The supreme court approved everything. Insurance Mandate for everyone.
I hope they removed some dental provisions that were not in favor of dentists.
I hope they removed some dental provisions that were not in favor of dentists.
-
CycleTrack and SDN are teaming up to make medical school admissions more transparent and accessible! Read the announcement to learn how we’re supporting the future of CycleTrack’s free application-tracking tools .
Obamacare Passes
Started by Cold Front
Get help with your application
Use all the free resources available to you from SDN: articles, guides, expert advising, forums discussions, and school research.
I don't think he does.
One thing is for sure, the real winners are the insurance companies that just got 30 million potential customers.
The medicaid program will expand, leading to more people on medicaid.
The IRS will expand, to audit and catch people who don't have insurance... this is now a law, and people will pay penalties if they don't have insurance.
I would think that more people having insurance will lead to more patients for dentists.
Even though medicaid reimbursements are low and many insurance plans don't cover dental care... 🙄
I'm glad it passed.
I am not sure how I feel about it yet....But
1. Brushing your teeth, flossing, and not doing meth go a long way. People should be focusing on preventative care.
2. Coming in for a check up every 6 months and getting sealants is a great idea for most people.
3. Gum disease seems to work incredibly fast. people seem to magically not notice their disappearing gums. I don't get what people expect dentists to do once the damage has been done.
1. Brushing your teeth, flossing, and not doing meth go a long way. People should be focusing on preventative care.
2. Coming in for a check up every 6 months and getting sealants is a great idea for most people.
3. Gum disease seems to work incredibly fast. people seem to magically not notice their disappearing gums. I don't get what people expect dentists to do once the damage has been done.
Last edited:
I don't understand do you mean that as in "passed the test" or do you honestly think that it had not been law for several years already?
Ignorance often is reflected in semantics.
Obama cares about the majority because it is what he needs to get elected. This bill is focused on taking from one to give to another. Taking from a few to give to many secures a political future.
I have read on the pains this bill will be in order to marginalize our physician friends but, what will it require of dentists? I have not read on those specific points, thanks.
I have read on the pains this bill will be in order to marginalize our physician friends but, what will it require of dentists? I have not read on those specific points, thanks.
No, the losers are the insurance companies and everyone purchasing their insurance since it's not a single payer system. Since the penalty for not subscribing to the individual mandate isn't severe, a solid majority of the population may opt to simply not carry health insurance and take the less expensive penalty fee. Since there is no penalty to simply hop back in the system when you get sick, and since everyone is now able to get insurance with pre-existing conditions, people will just buy back in when they get sick, more or less.
What will happen is insurance rates will skyrocket with time, as the majority of healthcare costs will be carried by the minority of the population (10%) that carries the majority of the healthcare costs, specifically the elderly. A small minority of insurance companies favored the ACA; most, obviously, were opposed to it, especially BCBS.
I ABSOLUTELY believe in universal health care, and I think it's a fundamental human right to have basic access to treatment. But I think this mess is simply that, a mess, and that American's need to stop being so damn political/ignorant and accept that Canadian/Bismarckian and other international systems WORK, and at a fraction of the cost. Market forces simply should not dictate social institutions like health care, b/c market systems only work when the incentive is to profit. Thus, that's why 18% of our GDP is health-care expenses and why we are bankrupting our economy. However, the ACA does little to limit the skyrocketing costs and that is one of its primary flaws, among many.
Our objective should be the oral and holistic health of the population, not a paycheck. And our focus should be prevention, not secondary or tertiary care.
The bill does address dentistry, mostly preventative aspects of oral health. Hygiene (specially Fluoride) reimbursement fees for dentists might go up as a result of this bill increasing funds for under 21 at medicaid, hygiene and dental school programs.
meanwhile, if you are an adult...
[YOUTUBE]kzw1_2b-I7A[/YOUTUBE]
Canada and other international systems are far behind the US on quality and research standards in their healthcare systems. Plus the taxes are crazy high at those nations, socialized systems have more problems than private systems. Don't just look at the $ problem.
I haven't read the whole the act, but one thing is certain, insurance premiums are gonna be so much more expensive D:..
I like to be an optimist and say that with this increased premium, it might be cheaper to pay (cash + the penalty) for a majority of services, and when you have something severe, just jump onto a plan until you're healed. I'm pretty sure this is what most people will do. Thus, this act might provide us with more cash patients. This is all hypothetical and I'm sure many people would argue that I'm wrong, but hey, I'm trying to make the best out of this situation.
At least I know who I'm voting for this fall ;]
I like to be an optimist and say that with this increased premium, it might be cheaper to pay (cash + the penalty) for a majority of services, and when you have something severe, just jump onto a plan until you're healed. I'm pretty sure this is what most people will do. Thus, this act might provide us with more cash patients. This is all hypothetical and I'm sure many people would argue that I'm wrong, but hey, I'm trying to make the best out of this situation.
At least I know who I'm voting for this fall ;]
So now I'm ignorant because I disagree with you? You know damn well what I meant. I'm glad it didn't get shot down today by the justices.I don't understand do you mean that as in "passed the test" or do you honestly think that it had not been law for several years already?
Ignorance often is reflected in semantics.
Happy now?
The Bismarckian system in Germany has been operating just fine for hundreds of years. The Canadian system has rapidly reduced waiting times, although pharmaceutical costs are rising. The quality of care in those nations is not "bad," it's just not the best. Plus, all of their patients are covered (in Germany not a person pays a penny for health care), physicians/dentists go to school completely subsidized, pay CHEAP malpractice and overhead, and are rewarded stipends to keep their populations healthy, championing preventative medicine and public health.
Do those nations pay higher taxes? Yes, and I think America should, too. You can't finance infrastructure and social institutions like health care or education without appropriate taxation. Americans just need to actually learn what a budget is and practice some self-control and delayed gratification here and there, while progressively taxing the 0.5% and cutting loopholes in the tax code.
There are very few problems with most universal systems. The German, Canadian, French, Japanese, and Taiwanese are far superior to our own overall; the British system is in shambles. America just needs to learn how to share the burden of research costs with other nations.
If you actually want to educate yourself, here ya go.
http://www.oecd.org/document/11/0,3746,en_2649_37407_16502667_1_1_1_37407,00.html#TOC
According to Obama, the American people are not going to see their taxes raised a penny....how would he fund it without raising taxes? That's the only way! And taking it out of the commerce clause and putting it as a tax...smh. I don't think the individual mandate is the way to go and there are examples of both good and bad socialized healthcare systems. Research Poland...(yikes!)
I think as healthcare providers it affects physicians more than dentists, but what happens if the whole system fails...
I think as healthcare providers it affects physicians more than dentists, but what happens if the whole system fails...
There are increased SS taxes, it's just for individuals who make at least $200k or if married filing jointly, $250k.
As a postmodern (INDEPENDENT) I wannred tonwatch both cnn and fox about this but unfortunately I didn't have access. Erin bunnett upfront talked about premium is estimated to go up 3.4% and 7.9% nxt yr. I guess it will eventually go down after so many ppl do regular check up and preventive care. That won't happen for at least 10-15 yr
Btw this country will not turn to uni healtj care within at least 20 yrs. Denmark sweden japan tjeir system works well b/c 1. Much less population or 2. Much more healthy diet.
I think obama care is gokng to the right direction but just concerned about the cost.
Whether this was wrong or not, it is already happened so we should focus more on how itbwill affect our taxes and dentistry.
I think we all need to study that my 2cents
Btw this country will not turn to uni healtj care within at least 20 yrs. Denmark sweden japan tjeir system works well b/c 1. Much less population or 2. Much more healthy diet.
I think obama care is gokng to the right direction but just concerned about the cost.
Whether this was wrong or not, it is already happened so we should focus more on how itbwill affect our taxes and dentistry.
I think we all need to study that my 2cents
Excellent post. The paycheck will still be there as well, however.
yes
This law is designed to destroy the private insurance industry as a first step to single-payer. If that's what you want, congratulations on the court ruling. I have no confidence that this will deliver anything as promised. We were told this would lower costs, provide higher quality, and not increase to the deficit. Seriously. This is the guy who said the oceans would recede and the earth would start to heal because we elected him. Forgive me if I remain skeptical. I can't help but think of the Reagan quote- "I'm from the government and I'm here to help".
I agree with everything you're saying. I voted for him in 08 because of his ideals and what he said his goals were. In the end he is a lair, fraud, a con-man. But, as they say, fool me once shame on you fool me twice shame on me. I will never vote for a democrat again.
Anywhere I can read about these provisions for dentists?
So what are illegal immigrants to do when they show up a doctor's or dental office without insurance? Is it a dead give-away that they're illegal since they don't have insurance? Or could it be that they opted out of having insurance by enjoying a tax hike or penalty? Is it possible to do such a thing?
To opt out of paying taxes when you don't pay them in the first place? Not sure I understand the question.
We better all get on board as a profession before we get sold a bunch of utopian dreams like our physician friends were. This legislation is totally partisan. No tort reform, no insurance purchases across state lines, useless creation of more mid-levels that make little economic sense. Politicians can't be trusted, and will look to ensure their own survival before yours. Guarantee it.
It's going to be really really long, but because it's fitting for this discussion and it should be out there some where on the internet, I searched for the term dental in the 950 page bill and condensed it into the 25 pages that are most relevant to dentistry. You can find the entire bill here: http://housedocs.house.gov/energycommerce/ppacacon.pdf
So Here We Go!
SEC. 2707 ø42 U.S.C. 300gg6¿. COMPREHENSIVE HEALTH INSURANCE
COVERAGE.
(a) COVERAGE FOR ESSENTIAL HEALTH BENEFITS PACKAGE.A
health insurance issuer that offers health insurance coverage in the
individual or small group market shall ensure that such coverage
includes the essential health benefits package required under section 1302(a) of the Patient Protection and Affordable Care Act.
(b) COST-SHARING UNDER GROUP HEALTH PLANS.A group
health plan shall ensure that any annual cost-sharing imposed
under the plan does not exceed the limitations provided for under
paragraphs (1) and (2) of section 1302(c).
(c) CHILD-ONLY PLANS.If a health insurance issuer offers
health insurance coverage in any level of coverage specified under
section 1302(d) of the Patient Protection and Affordable Care Act,
the issuer shall also offer such coverage in that level as a plan in
which the only enrollees are individuals who, as of the beginning
of a plan year, have not attained the age of 21.
(d) DENTAL ONLY.This section shall not apply to a plan described in section 1302(d)(2)(B)(ii)(I).
-----------------------------------------------------------------------------
(b) ESSENTIAL HEALTH BENEFITS.
(1) IN GENERAL.Subject to paragraph (2), the Secretary
shall define the essential health benefits, except that such benefits shall include at least the following general categories and
the items and services covered within the categories:
..........
(F) provide that if a plan described in section
1311(b)(2)(B)(ii) (relating to stand-alone dental benefits
plans) is offered through an Exchange, another health plan
offered through such Exchange shall not fail to be treated
as a qualified health plan solely because the plan does not
offer coverage of benefits offered through the stand-alone
plan that are otherwise required under paragraph (1)(J);
and
(G) periodically review the essential health benefits
under paragraph (1), and provide a report to Congress and
the public that contains
(i) an assessment of whether enrollees are facing
any difficulty accessing needed services for reasons of
coverage or cost;
(ii) an assessment of whether the essential health
benefits needs to be modified or updated to account for
changes in medical evidence or scientific advancement;
(iii) information on how the essential health benefits will be modified to address any such gaps in access
or changes in the evidence base;
(iv) an assessment of the potential of additional or
expanded benefits to increase costs and the interactions between the addition or expansion of benefits
and reductions in existing benefits to meet actuarial
limitations described in paragraph (2); and
(H) periodically update the essential health benefits
under paragraph (1) to address any gaps in access to coverage or changes in the evidence base the Secretary identifies in the review conducted under subparagraph (G).
(5) RULE OF CONSTRUCTION.Nothing in this title shall be
construed to prohibit a health plan from providing benefits in
excess of the essential health benefits described in this subsection.
----------------------------------------------------------------------------------------------
(6) ENROLLMENT PERIODS.The Secretary shall require an
Exchange to provide for
(A) an initial open enrollment, as determined by the
Secretary (such determination to be made not later than
July 1, 2012);
(B) annual open enrollment periods, as determined by
the Secretary for calendar years after the initial enrollment period;
(C) special enrollment periods specified in section 9801
of the Internal Revenue Code of 1986 and other special enrollment periods under circumstances similar to such periods under part D of title XVIII of the Social Security Act;
and
(D) special monthly enrollment periods for Indians (as
defined in section 4 of the Indian Health Care Improvement Act).
(d) REQUIREMENTS.
(1) IN GENERAL.An Exchange shall be a governmental
agency or nonprofit entity that is established by a State.
(2) OFFERING OF COVERAGE.
(A) IN GENERAL.An Exchange shall make available
qualified health plans to qualified individuals and qualified employers.
(B) LIMITATION.
VerDate 0ct 09 2002 13:03 Jun 09, 2010 Jkt 000000 PO 00000 Frm 00072 Fmt 9001 Sfmt 6601 F:\P11\NHI\COMP\PPACACON.005 HOLCPC
June 9, 2010 73 Sec. 1311 PPACA (Consolidated)
(i) IN GENERAL.An Exchange may not make
available any health plan that is not a qualified health
plan.
(ii) OFFERING OF STAND-ALONE DENTAL BENEFITS.Each Exchange within a State shall allow an
issuer of a plan that only provides limited scope dental
benefits meeting the requirements of section
9832(c)(2)(A) of the Internal Revenue Code of 1986 to
offer the plan through the Exchange (either separately
or in conjunction with a qualified health plan) if the
plan provides pediatric dental benefits meeting the requirements of section 1302(b)(1)(J)).
