Primary Health Care: A Path to Affordable Care

The Affordable Care Act (ACA) celebrated its third anniversary last month.  Looking ahead at the implementation of the ACA, an important deadline looms: January 1, 2014.  On that day, more Americans will have health care coverage - whether purchased through a state or the federal health insurance exchange or their state’s Medicaid expansion. 

But it’s important to note: Health insurance coverage does not necessarily ensure access to health care.

In the next ten years, the US will need an additional 52,000 primary care providers to meet the demands not only of the newly-insured, but also because of two significant demographic imperatives, namely a growing population  and aging Baby Boomers.   It’s estimated that for a healthcare system to be well functioning, primary care providers should make up 40 percent of the provider workforce. The current system only has 32 percent. 

What needs to be done?  The Society of General Internal Medicine (SGIM) has been educating members of Congress about the importance of primary care in a high functioning health system and its role in improving outcomes and controlling costs. Some lawmakers are listening. Senator Jack Reed (D-RI) and Representative Jim McDermott (D-WA) sponsored a Congressional briefing for members and staff last month entitled Why We Need Robust Primary Care in the U.S., and What Congress Can Do to Help.

Panelists included a general internist and a family physician, as well as consumer and insurer representatives.  All stressed that policy changes are needed with respect to the training of primary care physicians and their reimbursement; only this two-pronged approach will successfully address the shortage of primary care physicians.

What was striking was that all the panelists were in agreement that primary care physicians must be paid in such a way that they are rewarded for providing coordinated care that allows them to develop relationships with their patients.  It is in these care settings that both patient and physician satisfaction increases. 

This hearing was an important step to addressing this impending workforce and access crisis. SGIM will continue to educate Congress, and work to find legislative solutions, but patients must also lend their voice to this debate, as their access to quality, affordable care is at stake.

Erika Miller
Vice President and Council

Lisa Ellington

Big Thinkery, LLC, 1011 Kenilworth Court Northwest, Concord, NC, 28027