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Physicians Together -

A Commitment to
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By: Winston Wong, MD, MS


The National Council of Asian Pacific Islander Physicians (NCAPIP) notes with great concern the proposed legislative changes to Medicaid and Medicare program as advanced for consideration by Congressman Ryan:

20 Million Near-Elderly Will Not Have Medicare When They Retire. Starting in 2022, Medicare will be eliminated for new beneficiaries and converted into a voucher program.  The voucher will fail to keep pace with increases in the cost of health care so its value will decline every year, meaning that future seniors will not be able to get the benefits they need or even end up uninsured.

CBO: Voucher Proposal Will Double Health Care Costs for Seniors. The voucher will fail to keep pace with increases in the cost of health care and seniors will be forced to pay higher premiums in order to access the same benefits they would receive under the current system.  A typical senior will spend more than twice as much of his or her own income on health services under the Ryan proposal as compared to the current Medicare system.

Under the Republican Plan, Seniors Will Lose Guaranteed Benefits. Under current law, all seniors have guaranteed access to life-saving health benefits, including screenings for colon cancer, diabetes, and prostate cancer, as well as flu shots.  If the Republican plan becomes law, seniors that were eligible for guaranteed health benefits last year could lose their benefits.

Republican Proposal Could Force Seniors to Pay $3,500 More for Prescription Drugs. The proposal would "reopen" the prescription drug donut hole, requiring that seniors pay full price for prescription drugs.  Seniors would pay $3,500 more for their medications over the next ten years.  Seniors and people with disabilities who have high prescription drug costs could pay an additional $12,300 over the next 10 years.

Medicaid currently provides health coverage to roughly 50 million Americans, with the federal government picking up 50% of state's Medicaid costs. At a minimum, the Ryan Plan could remove at least 15 million Americans from the program.

NCAPIP stands with all Americans in the need to safeguard the fiscal security of our future generations. Part of financial security includes freedom from fear of the lack of health care when one is frail, elderly and poor. Asian, Pacific Islander, and Native Hawaiian communities face marginalized access to high quality health care in our present system of care.

As it stands, the Ryan proposal represents changes to the fundamental precepts of the social contract that our country has adopted: to provide health security to the most vulnerable in our society. This proposal has the potential to set back the advances we have worked for and made in improving care to AANHPI populations. We urge our elected officials to preserve this commitment to our peoples.


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By: Ho Luong Tran, MD, MPH


Mental health impacts every aspect of a person's life, including their physical health. Many Asian American, Native Hawaiian, and Pacific Islanders (AANHPI) suffer from mental health issues. These issues become serious problems as they often go undiagnosed and untreated in AANHPI peoples. This is due to stigmas within our communities, lack of affordable insurance, and a lack of providers trained to provide in language and culturally competent care. There also still exists a belief that AANHPI do not experience any mental health problems, a belief that is reinforced by a lack of data. There is little data that takes into account many of the variables that impact the mental health of AANHPI, furthermore, the data that exists may also be misleading because information on sub-ethnicities is not disaggregated. Knowledge of mental health needs of Native Hawaiians and Pacific Islanders is even more limited.

Among all ethnicities, Asian Americans and Pacific Islanders are the least likely to seek help for mental disorders. They are significantly less likely than Caucasians to mention their mental health concerns to friends or relatives, mental health professionals, or physicians. This may be due in part to cultural values and strong stigmas that prevent many from seeking assistance. In addition, Asian Americans who do seek mental health services experience more severe symptoms than other groups, likely due to delay in seeking treatment.


Asian Americans have an increased risk of depression, with Chinese Americans reporting the highest lifetime prevalence rate of depression. Social anxiety, social phobias, and trauma related disorders also occur at high rates among Asian Americans, especially among second-generation Asian Americans. In a study in 2005, suicide was the 8th leading cause of death for Asian Americans in comparison to the 9th leading cause of death for White Americans. In addition, Southeast Asian refugees are at high risk for post traumatic stress disorder (PTSD) associated with trauma experienced before and after immigration to the U.S. One study found that 70% of the Southeast Asian refugees receiving mental health care were diagnosed with PTSD.


Little is known about the mental health needs of AANHPI youth, but studies indicate that there are high rates of depression, anxiety, and suicide among this group. Asian American and Pacific Islander high school students were just as likely as black, Hispanic, and white students to have attempted suicide. Between 2002 and 2005, suicide was ranked as the 3rd leading cause of death for those between 15-24 years old. AANHPI females have among the highest rates of suicide ideation of any ethnic group and the highest rates of symptoms of depression between the ages of 15-24. Native Hawaiian youth have significantly higher rates of suicide attempts than other adolescents in Hawaii.

Suicide risk also increases with age. Older Asian American women have the highest suicide rate of all women over 65 years, and the suicide rate of elderly Chinese American women is 10 times higher than the rate among white elderly women. Some explanations for this increase in suicide rates may be related to difficulties adapting to US culture.


Feeling sad, worried, or anxious for a little while is normal, but ongoing feelings of sadness and numbness can be signs of depression and constant worrying can be a sign of an anxiety disorder. These feelings are not a sign of weakness. Mental health problems like anxiety and mood disorders are real illnesses just like diabetes or hepatitis.


With proper treatment, most symptoms of mental illnesses can be controlled. If you or someone you care about is worried about the possibility of mental illness, there is no shame in seeking treatment. Talk to your physician, clinic, or go online to find more information on mental health, or ask your primary care provider to refer you to a culturally and linguistically competent mental health professional. If you have thoughts of hurting or killing yourself, seek medical help immediately. Call 911, 1-800-SUICIDE, or 1-800-273-TALK or check your local phone book for the number of a suicide crisis center.

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