-------------------------------------------------------------------------------------------------------------------------------
(E) SPECIAL RULE FOR PEDIATRIC DENTAL COVERAGE.
For purposes of determining the amount of any monthly
premium, if an individual enrolls in both a qualified health
plan and a plan described in section 1311(d)(2)(B)(ii)(I) of
the Patient Protection and Affordable Care Act for any
plan year, the portion of the premium for the plan described in such section that (under regulations prescribed
by the Secretary) is properly allocable to pediatric dental
benefits which are included in the essential health benefits
required to be provided by a qualified health plan under
section 1302(b)(1)(J) of such Act shall be treated as a premium payable for a qualified health plan.
--------------------------------------------------------------------------------------------------------------
(5) SPECIAL RULE FOR PEDIATRIC DENTAL PLANS.If an individual enrolls in both a qualified health plan and a plan described in section 1311(d)(2)(B)(ii)(I) for any plan year, subsection (a) shall not apply to that portion of any reduction in
cost-sharing under subsection (c) that (under regulations prescribed by the Secretary) is properly allocable to pediatric dental benefits which are included in the essential health benefits
required to be provided by a qualified health plan under section 1302(b)(1)(J)
---------------------------------------------------------------------------------------------------------------------------
SEC. 2801. MACPAC ASSESSMENT OF POLICIES AFFECTING ALL MEDICAID BENEFICIARIES.
(a) IN GENERAL.Section 1900 of the Social Security Act (42
U.S.C. 1396) is amended
(1) in subsection (b)
(A) in paragraph (1)
(i) in the paragraph heading, by inserting FOR
ALL STATES before AND ANNUAL; and
(ii) in subparagraph (A), by striking childrens;
(iii) in subparagraph (B), by inserting , the Secretary, and States after Congress;
VerDate 0ct 09 2002 13:03 Jun 09, 2010 Jkt 000000 PO 00000 Frm 00239 Fmt 9001 Sfmt 6601 F:\P11\NHI\COMP\PPACACON.005 HOLCPC
June 9, 2010 Sec. 2801 PPACA (Consolidated) 240
(iv) in subparagraph (C), by striking March 1
and inserting March 15; and
(v) in subparagraph (D), by striking June 1 and
inserting June 15;
(B) in paragraph (2)
(i) in subparagraph (A)
(I) in clause (i)
(aa) by inserting the efficient provision
of after expenditures for; and
(bb) by striking hospital, skilled nursing
facility, physician, Federally-qualified health
center, rural health center, and other fees
and inserting payments to medical, dental,
and health professionals, hospitals, residential and long-term care providers, providers of
home and community based services, Federally-qualified health centers and rural health
clinics, managed care entities, and providers
of other covered items and services; and
(II) in clause (iii), by inserting (including how
such factors and methodologies enable such beneficiaries to obtain the services for which they are
eligible, affect provider supply, and affect providers that serve a disproportionate share of lowincome and other vulnerable populations) after
beneficiaries;
(ii) by redesignating subparagraphs (B) and (C) as
subparagraphs (F) and (H), respectively;
(iii) by inserting after subparagraph (A), the following:
------------------------------------------------------------------------------------------------------------------------------
PART TORAL HEALTHCARE PREVENTION
ACTIVITIES
SEC. 399LL ø42 U.S.C. 280k¿. ORAL HEALTHCARE PREVENTION EDUCATION CAMPAIGN.
(a) ESTABLISHMENT.The Secretary, acting through the Director of the Centers for Disease Control and Prevention and in consultation with professional oral health organizations, shall, subject
to the availability of appropriations, establish a 5-year national,
public education campaign (referred to in this section as the campaign) that is focused on oral healthcare prevention and education,
including prevention of oral disease such as early childhood and
other caries, periodontal disease, and oral cancer.
(b) REQUIREMENTS.In establishing the campaign, the Secretary shall
(1) ensure that activities are targeted towards specific
populations such as children, pregnant women, parents, the elderly, individuals with disabilities, and ethnic and racial minority populations, including Indians, Alaska Natives and Native Hawaiians (as defined in section 4(c) of the Indian Health
Care Improvement Act) in a culturally and linguistically appropriate manner; and
(2) utilize science-based strategies to convey oral health
prevention messages that include, but are not limited to, community water fluoridation and dental sealants.
(c) PLANNING AND IMPLEMENTATION.Not later than 2 years
after the date of enactment of this section, the Secretary shall
begin implementing the 5-year campaign. During the 2-year period
referred to in the previous sentence, the Secretary shall conduct
planning activities with respect to the campaign.
SEC. 399LL1 ø42 U.S.C. 280k1¿. RESEARCH-BASED DENTAL CARIES
DISEASE MANAGEMENT.
(a) IN GENERAL.The Secretary, acting through the Director
of the Centers for Disease Control and Prevention, shall award
demonstration grants to eligible entities to demonstrate the effectiveness of research-based dental caries disease management activities.
(b) ELIGIBILITY.To be eligible for a grant under this section,
an entity shall
(1) be a community-based provider of dental services (as
defined by the Secretary), including a Federally-qualified
health center, a clinic of a hospital owned or operated by a
State (or by an instrumentality or a unit of government within
a State), a State or local department of health, a dental program of the Indian Health Service, an Indian tribe or tribal organization, or an urban Indian organization (as such terms are
defined in section 4 of the Indian Health Care Improvement
Act), a health system provider, a private provider of dental services, medical, dental, public health, nursing, nutrition educational institutions, or national organizations involved in improving childrens oral health; and
(2) submit to the Secretary an application at such time,
in such manner, and containing such information as the Secretary may require.
(c) USE OF FUNDS.A grantee shall use amounts received
under a grant under this section to demonstrate the effectiveness
of research-based dental caries disease management activities.
(d) USE OF INFORMATION.The Secretary shall utilize information generated from grantees under this section in planning and
implementing the public education campaign under section 399LL.
SEC. 399LL2 ø42 U.S.C. 280k2¿. AUTHORIZATION OF APPROPRIATIONS.
There is authorized to be appropriated to carry out this part,
such sums as may be necessary..
(b) SCHOOL-BASED SEALANT PROGRAMS.Section 317M(c)(1) of
the Public Health Service Act (42 U.S.C. 247b14(c)(1)) is amended
by striking may award grants to States and Indian tribes and inserting shall award a grant to each of the 50 States and territories
and to Indians, Indian tribes, tribal organizations and urban Indian organizations (as such terms are defined in section 4 of the
Indian Health Care Improvement Act).
(c) ORAL HEALTH INFRASTRUCTURE.Section 317M of the Public Health Service Act (42 U.S.C. 247b14) is amended
(1) by redesignating subsections (d) and (e) as subsections
(e) and (f), respectively; and
(2) by inserting after subsection (c), the following:
(d) ORAL HEALTH INFRASTRUCTURE.
(1) COOPERATIVE AGREEMENTS.The Secretary, acting
through the Director of the Centers for Disease Control and
Prevention, shall enter into cooperative agreements with State,
territorial, and Indian tribes or tribal organizations (as those
terms are defined in section 4 of the Indian Health Care Improvement Act) to establish oral health leadership and program guidance, oral health data collection and interpretation,
(including determinants of poor oral health among vulnerable
populations), a multi-dimensional delivery system for oral
health, and to implement science-based programs (including
dental sealants and community water fluoridation) to improve
oral health.
(2) AUTHORIZATION OF APPROPRIATIONS.There is authorized to be appropriated such sums as necessary to carry out
this subsection for fiscal years 2010 through 2014..
(d) UPDATING NATIONAL ORAL HEALTHCARE SURVEILLANCE ACTIVITIES.ø42 U.S.C.280k3¿
(1) PRAMS.
(A) IN GENERAL.The Secretary of Health and Human
Services (referred to in this subsection as the Secretary)
shall carry out activities to update and improve the Pregnancy Risk Assessment Monitoring System (referred to in
this section as PRAMS) as it relates to oral healthcare.
(B) STATE REPORTS AND MANDATORY MEASUREMENTS.
te of enactment of this Act, and every 5 years thereafter, a State shall submit to the Secretary a report
concerning activities conducted within the State under
PRAMS.
(ii) MEASUREMENTS.The oral healthcare measurements developed by the Secretary for use under
PRAMS shall be mandatory with respect to States for
purposes of the State reports under clause (i).
(C) FUNDING.There is authorized to be appropriated
to carry out this paragraph, such sums as may be necessary.
(2) NATIONAL HEALTH AND NUTRITION EXAMINATION SURVEY.The Secretary shall develop oral healthcare components
that shall include tooth-level surveillance for inclusion in the
National Health and Nutrition Examination Survey. Such components shall be updated by the Secretary at least every 6
years. For purposes of this paragraph, the term tooth-level
surveillance means a clinical examination where an examiner
looks at each dental surface, on each tooth in the mouth and
as expanded by the Division of Oral Health of the Centers for
Disease Control and Prevention.
(3) MEDICAL EXPENDITURES PANEL SURVEY.The Secretary
shall ensure that the Medical Expenditures Panel Survey by
the Agency for Healthcare Research and Quality includes the
verification of dental utilization, expenditure, and coverage
findings through conduct of a look-back analysis.
(4) NATIONAL ORAL HEALTH SURVEILLANCE SYSTEM.
(A) APPROPRIATIONS.There is authorized to be appropriated, such sums as may be necessary for each of fiscal
years 2010 through 2014 to increase the participation of
States in the National Oral Health Surveillance System
from 16 States to all 50 States, territories, and District of
Columbia.
(B) REQUIREMENTS.The Secretary shall ensure that
the National Oral Health Surveillance System include the
measurement of early childhood caries.
---------------------------------------------------------------------------------------------------------
SEC. 510 ø29 U.S.C. 794f¿. ESTABLISHMENT OF STANDARDS FOR ACCESSIBLE MEDICAL DIAGNOSTIC EQUIPMENT.
(a) STANDARDS.Not later than 24 months after the date of
enactment of the Affordable Health Choices Act, the Architectural
and Transportation Barriers Compliance Board shall, in consultation with the Commissioner of the Food and Drug Administration,
promulgate regulatory standards in accordance with the Administrative Procedure Act (2 U.S.C. 551 et seq.) setting forth the minimum technical criteria for medical diagnostic equipment used in
(or in conjunction with) physicians offices, clinics, emergency
rooms, hospitals, and other medical settings. The standards shall
ensure that such equipment is accessible to, and usable by, individuals with accessibility needs, and shall allow independent entry to,
use of, and exit from the equipment by such individuals to the
maximum extent possible.
(b) MEDICAL DIAGNOSTIC EQUIPMENT COVERED.The standards issued under subsection (a) for medical diagnostic equipment
shall apply to equipment that includes examination tables, examination chairs (including chairs used for eye examinations or procedures, and dental examinations or procedures), weight scales,
mammography equipment, x-ray machines, and other radiological
equipment commonly used for diagnostic purposes by health professionals.
-----------------------------------------------------------------------------------------------
Subtitle BInnovations in the Health Care
Workforce
SEC. 5101 ø42 U.S.C. 294q¿. NATIONAL HEALTH CARE WORKFORCE COMMISSION.
(a) PURPOSE.It is the purpose of this section to establish a
National Health Care Workforce Commission that
(1) serves as a national resource for Congress, the President, States, and localities;
(2) communicates and coordinates with the Departments of
Health and Human Services, Labor, Veterans Affairs, Homeland Security, and Education on related activities administered
by one or more of such Departments;
(3) develops and commissions evaluations of education and
training activities to determine whether the demand for health
care workers is being met;
(4) identifies barriers to improved coordination at the Federal, State, and local levels and recommend ways to address
such barriers; and
(5) encourages innovations to address population needs,
constant changes in technology, and other environmental factors.
(b) ESTABLISHMENT.There is hereby established the National
Health Care Workforce Commission (in this section referred to as
the Commission).
.....
(3) SPECIFIC TOPICS TO BE REVIEWED.The topics described
in this paragraph include
(A) current health care workforce supply and distribution, including demographics, skill sets, and demands, with
projected demands during the subsequent 10 and 25 year
periods;
(B) health care workforce education and training capacity, including the number of students who have completed education and training, including registered apprenticeships; the number of qualified faculty; the education
and training infrastructure; and the education and training demands, with projected demands during the subsequent 10 and 25 year periods;
(C) the education loan and grant programs in titles
VII and VIII of the Public Health Service Act (42 U.S.C.
292 et seq. and 296 et seq.), with recommendations on
whether such programs should become part of the Higher
Education Act of 1965 (20 U.S.C. 1001 et seq);
(D) the implications of new and existing Federal policies which affect the health care workforce, including
Medicare and Medicaid graduate medical education policies, titles VII and VIII of the Public Health Service Act
(42 U.S.C. 292 et seq. and 296 et seq.), the National
Health Service Corps (with recommendations for aligning
such programs with national health workforce priorities
and goals), and other health care workforce programs, including those supported through the Workforce Investment
Act of 1998 (29 U.S.C. 2801 et seq.), the Carl D. Perkins
Career and Technical Education Act of 2006 (20 U.S.C.
2301 et seq.), the Higher Education Act of 1965 (20 U.S.C.
1001 et seq.), and any other Federal health care workforce
programs;
(E) the health care workforce needs of special populations, such as minorities, rural populations, medically
underserved populations, gender specific needs, individuals
with disabilities, and geriatric and pediatric populations
with recommendations for new and existing Federal policies to meet the needs of these special populations; and (F) recommendations creating or revising national loan
repayment programs and scholarship programs to require
low-income, minority medical students to serve in their
home communities, if designated as medical underserved
community.
