Primary Care Crisis in America

A Senate panel heard today from the founder of an organization that stages medical clinics for patients who wait day and night in long lines for basic health care in parts of the world with severe doctor shortages - not in a Third World country in Africa or Latin America but right here in the United States.

"Health care in America is a privilege of the well-to-do and the well-insured that leaves about 50 million people flat out of luck," said Stan Brock, president of Remote Area Medical. People travel hundreds of miles and wait for days to see a doctor or dentist or to get their eyes checked at clinics Brock's organization has held in communities like Los Angeles and Knoxville, Tenn.

Nearly one in five Americans - some 60 million people - live in areas with too few primary care physicians and other health care professionals. "We've got a very serious problem, truly a life-or-death problem for thousands of people," said Sen. Bernie Sanders (I-Vt.), chairman of the primary care subcommittee. So we've got a very very serious problem, truly a life or death problem, and the lives of thousands of people depend upon what we do.

Sanders today introduced legislation to attract more doctors and other health care providers to primary care . The bill would boost funding for community health centers that provide medical, dental, and mental health care and low-cost prescription drugs. It also would dramatically increase opportunities for medical school graduates to go into family medicine. The bill also extends higher Medicare and Medicaid reimbursement rates for primary care providers.

The bill includes a major expansion of loan and scholarship programs for primary care providers through the National Health Service Corps. That program, Dr. James Hotz told the committee, "is the single most effective policy innovation this country has ever developed to address the primary care workforce challenge."

Of the 17,000 doctors who graduated from American medical schools in 2011, only 7 percent are pursuing careers in primary care, the first contact most patients have with the health care system. One recent graduate, Dr. Joseph Nichols, is a resident at the MedStar Franklin Square Family Health Center in Baltimore, Md. He told the subcommittee that he feels a responsibility to society. "Primary care is something needed and deserved by everyone, and yet it has a constituency of no one. Nobody raises her hand and says, 'I have primary care disease.'"

Improving primary care in the United States not only would provide better care for patients, it would save taxpayers' dollars. According to virtually every study, access to primary care results in better health outcomes, reduced health disparities and less spending because patients are treated before they become so sick that they require costly emergency room or hospital care.

For a summary of Sanders' bill, click here.