Se­nate Panel Di­ag­noses Pri­mary Care Cri­sis

Ver­mont Wit­ness Fo­cuses on Com­mu­nity Health Cen­ters

Stanstead Journal - - NEWS - Washington

A Se­nate panel to­day ex­am­ined a “ma­jor cri­sis” in pri­mary health care at a time when 30 mil­lion more pa­tients will soon get health in­surance un­der the Af­ford­able Care Act and worsen an al­ready acute doc­tor short­age.

One in five Amer­i­cans to­day live in ar­eas where they do not have ad­e­quate ac­cess to pri­mary care due to a short­age of providers, ac­cord­ing to Sen. Bernie San­ders (I-Vt.), the chair­man of the Se­nate Pri­mary Care and Ag­ing Sub­com­mit­tee.

“In our coun­try to­day we are spend­ing al­most twice as much per capita on health care as any other ma­jor coun­try yet our health out­comes in terms of life ex­pectancy, in­fant mor­tal­ity and disease preven­tion are not par­tic­u­larly good,” San­ders said. “One of the rea­sons for that is that we have a ma­jor cri­sis re­gard­ing pri­mary health care ac­cess which re­sults in lower qual­ity health care for our peo­ple and greater ex­pen­di­tures.”

Ac­cord­ing to a report re­leased at the hear­ing, as many as 45,000 peo­ple die each year be­cause they do not have health in­surance and do not get to a doc­tor on time. A

sig­nif­i­cant rea­son for the lack of ac­cess to care is that less than one-third of all doc­tors in Amer­ica to­day prac­tice pri­mary care, down for half of all physi­cians 50 years ago. The prob­lem is likely to get worse be­cause many pri­mary care doc­tors are near­ing re­tire­ment and fewer and fewer med­i­cal stu­dents are in­ter­ested in be­com­ing fam­ily prac­ti­tion­ers.

Tess Kuen­ning, ex­ec­u­tive di­rec­tor of the Mont­pe­lier, Vt.-based Bi-State Pri­mary Care As­so­ci­a­tion, tes­ti­fied that com­mu­nity health cen­ters could pro­vide af­ford­able care for more pa­tients. The 2010 health care law in­cluded a San­ders pro­vi­sion that au­tho­rized $11 bil­lion to dou­ble the num­ber of pa­tients cared for at health cen­ters. Funds needed to reach that goal, how­ever, have not been com­mit­ted.

In Ver­mont, Kuen­ning said, more than 110,000 pa­tients re­ceive care at one of eight com­mu­nity health cen­ters through­out the state. With ad­di­tional fund­ing, she added, three more com­mu­ni­ties “are fully poised to ap­ply for com­pet­i­tive fed­eral fund- ing to bring med­i­cal, dental and be­hav­ioral health ser­vices to com­mu­ni­ties in need.”

Dr. Clau­dia M. Fe­gan, the chief med­i­cal of­fi­cer at Cook County Hospi­tal in Chicago, told the sub­com­mit­tee she sees ev­i­dence ev­ery day of pa­tients with­out pri­mary doc­tors. “Ev­ery sin­gle day, peo­ple with­out a physi­cian line up across the street from our hospi­tal to be seen in our walk-in clinic … They hope to be one of the lucky ones who will be given a physi­cian of their very own, who will get to know them and take care of them and be avail­able when they have a prob­lem or ques­tion, some­one to help them meet their med­i­cal needs, some­one to help them nav­i­gate our com­pli­cated health care sys­tem to get what they need.”

An­other wit­ness, Prince­ton econ­o­mist Uwe E. Rein­hardt, said Medi­care and Med­i­caid pay­ments should be re­aligned to ad­dress the acute short­age of pri­mary care physi­cians.

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