(4) HIGH PRIORITY AREAS.
(A) IN GENERAL.The initial high priority topics described in this paragraph include each of the following:
(i) Integrated health care workforce planning that
identifies health care professional skills needed and
maximizes the skill sets of health care professionals
across disciplines.
(ii) An analysis of the nature, scopes of practice,
and demands for health care workers in the enhanced
information technology and management workplace.
(iii) An analysis of how to align Medicare and
Medicaid graduate medical education policies with national workforce goals.
(iv) øAs added by section 10501(a)(3)¿ An analysis
of, and recommendations for, eliminating the barriers
to entering and staying in primary care, including provider compensation.
(v) The education and training capacity, projected
demands, and integration with the health care delivery system of each of the following:
(I) Nursing workforce capacity at all levels.
(II) Oral health care workforce capacity at all
levels.
(III) Mental and behavioral health care workforce capacity at all levels.
(IV) Allied health and public health care
workforce capacity at all levels.
(V) Emergency medical service workforce capacity, including the retention and recruitment of
the volunteer workforce, at all levels.
(VI) The geographic distribution of health
care providers as compared to the identified
health care workforce needs of States and regions.
..........
(i) DEFINITIONS.In this section:
(1) HEALTH CARE WORKFORCE.The term health care
workforce includes all health care providers with direct patient care and support responsibilities, such as physicians,
nurses, nurse practitioners, primary care providers, preventive
medicine physicians, optometrists, ophthalmologists, physician
assistants, pharmacists, dentists, dental hygienists, and other
VerDate 0ct 09 2002 13:03 Jun 09, 2010 Jkt 000000 PO 00000 Frm 00525 Fmt 9001 Sfmt 6601 F:\P11\NHI\COMP\PPACACON.005 HOLCPC
June 9, 2010 Sec. 5102 PPACA (Consolidated) 526
oral healthcare professionals, allied health professionals, doctors of chiropractic, community health workers, health care
paraprofessionals, direct care workers, psychologists and other
behavioral and mental health professionals (including substance abuse prevention and treatment providers), social workers, physical and occupational therapists, certified nurse midwives, podiatrists, the EMS workforce (including professional
and volunteer ambulance personnel and firefighters who perform emergency medical services), licensed complementary and
alternative medicine providers, integrative health practitioners, public health professionals, and any other health professional that the Comptroller General of the United States determines appropriate
(2) HEALTH PROFESSIONALS.The term health professionals includes
(A) dentists, dental hygienists, primary care providers,
specialty physicians, nurses, nurse practitioners, physician
assistants, psychologists and other behavioral and mental
health professionals (including substance abuse prevention
and treatment providers), social workers, physical and occupational therapists, øpossible intended addition by section 10501(a)(3)which amended subsection (i)(2)(B): optometrists, ophthalmologists,¿ public health professionals,
clinical pharmacists, allied health professionals, doctors of
chiropractic, community health workers, school nurses,
certified nurse midwives, podiatrists, licensed complementary and alternative medicine providers, the EMS workforce (including professional and volunteer ambulance personnel and firefighters who perform emergency medical
services), and integrative health practitioners;
(B) national representatives of health professionals;
(C) representatives of schools of medicine, osteopathy,
nursing, dentistry, optometry, pharmacy, chiropractic, allied health, educational programs for public health professionals, behavioral and mental health professionals (as so
defined), social workers, pharmacists, physical and occupational therapists, øpossible intended addition by section
10501(a)(3)which amended subsection (i)(2)(B): optometrists, ophthalmologists,¿ oral health care industry dentistry and dental hygiene, and physician assistants;
(D) representatives of public and private teaching hospitals, and ambulatory health facilities, including Federal
medical facilities; and
(E) any other health professional the Comptroller General of the United States determines appropriate.
---------------------------------------------------------------------------------------------------------
SEC. 748 ø42 U.S.C. 293k2¿. TRAINING IN GENERAL, PEDIATRIC, AND
PUBLIC HEALTH DENTISTRY.
(a) SUPPORT AND DEVELOPMENT OF DENTAL TRAINING PROGRAMS.
(1) IN GENERAL.The Secretary may make grants to, or
enter into contracts with, a school of dentistry, public or nonprofit private hospital, or a public or private nonprofit entity
which the Secretary has determined is capable of carrying out
such grant or contract
(A) to plan, develop, and operate, or participate in, an
approved professional training program in the field of general dentistry, pediatric dentistry, or public health dentistry for dental students, residents, practicing dentists,
dental hygienists, or other approved primary care dental
trainees, that emphasizes training for general, pediatric, or
public health dentistry;
(B) to provide financial assistance to dental students,
residents, practicing dentists, and dental hygiene students
who are in need thereof, who are participants in any such
program, and who plan to work in the practice of general,
pediatric, public heath dentistry, or dental hygiene;
(C) to plan, develop, and operate a program for the
training of oral health care providers who plan to teach in
general, pediatric, public health dentistry, or dental hygiene;
(D) to provide financial assistance in the form of
traineeships and fellowships to dentists who plan to teach
or are teaching in general, pediatric, or public health dentistry;
(E) to meet the costs of projects to establish, maintain, or improve dental faculty development programs in
primary care (which may be departments, divisions or
other units);
(F) to meet the costs of projects to establish, maintain, or improve predoctoral and postdoctoral training in
primary care programs;
(G) to create a loan repayment program for faculty in
dental programs; and
(H) to provide technical assistance to pediatric training programs in developing and implementing instruction
regarding the oral health status, dental care needs, and risk-based clinical disease management of all pediatric
populations with an emphasis on underserved children.
(2) FACULTY LOAN REPAYMENT.
(A) IN GENERAL.A grant or contract under subsection (a)(1)(G) may be awarded to a program of general,
pediatric, or public health dentistry described in such subsection to plan, develop, and operate a loan repayment program under which
(i) individuals agree to serve full-time as faculty
members; and
(ii) the program of general, pediatric or public
health dentistry agrees to pay the principal and interest on the outstanding student loans of the individuals.
(B) MANNER OF PAYMENTS.With respect to the payments described in subparagraph (A)(ii), upon completion
by an individual of each of the first, second, third, fourth,
and fifth years of service, the program shall pay an
amount equal to 10, 15, 20, 25, and 30 percent, respectively, of the individuals student loan balance as calculated based on principal and interest owed at the initiation of the agreement.
(b) ELIGIBLE ENTITY.For purposes of this subsection, entities
eligible for such grants or contracts in general, pediatric, or public
health dentistry shall include entities that have programs in dental
or dental hygiene schools, or approved residency or advanced education programs in the practice of general, pediatric, or public
Too big for one post Part II please make sure not to quote the whole thing if you reply:
health dentistry. Eligible entities may partner with schools of public health to permit the education of dental students, residents, and
dental hygiene students for a master's year in public health at a
school of public health.
‘‘(c) PRIORITIES IN MAKING AWARDS.—With respect to training
provided for under this section, the Secretary shall give priority in
awarding grants or contracts to the following:
‘‘(1) Qualified applicants that propose collaborative projects
between departments of primary care medicine and departments of general, pediatric, or public health dentistry.
‘‘(2) Qualified applicants that have a record of training the
greatest percentage of providers, or that have demonstrated
significant improvements in the percentage of providers, who
enter and remain in general, pediatric, or public health dentistry.
‘‘(3) Qualified applicants that have a record of training individuals who are from a rural or disadvantaged background,
or from underrepresented minorities.
‘‘(4) Qualified applicants that establish formal relationships with Federally qualified health centers, rural health centers, or accredited teaching facilities and that conduct training
of students, residents, fellows, or faculty at the center or facility.
‘‘(5) Qualified applicants that conduct teaching programs
targeting vulnerable populations such as older adults, homeless individuals, victims of abuse or trauma, individuals with
mental health or substance-related disorders, individuals with disabilities, and individuals with HIV/AIDS, and in the riskbased clinical disease management of all populations.
‘‘(6) Qualified applicants that include educational activities
in cultural competency and health literacy.
‘‘(7) Qualified applicants that have a high rate for placing
graduates in practice settings that serve underserved areas or
health disparity populations, or who achieve a significant increase in the rate of placing graduates in such settings.
‘‘(8) Qualified applicants that intend to establish a special
populations oral health care education center or training program for the didactic and clinical education of dentists, dental
health professionals, and dental hygienists who plan to teach
oral health care for people with developmental disabilities, cognitive impairment, complex medical problems, significant physical limitations, and vulnerable elderly.
‘‘(d) APPLICATION.—An eligible entity desiring a grant under
this section shall submit to the Secretary an application at such
time, in such manner, and containing such information as the Secretary may require.
‘‘(e) DURATION OF AWARD.—The period during which payments
are made to an entity from an award of a grant or contract under
subsection (a) shall be 5 years. The provision of such payments
shall be subject to annual approval by the Secretary and subject to
the availability of appropriations for the fiscal year involved to
make the payments.
‘‘(f) AUTHORIZATIONS OF APPROPRIATIONS.—For the purpose of
carrying out subsections (a) and (b), there is authorized to be appropriated $30,000,000 for fiscal year 2010 and such sums as may
be necessary for each of fiscal years 2011 through 2015.
‘‘(g) CARRYOVER FUNDS.—An entity that receives an award
under this section may carry over funds from 1 fiscal year to another without obtaining approval from the Secretary. In no case
may any funds be carried over pursuant to the preceding sentence
for more than 3 years.''.
SEC. 5304. ALTERNATIVE DENTAL HEALTH CARE PROVIDERS DEMONSTRATION PROJECT.
Subpart X of part D of title III of the Public Health Service Act
(42 U.S.C. 256f et seq.) is amended by adding at the end the following:
‘‘SEC. 340G–1 ø42 U.S.C. 256g–1¿. DEMONSTRATION PROGRAM.
‘‘(a) IN GENERAL.—
‘‘(1) AUTHORIZATION.—The Secretary is authorized to
award grants to 15 eligible entities to enable such entities to
establish a demonstration program to establish training programs to train, or to employ, alternative dental health care
providers in order to increase access to dental health care services in rural and other underserved communities.
‘‘(2) DEFINITION.—The term ‘alternative dental health care
providers' includes community dental health coordinators, advance practice dental hygienists, independent dental hygienists, supervised dental hygienists, primary care physicians,
dental therapists, dental health aides, and any other health
professional that the Secretary determines appropriate. disabilities, and individuals with HIV/AIDS, and in the riskbased clinical disease management of all populations.
‘‘(6) Qualified applicants that include educational activities
in cultural competency and health literacy.
‘‘(7) Qualified applicants that have a high rate for placing
graduates in practice settings that serve underserved areas or
health disparity populations, or who achieve a significant increase in the rate of placing graduates in such settings.
‘‘(8) Qualified applicants that intend to establish a special
populations oral health care education center or training program for the didactic and clinical education of dentists, dental
health professionals, and dental hygienists who plan to teach
oral health care for people with developmental disabilities, cognitive impairment, complex medical problems, significant physical limitations, and vulnerable elderly.
‘‘(d) APPLICATION.—An eligible entity desiring a grant under
this section shall submit to the Secretary an application at such
time, in such manner, and containing such information as the Secretary may require.
‘‘(e) DURATION OF AWARD.—The period during which payments
are made to an entity from an award of a grant or contract under
subsection (a) shall be 5 years. The provision of such payments
shall be subject to annual approval by the Secretary and subject to
the availability of appropriations for the fiscal year involved to
make the payments.
‘‘(f) AUTHORIZATIONS OF APPROPRIATIONS.—For the purpose of
carrying out subsections (a) and (b), there is authorized to be appropriated $30,000,000 for fiscal year 2010 and such sums as may
be necessary for each of fiscal years 2011 through 2015.
‘‘(g) CARRYOVER FUNDS.—An entity that receives an award
under this section may carry over funds from 1 fiscal year to another without obtaining approval from the Secretary. In no case
may any funds be carried over pursuant to the preceding sentence
for more than 3 years.''.
SEC. 5304. ALTERNATIVE DENTAL HEALTH CARE PROVIDERS DEMONSTRATION PROJECT.
Subpart X of part D of title III of the Public Health Service Act
(42 U.S.C. 256f et seq.) is amended by adding at the end the following:
‘‘SEC. 340G–1 ø42 U.S.C. 256g–1¿. DEMONSTRATION PROGRAM.
‘‘(a) IN GENERAL.—
‘‘(1) AUTHORIZATION.—The Secretary is authorized to
award grants to 15 eligible entities to enable such entities to
establish a demonstration program to establish training programs to train, or to employ, alternative dental health care
providers in order to increase access to dental health care services in rural and other underserved communities.
‘‘(2) DEFINITION.—The term ‘alternative dental health care
providers' includes community dental health coordinators, advance practice dental hygienists, independent dental hygienists, supervised dental hygienists, primary care physicians,
dental therapists, dental health aides, and any other health
professional that the Secretary determines appropriate.disabilities, and individuals with HIV/AIDS, and in the riskbased clinical disease management of all populations.
‘‘(6) Qualified applicants that include educational activities
in cultural competency and health literacy.
‘‘(7) Qualified applicants that have a high rate for placing
graduates in practice settings that serve underserved areas or
health disparity populations, or who achieve a significant increase in the rate of placing graduates in such settings.
