Interview Talking Points

[Monstermed]

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I'm approaching interviews with Drexel and other schools and I'm trying to prepare myself for the basic questions they might ask me about health policy. I've kinda devised a rough outline to organize my thoughts so every other word isn't "uhhh..." and "ummm...". Hope it doesn't come off too rehearsed at the interviews.

In no particular order....

What are the major problems with healthcare?

1. 42+ million uninsured

Problem: Rising group insurance premiums have made it unaffordable for small businesses to provide insurance for their employees. Insurance is most often employment-based, which leaves the unemployed uninsured. Medicaid only covers individuals who meet a baseline standard of poverty, which leaves many people who make too much to qualify for medicaid and too little to afford individual insurance rates.

Possible Solutions: I'm going to avoid trying to argue for universal health care because I don't really believe it's feasible and I don't know enough about it to make a good argument in favor of it. I'm going to suggest that the government give businesses tax incentives to insure more employees and expand the coverage of existing government-funded insurance programs to cover more individuals. Any other solutions that sound reasonable?

2. Rising cost of healthcare

Problem: Insurance premiums continue to rise making healthcare unaffordable for millions of Americans. Increased lifespans, an aging baby-boomer generation and new expensive technologies are raising the cost of healthcare and, consequently, the rise in insurance premiuns (Should I add\subtract something from this list? Should I also blame greedy insurance companies)?

Possible Solutions:
a. Regulation of insurance industry profit margins
b. Tax incentives for individuals
c. More preventative care
d. ?????

3. Malpractice (should I discuss this as part of number 2?)

Problem: Malpractice insurance premiums continue to rise creating an environment that is inhospitable for doctors. The system creates an environment where doctors are scared of the high cost and high stress of litigation, which promotes a "I didn't do it" mentality. Doctors will be less willing to engage in quality improvement when the possibility of litigation over documented practices and mistakes looms over them.

Possible Solutions:
a. Cap pain and suffering damages at 300K to 400K (kinda arbitrary, I guess) and leave economic damages open-ended.
b. Create state review boards composed of physicians to weed out frivolous lawsuits that need not be litigated.
c. Shift insurance premiums away from community-ratings to experience-ratings to allow good physicians to pay lower rates.
d. Make it easier for physicians to report incompetent colleagues.

4. Managed Care vs. Quality Care

Problem: The current managed care system often sets doctors up in a position that can compromise quality care. Fee-for-service payments create a system where doctors will likely perform more services than necessary and a capitation system creates a system where doctors are unwilling to give expensive tests when they risk financial losses. Insurance plans often do not provide funding for tests and drugs that a patient may need, so a physician often has to give alternate drugs or inferior care to suit their financial needs. The system creates a situation where the uninsured and those with high deductibles (cheaper insurance plans) will risk a continued decline in their health over expensive medical bills. The system needs a way to remove financial considerations from medical considerations.

Potential Solutions:
a. Doctors should be paid a set salary so their income is not the dependent on the quantity or quality of service they provide.
b. Doctors should be limited in the number of patients they can cover (not sure about this one...)
c. The list of treatments and medications covered by insurance plans should be increased (no idea how to effect this change...legislation?)

QUESTIONS
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1. Do you agree that these are the most important issues in healthcare? How would you rank them if I had to just choose two?
2. Are there any inaccuracies in the info?
3. Should I omit some solutions? Can you suggest better ones?

I don't want to get into a debate about any of these issues. Maybe I'll do that after my interviews. I'd appreciate some help. I don't have much time left.

 

[Robz]

You know, I am finishing up my MPH and was asked this in a lot of my interviews. I felt the best way to prepare is to have what you believe in and stand your ground. I went into my interviews without a prepared answer and usually when the topics switched over to health care I could talk forever. Made my interviews extra fun to talk about all sorts of health care issues.

 

[Monstermed]

Originally posted by Robz
You know, I am finishing up my MPH and was asked this in a lot of my interviews. I felt the best way to prepare is to have what you believe in and stand your ground. I went into my interviews without a prepared answer and usually when the topics switched over to health care I could talk forever. Made my interviews extra fun to talk about all sorts of health care issues.

I honestly don't have enough knowledge or experience to have these lengthy discussions.

 

[Bendrix]

I think you'll be fine so long as you can define the problems and discuss a few policy alternatives. I'd be careful not to adhere too closely to your talking points, though. Policy questions serve to probe your familiarity with the issues, and by giving clearly rehearsed responses, you tend to demonstrate a lack of familiarity. Try to stay away from the script and to maintain a conversational demeanor. You want to leave the impression that there's nothing unusual about your discussing heath care policy.

Ultimately, it seems that most people spend a bit too much time sweating the policy issues. I think I was only asked one broad policy question over the course of interviews at a dozen schools. I spent far, far more time discussing my reasons for applying to med school and my answer to the tell-me-about-yourself question.