that well. Take the Nancy Pelosi approach.

 

[Escape_Goat]

Alternatively, you can use the Tea Party/GOP approach and just make things up about as you go.

 

[HopefulSlav]

You're supposed to know that it is putting the price burden on young healthy people, giving them a financial incentive by not signing up. Thus destroying the system we're going to have and the only thing that can save them would be.....


You've guessed it: government.

Plus the medical device tax.

Oh, and rationing.

Oh, can't forget about death panels.

 

[HopefulSlav]

You don't need to know the ACA that well. Take the Nancy Pelosi approach.

You have to be admitted before you can see what's in it!

 

[shawshank613]

Michigan also has a short course on the US Healthcare System through Coursera:
https://www.coursera.org/course/ushealthcare

It just started one or two weeks back. I haven't actually done it yet but am planning to watch the video lectures once secondaries are done

 

[NickNaylor]

You're supposed to know that it is putting the price burden on young healthy people, giving them a financial incentive by not signing up. Thus destroying the system we're going to have and the only thing that can save them would be.....


You've guessed it: government.

Plus the medical device tax.

Oh, and rationing.

Oh, can't forget about death panels.

^ This is an example of the kind of stuff to not say.

 

[Redpancreas]

Know the basic clauses:

Medicaid Expansion (is the state you're interviewing in it expanding medicaid? how many new members will be covered?)

No Pre-existing Condition...

Coverage Regulations....

Know that it means that loans repayment schemes are now lower than the rates of payment during residency...


I wouldn't research too much about it though unless you're really interested. Also, I was able to go and hold a position about it due to a couple of economics classes and political experiences I had, but I would avoid a strong position. Willing to acknowledge what you do and don't know is a good quality to have in the medical field.

 

[jazzfragment]

I would avoid a strong position. Willing to acknowledge what you do and don't know is a good quality to have in the medical field.

This is probably good advice, but I can't shake the feeling that because we are always on a ladder, and there is always the chance of offending somebody, that doctors are afraid to advocate for what they think is best for their profession and its role in society.

 

[Redpancreas]

This is probably good advice, but I can't shake the feeling that because we are always on a ladder, and there is always the chance of offending somebody, that doctors are afraid to advocate for what they think is best for their profession and its role in society.

When I get to medical school, I do plan on being outspoken about health policy. It's just that in a precarious interview position, I'm not aiming to get into any fierce debates. I would probably be more well-versed in the potential economic strengths weaknesses of the law than most interviewers but my guesses as compared with the next person's are probably just accurate. The point is not to intellectually "defeat" the interviewer and be crowned with an acceptance (Though I'm not saying that that's what you said either). If anything, that would turn the interview off and it would take valuable time away from: why this school/why medicine. Going back to what you said though, once we gain our medical license, I do not think any organization would be willing to penalize us for speaking our views so long as we act well-reasoned, backed by considerably literature research, acknowledging of weaknesses, moderate, and positive. I'm not looking to do anything extreme here...I'm not trying to ban NPs/legalize all genetic testing/ban embryonic stem cell research but I would be willing to do some things like take a closer look at how pharmaceutical companies are involved in the training of future physicians and explore some options as to how physicians should be compensation (not looking to cut down compensation volume, simply payment method) because those are what I think some of the real problems in our healthcare industry stem from... If someone wants to try and sign a petition to abolish the ACA or perhaps one wants to put all private insurers/practitioners out of business, this is where I think the trouble would and should start at a professional level...I think most who are interested in policy, however, are not absolutists and realize the true complexities of these issues. Those on the left should look to the NHS and its recent struggles and wonder whether universal healthcare is a best option. Those on the right should look at the US' amenable mortality rate as compared to the next top 20 nations in GDP/capita. Also, those who think that it's all "behavioral" and that we should should place unprecedented focus on prevention are simpletons as well in my opinion. There have been numerous studies which have shown that such preventative measures have been more expensive and less efficient (in terms of improving quality of life years) than interventional techniques. The design for success is complex and that's why we need physicians to help acknowledge this and work towards improving our system.

 

[Sardinia]

This is probably good advice, but I can't shake the feeling that because we are always on a ladder, and there is always the chance of offending somebody, that doctors are afraid to advocate for what they think is best for their profession and its role in society.

What are you talking about. Everyone knows PBM's are the ones that do the prescribing for primary care patients. When the over-educated servants in white coats begin to disobey, thrown down the prior authorization thunder bolts to remind them where they stand in the medical hierarchy.

 

[NickNaylor]

What are you talking about. Everyone knows PBM's are the ones that do the prescribing for primary care patients. When the over-educated servants in white coats begin to disobey, thrown down the prior authorization thunder bolts to remind them where they stand in the medical hierarchy.

WOW YOU'RE SO WISE USING THINGS LIKE "PBM" PLS TELL ME HOW HEALTHCARE WORKS???

🙄

 

[1cor1311]

A common question I've heard gets asked is "What would you change about the healthcare system?" but since there has been a major overhaul recently, would that question be directed more towards "what would you change about the affordable care act?" ?

Also how in depth should we be able to discuss this?

Know enough to not call it obamacare.
Also nicknaylors post is more or less what I discussed with my interviewers.

 

[rachanaaa]

The website below explains the ACA simply and concisely, and it answered a bunch of questions I had pre-interview. Hope this helps!

http://obamacarefacts.com/

 

[Kinch]

I was asked very broadly what my thoughts on the law were because I do some volunteering related to it. I pretty briefly mentioned what I thought some of the main pros/cons were, stayed pretty neutral. Afterwards the physician basically said, yeah I have no idea either, I guess we'll find out, and made a slight joke about the website. All in all the convo on this topic lasted about 2-3 minutes. I personally think it would be pretty harsh to judge a premed on their knowledge of the ins and outs of the law unless their a health policy/econ major etc., probably just want to make sure you're aware of it and have considered it to some extent if asked.

Also, for those curious if its a common question, of approximately 15 1-on-1 interviews to date this cycle, this was the one time it was asked.