‘‘(8) Qualified applicants that intend to establish a special
populations oral health care education center or training program for the didactic and clinical education of dentists, dental
health professionals, and dental hygienists who plan to teach
oral health care for people with developmental disabilities, cognitive impairment, complex medical problems, significant physical limitations, and vulnerable elderly.
‘‘(d) APPLICATION.—An eligible entity desiring a grant under
this section shall submit to the Secretary an application at such
time, in such manner, and containing such information as the Secretary may require.
‘‘(e) DURATION OF AWARD.—The period during which payments
are made to an entity from an award of a grant or contract under
subsection (a) shall be 5 years. The provision of such payments
shall be subject to annual approval by the Secretary and subject to
the availability of appropriations for the fiscal year involved to
make the payments.
‘‘(f) AUTHORIZATIONS OF APPROPRIATIONS.—For the purpose of
carrying out subsections (a) and (b), there is authorized to be appropriated $30,000,000 for fiscal year 2010 and such sums as may
be necessary for each of fiscal years 2011 through 2015.
‘‘(g) CARRYOVER FUNDS.—An entity that receives an award
under this section may carry over funds from 1 fiscal year to another without obtaining approval from the Secretary. In no case
may any funds be carried over pursuant to the preceding sentence
for more than 3 years.''.
SEC. 5304. ALTERNATIVE DENTAL HEALTH CARE PROVIDERS DEMONSTRATION PROJECT.
Subpart X of part D of title III of the Public Health Service Act
(42 U.S.C. 256f et seq.) is amended by adding at the end the following:
‘‘SEC. 340G–1 ø42 U.S.C. 256g–1¿. DEMONSTRATION PROGRAM.
‘‘(a) IN GENERAL.—
‘‘(1) AUTHORIZATION.—The Secretary is authorized to
award grants to 15 eligible entities to enable such entities to
establish a demonstration program to establish training programs to train, or to employ, alternative dental health care
providers in order to increase access to dental health care services in rural and other underserved communities.
‘‘(2) DEFINITION.—The term ‘alternative dental health care
providers' includes community dental health coordinators, advance practice dental hygienists, independent dental hygienists, supervised dental hygienists, primary care physicians,
dental therapists, dental health aides, and any other health
professional that the Secretary determines appropriate.
‘‘(b) TIMEFRAME.—The demonstration projects funded under
this section shall begin not later than 2 years after the date of enactment of this section, and shall conclude not later than 7 years
after such date of enactment.
‘‘(c) ELIGIBLE ENTITIES.—To be eligible to receive a grant under
subsection (a), an entity shall—
‘‘(1) be—
‘‘(A) an institution of higher education, including a
community college;
‘‘(B) a public-private partnership;
‘‘(C) a federally qualified health center;
‘‘(D) an Indian Health Service facility or a tribe or
tribal organization (as such terms are defined in section 4
of the Indian Self-Determination and Education Assistance
Act);
‘‘(E) a State or county public health clinic, a health facility operated by an Indian tribe or tribal organization, or
urban Indian organization providing dental services; or
‘‘(F) a public hospital or health system;
‘‘(2) be within a program accredited by the Commission on
Dental Accreditation or within a dental education program in
an accredited institution; and
‘‘(3) shall submit an application to the Secretary at such
time, in such manner, and containing such information as the
Secretary may require.
‘‘(d) ADMINISTRATIVE PROVISIONS.—
‘‘(1) AMOUNT OF GRANT.—Each grant under this section
shall be in an amount that is not less than $4,000,000 for the
5-year period during which the demonstration project being
conducted.
‘‘(2) DISBURSEMENT OF FUNDS.—
‘‘(A) PRELIMINARY DISBURSEMENTS.—Beginning 1 year
after the enactment of this section, the Secretary may disperse to any entity receiving a grant under this section not
more than 20 percent of the total funding awarded to such
entity under such grant, for the purpose of enabling the
entity to plan the demonstration project to be conducted
under such grant.
‘‘(B) SUBSEQUENT DISBURSEMENTS.—The remaining
amount of grant funds not dispersed under subparagraph
(A) shall be dispersed such that not less than 15 percent
of such remaining amount is dispersed each subsequent
year.
‘‘(e) COMPLIANCE WITH STATE REQUIREMENTS.—Each entity receiving a grant under this section shall certify that it is in compliance with all applicable State licensing requirements.
‘‘(f) EVALUATION.—The Secretary shall contract with the Director of the Institute of Medicine to conduct a study of the demonstration programs conducted under this section that shall provide analysis, based upon quantitative and qualitative data, regarding access to dental health care in the United States.
‘‘(g) CLARIFICATION REGARDING DENTAL HEALTH AIDE PROGRAM.—Nothing in this section shall prohibit a dental health aide training program approved by the Indian Health Service from
being eligible for a grant under this section.
‘‘(h) AUTHORIZATION OF APPROPRIATIONS.—There is authorized
to be appropriated such sums as may be necessary to carry out this
section.''
‘‘PART D—UNITED STATES PUBLIC HEALTH
SCIENCES TRACK
‘‘SEC. 271 ø42 U.S.C. 239l¿. ESTABLISHMENT.
‘‘(a) UNITED STATES PUBLIC HEALTH SERVICES TRACK.—
‘‘(1) IN GENERAL.—There is hereby authorized to be established a United States Public Health Sciences Track (referred
to in this part as the ‘Track'), at sites to be selected by the Secretary, with authority to grant appropriate advanced degrees
in a manner that uniquely emphasizes team-based service,
public health, epidemiology, and emergency preparedness and
response. It shall be so organized as to graduate not less
than—
‘‘(A) 150 medical students annually, 10 of whom shall
be awarded studentships to the Uniformed Services University of Health Sciences;
‘‘(B) 100 dental students annually;
‘‘(C) 250 nursing students annually;
‘‘(D) 100 public health students annually;
‘‘(E) 100 behavioral and mental health professional
students annually;
‘‘(F) 100 physician assistant or nurse practitioner students annually; and
‘‘(G) 50 pharmacy students annually.
‘‘(2) LOCATIONS.—The Track shall be located at existing
and accredited, affiliated health professions education training
programs at academic health centers located in regions of the
United States determined appropriate by the Surgeon General,
in consultation with the National Health Care Workforce Commission established in section 5101 of the Patient Protection
and Affordable Care Act.
‘‘(b) NUMBER OF GRADUATES.—Except as provided in subsection
(a), the number of persons to be graduated from the Track shall be
prescribed by the Secretary. In so prescribing the number of persons to be graduated from the Track, the Secretary shall institute
actions necessary to ensure the maximum number of first-year enrollments in the Track consistent with the academic capacity of the
affiliated sites and the needs of the United States for medical, dental, and nursing personnel. ‘‘(c) DEVELOPMENT.—The development of the Track may be by
such phases as the Secretary may prescribe subject to the requirements of subsection (a).
‘‘(d) INTEGRATED LONGITUDINAL PLAN.—The Surgeon General
shall develop an integrated longitudinal plan for health professions
continuing education throughout the continuum of health-related
education, training, and practice. Training under such plan shall
emphasize patient-centered, interdisciplinary, and care coordination skills. Experience with deployment of emergency response
teams shall be included during the clinical experiences.
‘‘(e) FACULTY DEVELOPMENT.—The Surgeon General shall develop faculty development programs and curricula in decentralized
venues of health care, to balance urban, tertiary, and inpatient
venues.
…..
‘‘(d) PROGRAMS.—The Surgeon General may establish the following educational programs for Track students:
VerDate 0ct 09 2002 13:03 Jun 09, 2010 Jkt 000000 PO 00000 Frm 00568 Fmt 9001 Sfmt 6601 F:\P11\NHI\COMP\PPACACON.005 HOLCPC
June 9, 2010 569 Sec. 5315 PPACA (Consolidated) \272 PHSA
‘‘(1) Postdoctoral, postgraduate, and technological programs.
‘‘(2) A cooperative program for medical, dental, physician
assistant, pharmacy, behavioral and mental health, public
health, and nursing students.
‘‘(3) Other programs that the Surgeon General determines
necessary in order to operate the Track in a cost-effective manner.
‘‘(e) CONTINUING MEDICAL EDUCATION.—The Surgeon General
shall establish programs in continuing medical education for members of the health professions to the end that high standards of
health care may be maintained within the United States.
‘‘(f) AUTHORITY OF THE SURGEON GENERAL.—
‘‘(1) IN GENERAL.—The Surgeon General is authorized—
‘‘(A) to enter into contracts with, accept grants from,
and make grants to any nonprofit entity for the purpose of
carrying out cooperative enterprises in medical, dental,
physician assistant, pharmacy, behavioral and mental
health, public health, and nursing research, consultation,
and education
…..
‘‘(3) SCIENTISTS.—Scientists or other medical, dental, or
nursing personnel utilized by the Track under an agreement
described in paragraph (1) may be appointed to any position
within the Track and may be permitted to perform such duties
within the Track as the Surgeon General may approve
….
‘‘SEC. 273 ø42 U.S.C. 239l–2¿. STUDENTS; SELECTION; OBLIGATION.
‘‘(a) STUDENT SELECTION.—
‘‘(1) IN GENERAL.—Medical, dental, physician assistant,
pharmacy, behavioral and mental health, public health, and
nursing students at the Track shall be selected under procedures prescribed by the Surgeon General. In so prescribing, the
Surgeon General shall consider the recommendations of the
National Health Care Workforce Commission.
‘‘(2) PRIORITY.—In developing admissions procedures under
paragraph (1), the Surgeon General shall ensure that such procedures give priority to applicant medical, dental, physician assistant, pharmacy, behavioral and mental health, public
health, and nursing students from rural communities and
underrepresented minorities.
‘‘(b) CONTRACT AND SERVICE OBLIGATION.—
‘‘(1) CONTRACT.—Upon being admitted to the Track, a medical, dental, physician assistant, pharmacy, behavioral and
mental health, public health, or nursing student shall enter
into a written contract with the Surgeon General that shall
contain—
‘‘(A) an agreement under which—
‘‘(i) subject to subparagraph (B), the Surgeon General agrees to provide the student with tuition (or tuition remission) and a student stipend (described in
paragraph (2)) in each school year for a period of years
(not to exceed 4 school years) determined by the student, during which period the student is enrolled in
the Track at an affiliated or other participating health
professions institution pursuant to an agreement between the Track and such institution; and
‘‘(ii) subject to subparagraph (B), the student
agrees—
‘‘(I) to accept the provision of such tuition and
student stipend to the student;
‘‘(II) to maintain enrollment at the Track until
the student completes the course of study involved;
‘‘(III) while enrolled in such course of study, to
maintain an acceptable level of academic standing
(as determined by the Surgeon General);
‘‘(IV) if pursuing a degree from a school of
medicine or osteopathic medicine, dental, public
health, or nursing school or a physician assistant,
pharmacy, or behavioral and mental health professional program, to complete a residency or internship in a specialty that the Surgeon General
determines is appropriate; and
‘‘(V) to serve for a period of time (referred to
in this part as the ‘period of obligated service')
within the Commissioned Corps of the Public
Health Service equal to 2 years for each school year during which such individual was enrolled at
the College, reduced as provided for in paragraph
(3);
‘‘(B) a provision that any financial obligation of the
United States arising out of a contract entered into under
this part and any obligation of the student which is conditioned thereon, is contingent upon funds being appropriated to carry out this part;
‘‘(C) a statement of the damages to which the United
States is entitled for the student's breach of the contract;
and
‘‘(D) such other statements of the rights and liabilities
of the Secretary and of the individual, not inconsistent
with the provisions of this part.
‘‘(2) TUITION AND STUDENT STIPEND.—
‘‘(A) TUITION REMISSION RATES.—The Surgeon General,
based on the recommendations of the National Health
Care Workforce Commission, shall establish Federal tuition remission rates to be used by the Track to provide reimbursement to affiliated and other participating health
professions institutions for the cost of educational services
provided by such institutions to Track students. The agreement entered into by such participating institutions under
paragraph (1)(A)(i) shall contain an agreement to accept as
payment in full the established remission rate under this
subparagraph.
‘‘(B) STIPEND.—The Surgeon General, based on the
recommendations of the National Health Care Workforce
Commission, shall establish and update Federal stipend
rates for payment to students under this part.
‘‘(3) REDUCTIONS IN THE PERIOD OF OBLIGATED SERVICE.—
The period of obligated service under paragraph (1)(A)(ii)(V)
shall be reduced—
‘‘(A) in the case of a student who elects to participate
in a high-needs speciality residency (as determined by the
National Health Care Workforce Commission), by 3
months for each year of such participation (not to exceed
a total of 12 months); and
‘‘(B) in the case of a student who, upon completion of
their residency, elects to practice in a Federal medical facility (as defined in section 781(e)) that is located in a
health professional shortage area (as defined in section
332), by 3 months for year of full-time practice in such a
facility (not to exceed a total of 12 months).
‘‘(c) SECOND 2 YEARS OF SERVICE.—During the third and fourth
years in which a medical, dental, physician assistant, pharmacy,
behavioral and mental health, public health, or nursing student is
enrolled in the Track, training should be designed to prioritize clinical rotations in Federal medical facilities in health professional
shortage areas, and emphasize a balance of hospital and community-based experiences, and training within interdisciplinary
teams.
‘‘(d) DENTIST, PHYSICIAN ASSISTANT, PHARMACIST, BEHAVIORAL
AND MENTAL HEALTH PROFESSIONAL, PUBLIC HEALTH PROFES SIONAL, AND NURSE TRAINING.—The Surgeon General shall establish provisions applicable with respect to dental, physician assistant, pharmacy, behavioral and mental health, public health, and
nursing students that are comparable to those for medical students
under this section, including service obligations, tuition support,
and stipend support. The Surgeon General shall give priority to
health professions training institutions that train medical, dental,
physician assistant, pharmacy, behavioral and mental health, public health, and nursing students for some significant period of time
together, but at a minimum have a discrete and shared core curriculum.
