Primary Care is on the Mind of Congress – But what about the Presidential Candidates?
September 17th, 2008 by Candice Chen (email author)In the past week, both the House Ways and Means Subcommittee on Health and the Senate Finance Committee have held hearings to examine the Medicare physician payment system. Both hearings quickly evolved to discuss:
- Source: JAMA Annual Graduate Medical Education data
1. The pending primary care crisis – medical students are increasingly choosing medical subspecialties over primary care.
2. Primary care’s role in developing a more cost-effective quality health care system – analysis of Medicare claims indicates regional differences in Medicare spending. Higher spending regions are largely explained by more specialty-oriented practice but have no increase in quality or access to care (Goodman, 2003).
But what about the presidential candidates? In her Sept. 16 Good Morning America interview, former candidate Hillary Clinton encourages Americans to re-focus on the issues and she tells us from her experiences traveling America, “concerns about healthcare, that’s what’s on the minds of Americans.” But if primary care is a key leg to cost-effective quality health care for all Americans, what do Barack Obama and John McCain’s health plans say about primary care?
The answer is – not much. Barack Obama at least recognizes the problem and the need to address it.
WORKFORCE. Primary care providers and public health practitioners have and will continue to lead efforts to protect and promote the nation’s health. Yet, the numbers of both are dwindling, and the existing workforce is further challenged by inadequate training about new health threats such as bioterrorism and avian flu, antiquated funding and reimbursement mechanisms, and limited access to real-time information and technical support. Barack Obama and Joe Biden will expand funding—including loan repayment, adequate reimbursement, grants for training curricula, and infrastructure support to improve working conditions— to ensure a strong workforce that will champion prevention and public health activities (excerpt from Obama/Biden Health Plan).
John McCain’s plan never mentions it.