‘‘(e) ELITE FEDERAL DISASTER TEAMS.—The Surgeon General,
in consultation with the Secretary, the Director of the Centers for
Disease Control and Prevention, and other appropriate military
and Federal government agencies, shall develop criteria for the appointment of highly qualified Track faculty, medical, dental, physician assistant, pharmacy, behavioral and mental health, public
health, and nursing students, and graduates to elite Federal disaster preparedness teams to train and to respond to public health
emergencies, natural disasters, bioterrorism events, and other
emergencies.
‘‘(f) STUDENT DROPPED FROM TRACK IN AFFILIATE SCHOOL.—A
medical, dental, physician assistant, pharmacy, behavioral and
mental health, public health, or nursing student who, under regulations prescribed by the Surgeon General, is dropped from the
Track in an affiliated school for deficiency in conduct or studies, or
for other reasons, shall be liable to the United States for all tuition
and stipend support provided to the student.
‘‘SEC. 274 ø42 U.S.C. 239l–3¿. FUNDING.
‘‘Beginning with fiscal year 2010, the Secretary shall transfer
from the Public Health and Social Services Emergency Fund such
sums as may be necessary to carry out this part.''. SEC. 5508. INCREASING TEACHING CAPACITY.
(a) TEACHING HEALTH CENTERS TRAINING AND ENHANCEMENT.—Part C of title VII of the Public Health Service Act (42
U.S.C. 293k et. seq.), as amended by section 5303, is further
amended by inserting after section 749 the following:
‘‘SEC. 749A ø42 U.S.C. 293l–1¿. TEACHING HEALTH CENTERS DEVELOPMENT GRANTS.
‘‘(a) PROGRAM AUTHORIZED.—The Secretary may award grants
under this section to teaching health centers for the purpose of establishing new accredited or expanded primary care residency programs.
‘‘(b) AMOUNT AND DURATION.—Grants awarded under this section shall be for a term of not more than 3 years and the maximum
award may not be more than $500,000.
‘‘(c) USE OF FUNDS.—Amounts provided under a grant under
this section shall be used to cover the costs of—
‘‘(1) establishing or expanding a primary care residency
training program described in subsection (a), including costs
associated with—
‘‘(A) curriculum development;
‘‘(B) recruitment, training and retention of residents
and faculty:
‘‘(C) accreditation by the Accreditation Council for
Graduate Medical Education (ACGME), the American Dental Association (ADA), or the American Osteopathic Association (AOA); and
‘‘(D) faculty salaries during the development phase;
and
‘‘(2) technical assistance provided by an eligible entity.
‘‘(d) APPLICATION.—A teaching health center seeking a grant
under this section shall submit an application to the Secretary at
such time, in such manner, and containing such information as the
Secretary may require.
‘‘(e) PREFERENCE FOR CERTAIN APPLICATIONS.—In selecting recipients for grants under this section, the Secretary shall give preference to any such application that documents an existing affiliation agreement with an area health education center program as
defined in sections 751 and 799B
PART 3—INDIAN HEALTH CARE
IMPROVEMENT
SEC. 10221. INDIAN HEALTH CARE IMPROVEMENT.
(a) IN GENERAL.—Except as provided in subsection (b), S. 1790
entitled ‘‘A bill to amend the Indian Health Care Improvement Act
to revise and extend that Act, and for other purposes.'', as reported
by the Committee on Indian Affairs of the Senate in December
2009, is enacted into law. øThe bill, as enacted and amended by
subsection (b), is shown in a separate compiled document.¿
(b) AMENDMENTS.—øAmendments below are incorporated into
the separate compiled document.¿
(1) Section 119 of the Indian Health Care Improvement
Act (as amended by section 111 of the bill referred to in subsection (a)) is amended—
(A) in subsection (d)—
(i) in paragraph (2), by striking ‘‘In establishing''
and inserting ‘‘Subject to paragraphs (3) and (4), in establishing''; and
(ii) by adding at the end the following:
‘‘(3) ELECTION OF INDIAN TRIBE OR TRIBAL ORGANIZATION.—
‘‘(A) IN GENERAL.—Subparagraph (B) of paragraph (2)
shall not apply in the case of an election made by an Indian tribe or tribal organization located in a State (other
than Alaska) in which the use of dental health aide therapist services or midlevel dental health provider services is
authorized under State law to supply such services in accordance with State law.
‘‘(B) ACTION BY SECRETARY.—On an election by an Indian tribe or tribal organization under subparagraph (A),
the Secretary, acting through the Service, shall facilitate
implementation of the services elected.
‘‘(4) VACANCIES.—The Secretary shall not fill any vacancy
for a certified dentist in a program operated by the Service
with a dental health aide therapist.''; and
(B) by adding at the end the following:
‘‘(e) EFFECT OF SECTION.—Nothing in this section shall restrict
the ability of the Service, an Indian tribe, or a tribal organization
to participate in any program or to provide any service authorized
by any other Federal law.'
SEC. 10502. INFRASTRUCTURE TO EXPAND ACCESS TO CARE.
(a) APPROPRIATION.—There are authorized to be appropriated,
and there are appropriated to the Department of Health and
Human Services, $100,000,000 for fiscal year 2010, to remain available for obligation until September 30, 2011, to be used for debt
service on, or direct construction or renovation of, a health care facility that provides research, inpatient tertiary care, or outpatient
clinical services. Such facility shall be affiliated with an academic
health center at a public research university in the United States
that contains a State's sole public academic medical and dental
school.
(b) REQUIREMENT.—Amount appropriated under subsection (a)
may only be made available by the Secretary of Health and Human
Services upon the receipt of an application from the Governor of a
State that certifies that—
(1) the new health care facility is critical for the provision
of greater access to health care within the State;
(2) such facility is essential for the continued financial viability of the State's sole public medical and dental school and
its academic health center;
(3) the request for Federal support represents not more
than 40 percent of the total cost of the proposed new facility;
and
(4) the State has established a dedicated funding mechanism to provide all remaining funds necessary to complete the
construction or renovation of the proposed facility
health dentistry. Eligible entities may partner with schools of public health to permit the education of dental students, residents, and
dental hygiene students for a master's year in public health at a
school of public health.
‘‘(c) PRIORITIES IN MAKING AWARDS.—With respect to training
provided for under this section, the Secretary shall give priority in
awarding grants or contracts to the following:
‘‘(1) Qualified applicants that propose collaborative projects
between departments of primary care medicine and departments of general, pediatric, or public health dentistry.
‘‘(2) Qualified applicants that have a record of training the
greatest percentage of providers, or that have demonstrated
significant improvements in the percentage of providers, who
enter and remain in general, pediatric, or public health dentistry.
‘‘(3) Qualified applicants that have a record of training individuals who are from a rural or disadvantaged background,
or from underrepresented minorities.
‘‘(4) Qualified applicants that establish formal relationships with Federally qualified health centers, rural health centers, or accredited teaching facilities and that conduct training
of students, residents, fellows, or faculty at the center or facility.
‘‘(5) Qualified applicants that conduct teaching programs
targeting vulnerable populations such as older adults, homeless individuals, victims of abuse or trauma, individuals with
mental health or substance-related disorders, individuals with disabilities, and individuals with HIV/AIDS, and in the riskbased clinical disease management of all populations.
‘‘(6) Qualified applicants that include educational activities
in cultural competency and health literacy.
‘‘(7) Qualified applicants that have a high rate for placing
graduates in practice settings that serve underserved areas or
health disparity populations, or who achieve a significant increase in the rate of placing graduates in such settings.
‘‘(8) Qualified applicants that intend to establish a special
populations oral health care education center or training program for the didactic and clinical education of dentists, dental
health professionals, and dental hygienists who plan to teach
oral health care for people with developmental disabilities, cognitive impairment, complex medical problems, significant physical limitations, and vulnerable elderly.
‘‘(d) APPLICATION.—An eligible entity desiring a grant under
this section shall submit to the Secretary an application at such
time, in such manner, and containing such information as the Secretary may require.
‘‘(e) DURATION OF AWARD.—The period during which payments
are made to an entity from an award of a grant or contract under
subsection (a) shall be 5 years. The provision of such payments
shall be subject to annual approval by the Secretary and subject to
the availability of appropriations for the fiscal year involved to
make the payments.
‘‘(f) AUTHORIZATIONS OF APPROPRIATIONS.—For the purpose of
carrying out subsections (a) and (b), there is authorized to be appropriated $30,000,000 for fiscal year 2010 and such sums as may
be necessary for each of fiscal years 2011 through 2015.
‘‘(g) CARRYOVER FUNDS.—An entity that receives an award
under this section may carry over funds from 1 fiscal year to another without obtaining approval from the Secretary. In no case
may any funds be carried over pursuant to the preceding sentence
for more than 3 years.''.
SEC. 5304. ALTERNATIVE DENTAL HEALTH CARE PROVIDERS DEMONSTRATION PROJECT.
Subpart X of part D of title III of the Public Health Service Act
(42 U.S.C. 256f et seq.) is amended by adding at the end the following:
‘‘SEC. 340G–1 ø42 U.S.C. 256g–1¿. DEMONSTRATION PROGRAM.
‘‘(a) IN GENERAL.—
‘‘(1) AUTHORIZATION.—The Secretary is authorized to
award grants to 15 eligible entities to enable such entities to
establish a demonstration program to establish training programs to train, or to employ, alternative dental health care
providers in order to increase access to dental health care services in rural and other underserved communities.
‘‘(2) DEFINITION.—The term ‘alternative dental health care
providers' includes community dental health coordinators, advance practice dental hygienists, independent dental hygienists, supervised dental hygienists, primary care physicians,
dental therapists, dental health aides, and any other health
professional that the Secretary determines appropriate. disabilities, and individuals with HIV/AIDS, and in the riskbased clinical disease management of all populations.
‘‘(6) Qualified applicants that include educational activities
in cultural competency and health literacy.
‘‘(7) Qualified applicants that have a high rate for placing
graduates in practice settings that serve underserved areas or
health disparity populations, or who achieve a significant increase in the rate of placing graduates in such settings.
‘‘(8) Qualified applicants that intend to establish a special
populations oral health care education center or training program for the didactic and clinical education of dentists, dental
health professionals, and dental hygienists who plan to teach
oral health care for people with developmental disabilities, cognitive impairment, complex medical problems, significant physical limitations, and vulnerable elderly.
‘‘(d) APPLICATION.—An eligible entity desiring a grant under
this section shall submit to the Secretary an application at such
time, in such manner, and containing such information as the Secretary may require.
‘‘(e) DURATION OF AWARD.—The period during which payments
are made to an entity from an award of a grant or contract under
subsection (a) shall be 5 years. The provision of such payments
shall be subject to annual approval by the Secretary and subject to
the availability of appropriations for the fiscal year involved to
make the payments.
‘‘(f) AUTHORIZATIONS OF APPROPRIATIONS.—For the purpose of
carrying out subsections (a) and (b), there is authorized to be appropriated $30,000,000 for fiscal year 2010 and such sums as may
be necessary for each of fiscal years 2011 through 2015.
‘‘(g) CARRYOVER FUNDS.—An entity that receives an award
under this section may carry over funds from 1 fiscal year to another without obtaining approval from the Secretary. In no case
may any funds be carried over pursuant to the preceding sentence
for more than 3 years.''.
SEC. 5304. ALTERNATIVE DENTAL HEALTH CARE PROVIDERS DEMONSTRATION PROJECT.
Subpart X of part D of title III of the Public Health Service Act
(42 U.S.C. 256f et seq.) is amended by adding at the end the following:
‘‘SEC. 340G–1 ø42 U.S.C. 256g–1¿. DEMONSTRATION PROGRAM.
‘‘(a) IN GENERAL.—
‘‘(1) AUTHORIZATION.—The Secretary is authorized to
award grants to 15 eligible entities to enable such entities to
establish a demonstration program to establish training programs to train, or to employ, alternative dental health care
providers in order to increase access to dental health care services in rural and other underserved communities.
‘‘(2) DEFINITION.—The term ‘alternative dental health care
providers' includes community dental health coordinators, advance practice dental hygienists, independent dental hygienists, supervised dental hygienists, primary care physicians,
dental therapists, dental health aides, and any other health
professional that the Secretary determines appropriate.disabilities, and individuals with HIV/AIDS, and in the riskbased clinical disease management of all populations.
‘‘(6) Qualified applicants that include educational activities
in cultural competency and health literacy.
‘‘(7) Qualified applicants that have a high rate for placing
graduates in practice settings that serve underserved areas or
health disparity populations, or who achieve a significant increase in the rate of placing graduates in such settings.
‘‘(8) Qualified applicants that intend to establish a special
populations oral health care education center or training program for the didactic and clinical education of dentists, dental
health professionals, and dental hygienists who plan to teach
oral health care for people with developmental disabilities, cognitive impairment, complex medical problems, significant physical limitations, and vulnerable elderly.
‘‘(d) APPLICATION.—An eligible entity desiring a grant under
this section shall submit to the Secretary an application at such
time, in such manner, and containing such information as the Secretary may require.
‘‘(e) DURATION OF AWARD.—The period during which payments
are made to an entity from an award of a grant or contract under
subsection (a) shall be 5 years. The provision of such payments
shall be subject to annual approval by the Secretary and subject to
the availability of appropriations for the fiscal year involved to
make the payments.
‘‘(f) AUTHORIZATIONS OF APPROPRIATIONS.—For the purpose of
carrying out subsections (a) and (b), there is authorized to be appropriated $30,000,000 for fiscal year 2010 and such sums as may
be necessary for each of fiscal years 2011 through 2015.
‘‘(g) CARRYOVER FUNDS.—An entity that receives an award
under this section may carry over funds from 1 fiscal year to another without obtaining approval from the Secretary. In no case
may any funds be carried over pursuant to the preceding sentence
for more than 3 years.''.
SEC. 5304. ALTERNATIVE DENTAL HEALTH CARE PROVIDERS DEMONSTRATION PROJECT.
Subpart X of part D of title III of the Public Health Service Act
(42 U.S.C. 256f et seq.) is amended by adding at the end the following:
‘‘SEC. 340G–1 ø42 U.S.C. 256g–1¿. DEMONSTRATION PROGRAM.
‘‘(a) IN GENERAL.—
‘‘(1) AUTHORIZATION.—The Secretary is authorized to
award grants to 15 eligible entities to enable such entities to
establish a demonstration program to establish training programs to train, or to employ, alternative dental health care
providers in order to increase access to dental health care services in rural and other underserved communities.
‘‘(2) DEFINITION.—The term ‘alternative dental health care
providers' includes community dental health coordinators, advance practice dental hygienists, independent dental hygienists, supervised dental hygienists, primary care physicians,
dental therapists, dental health aides, and any other health
professional that the Secretary determines appropriate.
‘‘(b) TIMEFRAME.—The demonstration projects funded under
this section shall begin not later than 2 years after the date of enactment of this section, and shall conclude not later than 7 years
after such date of enactment.
‘‘(c) ELIGIBLE ENTITIES.—To be eligible to receive a grant under
subsection (a), an entity shall—
‘‘(1) be—
‘‘(A) an institution of higher education, including a
community college;
‘‘(B) a public-private partnership;
‘‘(C) a federally qualified health center;
‘‘(D) an Indian Health Service facility or a tribe or
tribal organization (as such terms are defined in section 4
of the Indian Self-Determination and Education Assistance
Act);
‘‘(E) a State or county public health clinic, a health facility operated by an Indian tribe or tribal organization, or
urban Indian organization providing dental services; or
‘‘(F) a public hospital or health system;
‘‘(2) be within a program accredited by the Commission on
Dental Accreditation or within a dental education program in
an accredited institution; and
‘‘(3) shall submit an application to the Secretary at such
time, in such manner, and containing such information as the
Secretary may require.
‘‘(d) ADMINISTRATIVE PROVISIONS.—
‘‘(1) AMOUNT OF GRANT.—Each grant under this section
shall be in an amount that is not less than $4,000,000 for the
5-year period during which the demonstration project being
conducted.
‘‘(2) DISBURSEMENT OF FUNDS.—
‘‘(A) PRELIMINARY DISBURSEMENTS.—Beginning 1 year
after the enactment of this section, the Secretary may disperse to any entity receiving a grant under this section not
more than 20 percent of the total funding awarded to such
entity under such grant, for the purpose of enabling the
entity to plan the demonstration project to be conducted
under such grant.
‘‘(B) SUBSEQUENT DISBURSEMENTS.—The remaining
amount of grant funds not dispersed under subparagraph
(A) shall be dispersed such that not less than 15 percent
of such remaining amount is dispersed each subsequent
year.
‘‘(e) COMPLIANCE WITH STATE REQUIREMENTS.—Each entity receiving a grant under this section shall certify that it is in compliance with all applicable State licensing requirements.
‘‘(f) EVALUATION.—The Secretary shall contract with the Director of the Institute of Medicine to conduct a study of the demonstration programs conducted under this section that shall provide analysis, based upon quantitative and qualitative data, regarding access to dental health care in the United States.
‘‘(g) CLARIFICATION REGARDING DENTAL HEALTH AIDE PROGRAM.—Nothing in this section shall prohibit a dental health aide training program approved by the Indian Health Service from
being eligible for a grant under this section.
‘‘(h) AUTHORIZATION OF APPROPRIATIONS.—There is authorized
to be appropriated such sums as may be necessary to carry out this
section.''
‘‘PART D—UNITED STATES PUBLIC HEALTH
SCIENCES TRACK
‘‘SEC. 271 ø42 U.S.C. 239l¿. ESTABLISHMENT.
‘‘(a) UNITED STATES PUBLIC HEALTH SERVICES TRACK.—
‘‘(1) IN GENERAL.—There is hereby authorized to be established a United States Public Health Sciences Track (referred
to in this part as the ‘Track'), at sites to be selected by the Secretary, with authority to grant appropriate advanced degrees
in a manner that uniquely emphasizes team-based service,
public health, epidemiology, and emergency preparedness and
response. It shall be so organized as to graduate not less
than—
‘‘(A) 150 medical students annually, 10 of whom shall
be awarded studentships to the Uniformed Services University of Health Sciences;
‘‘(B) 100 dental students annually;
‘‘(C) 250 nursing students annually;
‘‘(D) 100 public health students annually;
‘‘(E) 100 behavioral and mental health professional
students annually;
‘‘(F) 100 physician assistant or nurse practitioner students annually; and
‘‘(G) 50 pharmacy students annually.
‘‘(2) LOCATIONS.—The Track shall be located at existing
and accredited, affiliated health professions education training
programs at academic health centers located in regions of the
United States determined appropriate by the Surgeon General,
in consultation with the National Health Care Workforce Commission established in section 5101 of the Patient Protection
and Affordable Care Act.
‘‘(b) NUMBER OF GRADUATES.—Except as provided in subsection
(a), the number of persons to be graduated from the Track shall be
prescribed by the Secretary. In so prescribing the number of persons to be graduated from the Track, the Secretary shall institute
actions necessary to ensure the maximum number of first-year enrollments in the Track consistent with the academic capacity of the
affiliated sites and the needs of the United States for medical, dental, and nursing personnel. ‘‘(c) DEVELOPMENT.—The development of the Track may be by
such phases as the Secretary may prescribe subject to the requirements of subsection (a).
‘‘(d) INTEGRATED LONGITUDINAL PLAN.—The Surgeon General
shall develop an integrated longitudinal plan for health professions
continuing education throughout the continuum of health-related
education, training, and practice. Training under such plan shall
emphasize patient-centered, interdisciplinary, and care coordination skills. Experience with deployment of emergency response
teams shall be included during the clinical experiences.
‘‘(e) FACULTY DEVELOPMENT.—The Surgeon General shall develop faculty development programs and curricula in decentralized
venues of health care, to balance urban, tertiary, and inpatient
venues.
…..
‘‘(d) PROGRAMS.—The Surgeon General may establish the following educational programs for Track students:
VerDate 0ct 09 2002 13:03 Jun 09, 2010 Jkt 000000 PO 00000 Frm 00568 Fmt 9001 Sfmt 6601 F:\P11\NHI\COMP\PPACACON.005 HOLCPC
June 9, 2010 569 Sec. 5315 PPACA (Consolidated) \272 PHSA
‘‘(1) Postdoctoral, postgraduate, and technological programs.
‘‘(2) A cooperative program for medical, dental, physician
assistant, pharmacy, behavioral and mental health, public
health, and nursing students.
‘‘(3) Other programs that the Surgeon General determines
necessary in order to operate the Track in a cost-effective manner.
‘‘(e) CONTINUING MEDICAL EDUCATION.—The Surgeon General
shall establish programs in continuing medical education for members of the health professions to the end that high standards of
health care may be maintained within the United States.
‘‘(f) AUTHORITY OF THE SURGEON GENERAL.—
‘‘(1) IN GENERAL.—The Surgeon General is authorized—
‘‘(A) to enter into contracts with, accept grants from,
and make grants to any nonprofit entity for the purpose of
carrying out cooperative enterprises in medical, dental,
physician assistant, pharmacy, behavioral and mental
health, public health, and nursing research, consultation,
and education
…..
‘‘(3) SCIENTISTS.—Scientists or other medical, dental, or
nursing personnel utilized by the Track under an agreement
described in paragraph (1) may be appointed to any position
within the Track and may be permitted to perform such duties
within the Track as the Surgeon General may approve
….
‘‘SEC. 273 ø42 U.S.C. 239l–2¿. STUDENTS; SELECTION; OBLIGATION.
‘‘(a) STUDENT SELECTION.—
‘‘(1) IN GENERAL.—Medical, dental, physician assistant,
pharmacy, behavioral and mental health, public health, and
nursing students at the Track shall be selected under procedures prescribed by the Surgeon General. In so prescribing, the
Surgeon General shall consider the recommendations of the
National Health Care Workforce Commission.
‘‘(2) PRIORITY.—In developing admissions procedures under
paragraph (1), the Surgeon General shall ensure that such procedures give priority to applicant medical, dental, physician assistant, pharmacy, behavioral and mental health, public
health, and nursing students from rural communities and
underrepresented minorities.
‘‘(b) CONTRACT AND SERVICE OBLIGATION.—
‘‘(1) CONTRACT.—Upon being admitted to the Track, a medical, dental, physician assistant, pharmacy, behavioral and
mental health, public health, or nursing student shall enter
into a written contract with the Surgeon General that shall
contain—
‘‘(A) an agreement under which—
‘‘(i) subject to subparagraph (B), the Surgeon General agrees to provide the student with tuition (or tuition remission) and a student stipend (described in
paragraph (2)) in each school year for a period of years
(not to exceed 4 school years) determined by the student, during which period the student is enrolled in
the Track at an affiliated or other participating health
professions institution pursuant to an agreement between the Track and such institution; and
‘‘(ii) subject to subparagraph (B), the student
agrees—
‘‘(I) to accept the provision of such tuition and
student stipend to the student;
‘‘(II) to maintain enrollment at the Track until
the student completes the course of study involved;
‘‘(III) while enrolled in such course of study, to
maintain an acceptable level of academic standing
(as determined by the Surgeon General);
‘‘(IV) if pursuing a degree from a school of
medicine or osteopathic medicine, dental, public
health, or nursing school or a physician assistant,
pharmacy, or behavioral and mental health professional program, to complete a residency or internship in a specialty that the Surgeon General
determines is appropriate; and
‘‘(V) to serve for a period of time (referred to
in this part as the ‘period of obligated service')
within the Commissioned Corps of the Public
Health Service equal to 2 years for each school year during which such individual was enrolled at
the College, reduced as provided for in paragraph
(3);
‘‘(B) a provision that any financial obligation of the
United States arising out of a contract entered into under
this part and any obligation of the student which is conditioned thereon, is contingent upon funds being appropriated to carry out this part;
‘‘(C) a statement of the damages to which the United
States is entitled for the student's breach of the contract;
and
‘‘(D) such other statements of the rights and liabilities
of the Secretary and of the individual, not inconsistent
with the provisions of this part.
‘‘(2) TUITION AND STUDENT STIPEND.—
‘‘(A) TUITION REMISSION RATES.—The Surgeon General,
based on the recommendations of the National Health
Care Workforce Commission, shall establish Federal tuition remission rates to be used by the Track to provide reimbursement to affiliated and other participating health
professions institutions for the cost of educational services
provided by such institutions to Track students. The agreement entered into by such participating institutions under
paragraph (1)(A)(i) shall contain an agreement to accept as
payment in full the established remission rate under this
subparagraph.
‘‘(B) STIPEND.—The Surgeon General, based on the
recommendations of the National Health Care Workforce
Commission, shall establish and update Federal stipend
rates for payment to students under this part.
‘‘(3) REDUCTIONS IN THE PERIOD OF OBLIGATED SERVICE.—
The period of obligated service under paragraph (1)(A)(ii)(V)
shall be reduced—
‘‘(A) in the case of a student who elects to participate
in a high-needs speciality residency (as determined by the
National Health Care Workforce Commission), by 3
months for each year of such participation (not to exceed
a total of 12 months); and
‘‘(B) in the case of a student who, upon completion of
their residency, elects to practice in a Federal medical facility (as defined in section 781(e)) that is located in a
health professional shortage area (as defined in section
332), by 3 months for year of full-time practice in such a
facility (not to exceed a total of 12 months).
‘‘(c) SECOND 2 YEARS OF SERVICE.—During the third and fourth
years in which a medical, dental, physician assistant, pharmacy,
behavioral and mental health, public health, or nursing student is
enrolled in the Track, training should be designed to prioritize clinical rotations in Federal medical facilities in health professional
shortage areas, and emphasize a balance of hospital and community-based experiences, and training within interdisciplinary
teams.
‘‘(d) DENTIST, PHYSICIAN ASSISTANT, PHARMACIST, BEHAVIORAL
AND MENTAL HEALTH PROFESSIONAL, PUBLIC HEALTH PROFES SIONAL, AND NURSE TRAINING.—The Surgeon General shall establish provisions applicable with respect to dental, physician assistant, pharmacy, behavioral and mental health, public health, and
nursing students that are comparable to those for medical students
under this section, including service obligations, tuition support,
and stipend support. The Surgeon General shall give priority to
health professions training institutions that train medical, dental,
physician assistant, pharmacy, behavioral and mental health, public health, and nursing students for some significant period of time
together, but at a minimum have a discrete and shared core curriculum.
‘‘(e) ELITE FEDERAL DISASTER TEAMS.—The Surgeon General,
in consultation with the Secretary, the Director of the Centers for
Disease Control and Prevention, and other appropriate military
and Federal government agencies, shall develop criteria for the appointment of highly qualified Track faculty, medical, dental, physician assistant, pharmacy, behavioral and mental health, public
health, and nursing students, and graduates to elite Federal disaster preparedness teams to train and to respond to public health
emergencies, natural disasters, bioterrorism events, and other
emergencies.
‘‘(f) STUDENT DROPPED FROM TRACK IN AFFILIATE SCHOOL.—A
medical, dental, physician assistant, pharmacy, behavioral and
mental health, public health, or nursing student who, under regulations prescribed by the Surgeon General, is dropped from the
Track in an affiliated school for deficiency in conduct or studies, or
for other reasons, shall be liable to the United States for all tuition
and stipend support provided to the student.
‘‘SEC. 274 ø42 U.S.C. 239l–3¿. FUNDING.
‘‘Beginning with fiscal year 2010, the Secretary shall transfer
from the Public Health and Social Services Emergency Fund such
sums as may be necessary to carry out this part.''. SEC. 5508. INCREASING TEACHING CAPACITY.
(a) TEACHING HEALTH CENTERS TRAINING AND ENHANCEMENT.—Part C of title VII of the Public Health Service Act (42
U.S.C. 293k et. seq.), as amended by section 5303, is further
amended by inserting after section 749 the following:
‘‘SEC. 749A ø42 U.S.C. 293l–1¿. TEACHING HEALTH CENTERS DEVELOPMENT GRANTS.
‘‘(a) PROGRAM AUTHORIZED.—The Secretary may award grants
under this section to teaching health centers for the purpose of establishing new accredited or expanded primary care residency programs.
‘‘(b) AMOUNT AND DURATION.—Grants awarded under this section shall be for a term of not more than 3 years and the maximum
award may not be more than $500,000.
‘‘(c) USE OF FUNDS.—Amounts provided under a grant under
this section shall be used to cover the costs of—
‘‘(1) establishing or expanding a primary care residency
training program described in subsection (a), including costs
associated with—
‘‘(A) curriculum development;
‘‘(B) recruitment, training and retention of residents
and faculty:
‘‘(C) accreditation by the Accreditation Council for
Graduate Medical Education (ACGME), the American Dental Association (ADA), or the American Osteopathic Association (AOA); and
‘‘(D) faculty salaries during the development phase;
and
‘‘(2) technical assistance provided by an eligible entity.
‘‘(d) APPLICATION.—A teaching health center seeking a grant
under this section shall submit an application to the Secretary at
such time, in such manner, and containing such information as the
Secretary may require.
‘‘(e) PREFERENCE FOR CERTAIN APPLICATIONS.—In selecting recipients for grants under this section, the Secretary shall give preference to any such application that documents an existing affiliation agreement with an area health education center program as
defined in sections 751 and 799B
PART 3—INDIAN HEALTH CARE
IMPROVEMENT
SEC. 10221. INDIAN HEALTH CARE IMPROVEMENT.
(a) IN GENERAL.—Except as provided in subsection (b), S. 1790
entitled ‘‘A bill to amend the Indian Health Care Improvement Act
to revise and extend that Act, and for other purposes.'', as reported
by the Committee on Indian Affairs of the Senate in December
2009, is enacted into law. øThe bill, as enacted and amended by
subsection (b), is shown in a separate compiled document.¿
(b) AMENDMENTS.—øAmendments below are incorporated into
the separate compiled document.¿
(1) Section 119 of the Indian Health Care Improvement
Act (as amended by section 111 of the bill referred to in subsection (a)) is amended—
(A) in subsection (d)—
(i) in paragraph (2), by striking ‘‘In establishing''
and inserting ‘‘Subject to paragraphs (3) and (4), in establishing''; and
(ii) by adding at the end the following:
‘‘(3) ELECTION OF INDIAN TRIBE OR TRIBAL ORGANIZATION.—
‘‘(A) IN GENERAL.—Subparagraph (B) of paragraph (2)
shall not apply in the case of an election made by an Indian tribe or tribal organization located in a State (other
than Alaska) in which the use of dental health aide therapist services or midlevel dental health provider services is
authorized under State law to supply such services in accordance with State law.
‘‘(B) ACTION BY SECRETARY.—On an election by an Indian tribe or tribal organization under subparagraph (A),
the Secretary, acting through the Service, shall facilitate
implementation of the services elected.
‘‘(4) VACANCIES.—The Secretary shall not fill any vacancy
for a certified dentist in a program operated by the Service
with a dental health aide therapist.''; and
(B) by adding at the end the following:
‘‘(e) EFFECT OF SECTION.—Nothing in this section shall restrict
the ability of the Service, an Indian tribe, or a tribal organization
to participate in any program or to provide any service authorized
by any other Federal law.'
SEC. 10502. INFRASTRUCTURE TO EXPAND ACCESS TO CARE.
(a) APPROPRIATION.—There are authorized to be appropriated,
and there are appropriated to the Department of Health and
Human Services, $100,000,000 for fiscal year 2010, to remain available for obligation until September 30, 2011, to be used for debt
service on, or direct construction or renovation of, a health care facility that provides research, inpatient tertiary care, or outpatient
clinical services. Such facility shall be affiliated with an academic
health center at a public research university in the United States
that contains a State's sole public academic medical and dental
school.
(b) REQUIREMENT.—Amount appropriated under subsection (a)
may only be made available by the Secretary of Health and Human
Services upon the receipt of an application from the Governor of a
State that certifies that—
(1) the new health care facility is critical for the provision
of greater access to health care within the State;
(2) such facility is essential for the continued financial viability of the State's sole public medical and dental school and
its academic health center;
(3) the request for Federal support represents not more
than 40 percent of the total cost of the proposed new facility;
and
(4) the State has established a dedicated funding mechanism to provide all remaining funds necessary to complete the
construction or renovation of the proposed facility
I noticed the last post and thought I'd add a summary provided by Dr. Keri Discepolo and Dr. Andrew S. Kaplan in an article printed in The New York State Dental Journal in 2011.
Summary of Major Provisions of PPACA Affecting Dental Care
1. In order for a "qualified health plan" to be able to participate in the Healthcare
Exchange, it must include (among other provisions) "pediatric services, including oral
and vision care." (The legislation notably leaves out any required coverage for adults.)
2. Each state is permitted to allow insurance companies to offer the pediatric dental
benefit through a stand-alone plan or in conjunction with a qualified health plan as
long as the plan contains the essential dental health benefits required by HHS.
3. The Medicaid and CHIP Payment and Access Commission (MACPAC) is charged
with review and the updating of payments to dental professionals. (The legislation
notably leaves this as a gray area.)
4. Medicare Advantage plans generally paid more than comparable services in the
Medicare Fee for Service plans for comparable services. These additional payments
in some cases paid for dental services. The PPACA requires that the higher payment
first be applied towards cost-sharing reductions, second toward wellness and preventive care and, lastly, toward extra benefits not available in FFS plans, including
dental coverage.
5. The bill supports the creation of various "Oral Healthcare Prevention Activities,"
including funding for:
a. A national public education program on prevention of oral diseases such
as periodontal disease and caries that must be targeted to specific groups: e.g.
elderly, pregnant women, children, disabled and minorities.
b. A research-based dental caries management program provided to community-based dental providers, including the Indian Health Service.
6. School-based dental sealant programs.
7. Establishment of "oral health leadership and program guidance" through the
Centers for Disease Control (CDC).
8. Updating and expanding the CDC's National Oral Health Surveillance Programs to
be required in all 50 states, including:
a. The Pregnancy and Risk Assessment Monitoring System.
b. The National Health and Nutrition Examination Survey.
c. The Medical Expenditures Panel Survey.
9. Grants for school-based health centers, including "referrals to and follow up for
oral health services."
10. Medically accessible equipment for the disabled, including that found in dental
offices.
11. Health workforce provisions, including:
a. Creating new "dental cluster" health training programs to include, general,
pediatric, public health dentists and dental hygienists. This provision allows
grants to pay for student and resident training, financial assistance, program
development, loan repayment for students and faculty and the provision of
technical assistance in pediatric dental training programs.
b. Establishment of "demonstration projects" for "alternative dental health
care providers, including CDHCs, Advanced Practice Dental Hygienists,
Independent Dental Hygienists, Supervised Dental Hygienists, Primary Care
Physicians, Dental Therapists, Dental Health Aids or other as deemed appropriate by the Secretary of the HHS.
12. New and expanded "teaching health centers" to train primary healthcare providers, including dentists, in general and pediatric residencies in ambulatory patient
care centers.
Source url: http://www.dp5th.com/wp-content/uploads/2011/09/nydental_201109.pdf
Summary of Major Provisions of PPACA Affecting Dental Care
1. In order for a "qualified health plan" to be able to participate in the Healthcare
Exchange, it must include (among other provisions) "pediatric services, including oral
and vision care." (The legislation notably leaves out any required coverage for adults.)
2. Each state is permitted to allow insurance companies to offer the pediatric dental
benefit through a stand-alone plan or in conjunction with a qualified health plan as
long as the plan contains the essential dental health benefits required by HHS.
3. The Medicaid and CHIP Payment and Access Commission (MACPAC) is charged
with review and the updating of payments to dental professionals. (The legislation
notably leaves this as a gray area.)
4. Medicare Advantage plans generally paid more than comparable services in the
Medicare Fee for Service plans for comparable services. These additional payments
in some cases paid for dental services. The PPACA requires that the higher payment
first be applied towards cost-sharing reductions, second toward wellness and preventive care and, lastly, toward extra benefits not available in FFS plans, including
dental coverage.
5. The bill supports the creation of various "Oral Healthcare Prevention Activities,"
including funding for:
a. A national public education program on prevention of oral diseases such
as periodontal disease and caries that must be targeted to specific groups: e.g.
elderly, pregnant women, children, disabled and minorities.
b. A research-based dental caries management program provided to community-based dental providers, including the Indian Health Service.
6. School-based dental sealant programs.
7. Establishment of "oral health leadership and program guidance" through the
Centers for Disease Control (CDC).
8. Updating and expanding the CDC's National Oral Health Surveillance Programs to
be required in all 50 states, including:
a. The Pregnancy and Risk Assessment Monitoring System.
b. The National Health and Nutrition Examination Survey.
c. The Medical Expenditures Panel Survey.
9. Grants for school-based health centers, including "referrals to and follow up for
oral health services."
10. Medically accessible equipment for the disabled, including that found in dental
offices.
11. Health workforce provisions, including:
a. Creating new "dental cluster" health training programs to include, general,
pediatric, public health dentists and dental hygienists. This provision allows
grants to pay for student and resident training, financial assistance, program
development, loan repayment for students and faculty and the provision of
technical assistance in pediatric dental training programs.
b. Establishment of "demonstration projects" for "alternative dental health
care providers, including CDHCs, Advanced Practice Dental Hygienists,
Independent Dental Hygienists, Supervised Dental Hygienists, Primary Care
Physicians, Dental Therapists, Dental Health Aids or other as deemed appropriate by the Secretary of the HHS.
12. New and expanded "teaching health centers" to train primary healthcare providers, including dentists, in general and pediatric residencies in ambulatory patient
care centers.
Source url: http://www.dp5th.com/wp-content/uploads/2011/09/nydental_201109.pdf
From Stephen Colbert:
"I have to buy health insurance just because I'm alive?! What's next? I have to buy auto insurance just because I drive everywhere?? "
good point. in a comical way
I LOLed so hard right now reading this! hahahaha
Switzerland has the best nationalized system in the world, but they have cost issues as well.
It's always annoyed me that I must buy liability insurance for driving. I would prefer to just insure my own vehicles/self and if people want to drive without any insurance that's their own chance to take.
So yeah... okay joke but points to how stupid all these mandates are. Let people take their own risks and lay in their own beds. We dont need a big brother.
So yeah... okay joke but points to how stupid all these mandates are. Let people take their own risks and lay in their own beds. We dont need a big brother.
From Stephen Colbert:
"I have to buy health insurance just because I'm alive?! What's next? I have to buy auto insurance just because I drive everywhere?? "
good point. in a comical way
The point is not if you damage your own stuff, it's if you hurt/kill someone you have someone to pay those costs that any average person can't afford.
Same thing with health insurance, who do you think foots the bill when an uninsured person goes to the ER?
Soul, the world is a dangerous place. If my property was damaged by someone else while I was on the road and I choose not to get insurance then that is on me. I took a risk and now must pay the consequences. However, if a crime was committed there are avenues for justice in our courts.
You're operating from the stand point that people need to be saved from their bad decisions and how to do we pay for their bad decisions after they have made them. My view point is that if people don't buy insurance they should not receive any of the benefits of insurance. I don't agree with laws like EMTALA or the notion that hospitals should not screen patients on the basis of their ability to pay now or in the future. We should live and die by our choices and the consequences of those choices - fair or unfair.
Everyone should be free to make bad decisions and no one should be on the hook for them unless they choose to be. Therefore, I would much prefer not to pool my resources with irresponsible people and just take care of myself and my family. You can attempt to save humanity if you want though.
You're operating from the stand point that people need to be saved from their bad decisions and how to do we pay for their bad decisions after they have made them. My view point is that if people don't buy insurance they should not receive any of the benefits of insurance. I don't agree with laws like EMTALA or the notion that hospitals should not screen patients on the basis of their ability to pay now or in the future. We should live and die by our choices and the consequences of those choices - fair or unfair.
Everyone should be free to make bad decisions and no one should be on the hook for them unless they choose to be. Therefore, I would much prefer not to pool my resources with irresponsible people and just take care of myself and my family. You can attempt to save humanity if you want though.
Last edited:
I'm not a fan of more government, and more regulation. I'm not a fan of obamacare.
But I do think universal health care would be worth a tax increase. Not this 'everyone can buy insurance' garbage. But actual universal health care. I lived in South Korea for two years and was amazed at how convenient it was to get healthcare, and the quality of it.
But I suppose we'll just have to wait and see if the republicans can win the white house and repeal it.
But I do think universal health care would be worth a tax increase. Not this 'everyone can buy insurance' garbage. But actual universal health care. I lived in South Korea for two years and was amazed at how convenient it was to get healthcare, and the quality of it.
But I suppose we'll just have to wait and see if the republicans can win the white house and repeal it.
Yeah, I'm sure most people would love the idea of prices that are near whole sale cost. Never mind that it would be because the government controls prices. But hey - as long as it's not your goods that are being under-valued for the common good who cares right?
If the US economy slides further in the future industries can still survive and maybe even thrive if they're still in demand or figure out a good business model. But if they're tied to GDP or their prices are controlled by the government, like in universal health care, they have no hope. The government will keep slashing their prices as public revenue drops. Why would you ever want to be in that situation? Why not stand on your own and set your own prices that are appropriate to the market? Look at how public employees have been treated in the past few years!? You want to be lumped in with them?!?!?!
If the US economy slides further in the future industries can still survive and maybe even thrive if they're still in demand or figure out a good business model. But if they're tied to GDP or their prices are controlled by the government, like in universal health care, they have no hope. The government will keep slashing their prices as public revenue drops. Why would you ever want to be in that situation? Why not stand on your own and set your own prices that are appropriate to the market? Look at how public employees have been treated in the past few years!? You want to be lumped in with them?!?!?!
Last edited:
That is why you need politicians who can construct a model that is financially sound. Too many of our politicians lack the background to do so. Over 80% of lawmakers lack a background in business/economics. I don't think they are qualified to be making the most economical decisions for our country. Which is why I don't like obamacare, and don't advise the U.S. adopting a universal healthcare policy that is currently being used by another country.
I think if it were done right, a universal healthcare plan could get rid of the need for medicare/medicaid, the budget for those programs could be funneled into a universal healthcare system.
Too many people think our healthcare system is fine. Most of those people have likely never had to deal with the financial hardship of outrageous medical fees. Sure we can say that market efficiencies will win out, that Smith's 'invisible hand' will bring about fairness. This market is one that I would say it likely won't.
I think the biggest thing the federal government could do would be to bring down doctor's operating costs by putting a cap on how much they can be sued for malpractice. Doctors pay out the nose for malpractice insurance. If each doctor didn't have to pay tens of thousands, and for some over a couple hundred thousand per year of malpractice insurance, fees could be a little bit more tolerable. Doctors could still make the same amount they are, and patients would pay less. But to be honest, I really don't know much about the healthcare industry. I just know that our government has overcomplicated just about everything.
I see your point of view. And I respectfully disagree that each person should be on their own with regards to health care. If we want to be a great country we need to have an option for people that have no other options. However that does not mean pissing away money into something like extended unemployment. Sorry for that quip, but I see/know a lot of people that drag on gov't handouts and it pisses me off. 😀
Well, let's get the elephant out of the room here. How MUCH will dentist salaries depress? That's all we really want to know right?
Welp, I didn't want to do this. /Start rant
Half under the cloak of, "I won't be able to pay off my loans," every pre-dental and dental student is wondering how much they will have to wait before purchasing their new BMW. It's only natural, everyone is out for their own best interest. Yes, working with our hands, yes helping people, yes love science, yes the Challange, we all get it. You're reason for choosing whatever health profession is 100% justified. No mention of money either. You're a soddy liar if you say financial incentive wasn't at least a part of your reasoning. Don't worry, here's a news flash; It's human nature. I don't understand why health professionals are target for wanting money. Don't lawyers do the same? Accountants? Farmers? Politicians? Teachers even? Everyone wants to provide for their family in the best they can. Hell, I'd want to take my kid to Europe every summer? who wouldn't.
PharmDs, DDS/DMD, MD, OD, DO, you name it. Regardless of where they went or how they got in, everyone has worked very hard for a long period of time and for quite the hefty sum to get where they are.
We're all thinking this: Why is some schmuck who goes to school to get "trained" able to do the work we professionals are able? I studied for four years of gruling dental school after a ridiculous undergrad choked with science courses, volunteering, shadowing, DAT taking to get replaced by someone who tries to do my job? People are stupid. The Framers called it with mob rule(Happy 4th everyone). The People can't decide for themselves. They don't know any better. They're going to go to the cheapest option, and that's only natural. There will still be the smarter group who realize that dental work should be done by a dentist(or medical work done by an MD)
Guys, the answer is get the best grades so you can go to the cheapest school! -A barrage of gunners slowly but surely rise from the ashes of SDN gloom and doom, brimming with superiority, valor and a 4.3 GPA-
Look everyone is in trouble right now.
Pharmacists are the real ones that are screwed. Have you even taken a look at that board here on SDN? They're like a bunch of chickens with their heads cut off! I use to want to due pharmacy, so I know. Automation, HUGE supersaturation(not just oversaturation) that is only getting worse, mail order pharmacies(which make our dental chain dilemma look like a joke), and worse and worse work hours for higher and higher unemployment makes for quite a frightening job outlook! Dental therapists? They're helping people who otherwise wouldn't get help. Even if you lived in a rural area, those medicaid reimbursements wouldn't be enough. You wouldn't help them. At least you don't have 6 dental schools with **** requirements pumping out 200+ grads a year EACH + older pharmacists not retiring, thus, preventing YOU from getting a job.
Doctors? Nuff said.
Optometry? View interview question four.
http://studentdoctor.net/2012/07/20-questions-benjamin-s-chudner-o-d-f-a-a-o-2/
end rant.
What we really want to know, and despite popular belief- it's perfectly normal to ask this, is we're screwed. The healthcare system in our country is ruined. We need to fix it, and to do so, we the professionals might take a hit in salary. How much
Sincerely, just a good ole boy
Welp, I didn't want to do this. /Start rant
Half under the cloak of, "I won't be able to pay off my loans," every pre-dental and dental student is wondering how much they will have to wait before purchasing their new BMW. It's only natural, everyone is out for their own best interest. Yes, working with our hands, yes helping people, yes love science, yes the Challange, we all get it. You're reason for choosing whatever health profession is 100% justified. No mention of money either. You're a soddy liar if you say financial incentive wasn't at least a part of your reasoning. Don't worry, here's a news flash; It's human nature. I don't understand why health professionals are target for wanting money. Don't lawyers do the same? Accountants? Farmers? Politicians? Teachers even? Everyone wants to provide for their family in the best they can. Hell, I'd want to take my kid to Europe every summer? who wouldn't.
PharmDs, DDS/DMD, MD, OD, DO, you name it. Regardless of where they went or how they got in, everyone has worked very hard for a long period of time and for quite the hefty sum to get where they are.
We're all thinking this: Why is some schmuck who goes to school to get "trained" able to do the work we professionals are able? I studied for four years of gruling dental school after a ridiculous undergrad choked with science courses, volunteering, shadowing, DAT taking to get replaced by someone who tries to do my job? People are stupid. The Framers called it with mob rule(Happy 4th everyone). The People can't decide for themselves. They don't know any better. They're going to go to the cheapest option, and that's only natural. There will still be the smarter group who realize that dental work should be done by a dentist(or medical work done by an MD)
Guys, the answer is get the best grades so you can go to the cheapest school! -A barrage of gunners slowly but surely rise from the ashes of SDN gloom and doom, brimming with superiority, valor and a 4.3 GPA-
Look everyone is in trouble right now.
Pharmacists are the real ones that are screwed. Have you even taken a look at that board here on SDN? They're like a bunch of chickens with their heads cut off! I use to want to due pharmacy, so I know. Automation, HUGE supersaturation(not just oversaturation) that is only getting worse, mail order pharmacies(which make our dental chain dilemma look like a joke), and worse and worse work hours for higher and higher unemployment makes for quite a frightening job outlook! Dental therapists? They're helping people who otherwise wouldn't get help. Even if you lived in a rural area, those medicaid reimbursements wouldn't be enough. You wouldn't help them. At least you don't have 6 dental schools with **** requirements pumping out 200+ grads a year EACH + older pharmacists not retiring, thus, preventing YOU from getting a job.
Doctors? Nuff said.
Optometry? View interview question four.
http://studentdoctor.net/2012/07/20-questions-benjamin-s-chudner-o-d-f-a-a-o-2/
end rant.
What we really want to know, and despite popular belief- it's perfectly normal to ask this, is we're screwed. The healthcare system in our country is ruined. We need to fix it, and to do so, we the professionals might take a hit in salary. How much
Sincerely, just a good ole boy
This guy thinks cheapest school=best dental school no matter what because he goes to a cheap school. He doesn't care about location, alumni network of the school, prestige, whether one fits into the school, etc. PRICE PRICE PRICE . Thank you for sharing the ultimate secret of the world.
. Thank you for sharing the ultimate secret of the world.
lmao. your bravado is well received by me at least. as much as i hate to say it when there is talk of how partisanship slows us down, i agree. But, sometimes slowing down is essential if you can see where we'll end up. I think solving all the US's problems is intriguing thought exercise, but it's ultimately fruitless. Why don't we go back to discussing dental school, cases, ethics, and trends?
Or we just need a new sub forum:
Student Doctor Network Forums > Dental Forums [ DDS / DMD ] > Dental > Politics
or explain to the commies what freedom means?
lmao. your bravado is well received by me at least. as much as i hate to say it when there is talk of how partisanship slows us down, i agree. But, sometimes slowing down is essential if you can see where we'll end up. I think solving all the US's problems is intriguing thought exercise, but it's ultimately fruitless. Why don't we go back to discussing dental school, cases, ethics, and trends?
Or we just need a new sub forum:
Student Doctor Network Forums > Dental Forums [ DDS / DMD ] > Dental > Politics
or explain to the commies what freedom means?
"Don't shoot the messenger!" is my new custom title.
Solving all the US problems? Impossible. Trying to protect ourselves in an-ever dwindling country? Worth it.
Yes, I suppose we could further add sub-boards, but the traffic on those are just tragic.
lmao. your bravado is well received by me at least. as much as i hate to say it when there is talk of how partisanship slows us down, i agree. But, sometimes slowing down is essential if you can see where we'll end up. I think solving all the US's problems is intriguing thought exercise, but it's ultimately fruitless. Why don't we go back to discussing dental school, cases, ethics, and trends?
Or we just need a new sub forum:
Student Doctor Network Forums > Dental Forums [ DDS / DMD ] > Dental > Politics
or explain to the commies what freedom means?
We already have a political forum that has plenty of lively posters and debate. If you do take the time to go there, you'll also find Obamacare is being discussed.
Sociopolitical Issues: http://forums.studentdoctor.net/forumdisplay.php?f=12
this is a bad analogy for refuting soul's point.
thats like saying, if i drive a car, and i hit and injure someone for life and they didn't get health insurance, then its on them.
why is it that they should pay for my mistake? this is why everyone needs to have car insurance so that they can afford to pay the injured party.
I do think that we should be responsible for our choices, but sometimes things happen at a bad time. Universal health care is a good thing and everyone should be required to have it because bad things can happen suddenly. However, there should be premiums that reflect your current lifestyle (aka, if you're fat, smoker, drug user, alcoholic, etc... then your premium should be way higher than the dude who exercise, etc...)
You dont, so quit thinking immigrants are trying to intentionally do anything
Hospitals LIKE billing BS from the ED they can charge miedicaid $50 for a hangnail in a clinic or $500 in the ED
2 years at 100k volume ED doing admin and research
Stop getting your facts from sound bites
That is like .00001% expenditures
Add a little of your input stop regurgitating
A poor immigrant goes to the ED because its the only place that cant refuse them care or maybe the closest thing to primary care in 5 miles
These people do it just to **** with you? How does that make sense? And when they have a sick baby ban them till they figure out a primary care ped to take them?
Have you earned a dollar in your life? Whos spending your tax dollars?
Immigrants waiting 8 hours for a 15 min ED visit costs 2.5 trill
You dont have any reference frame on this issue, you dont understand base costs or even logic. How would it be possible these immigrants are geting boob jobs in the ED and gold teeth imlants to make it 2.5 trillion?
Sheep
Why are people so quick to jump on the poor
You dont understand hospital economics
And are you against a law that prevents poor people from dying in the street? Thats what it does
Its the basic and not even a generous level of care or respect.
Poor people pay a higher relative tax burden then any of you. Local, sales,
200 mill entire medicaid budget, 2.5 trillion annual problem
Does that look like you who have yet to pay taxes yourselves are being generous to these people? People are taxed on 10-15% income before keaving povertyy levels of care
Dental students are needed in this debate. Dentistry is more consumer then anything here
You guys are going to wish you had that immigrant to pay you $20 for check up.
Not a bustling market for dentistry or in ones youll practice
You dont understand hospital economics
And are you against a law that prevents poor people from dying in the street? Thats what it does
Its the basic and not even a generous level of care or respect.
Poor people pay a higher relative tax burden then any of you. Local, sales,
200 mill entire medicaid budget, 2.5 trillion annual problem
Does that look like you who have yet to pay taxes yourselves are being generous to these people? People are taxed on 10-15% income before keaving povertyy levels of care
Dental students are needed in this debate. Dentistry is more consumer then anything here
You guys are going to wish you had that immigrant to pay you $20 for check up.
Not a bustling market for dentistry or in ones youll practice
Poverty, mental illness are not choices
Youre a dental student and dont know anything past the mouth as this statement shows
