Sanders Op-Ed: A Revolution in Primary Health Care

By:  Sen. Bernie Sanders and Rep. James Clyburn
The Hill

Community health centers provide high-quality primary care at a significant savings for millions of Americans, but 60 million people in this country still lack meaningful access to primary health care, dental care, mental health counseling and low-cost prescription drugs.  Congress is on the verge of taking a dramatic step toward closing that gap and making a revolutionary improvement in primary health care in America.

As we work to address both our economic and health care crises in America, putting significantly more resources into community health centers is a smart way to help millions of Americans stay healthy while saving taxpayers’ money and creating jobs.

The simple fact is that without access to care, people will continue to fall through the cracks even if they manage to have health insurance coverage. There are 45,000 Americans who die every year because they do not get to a doctor on a regular basis. The Federally Qualified Health Center program, which provides critical access to care in all 50 states, has been shortchanged for too many years.

Conceived in 1965 by Senator Edward Kennedy as a bold, new experiment in the delivery of preventive and primary health care services to our nation's most vulnerable people, community health centers are an enduring model of primary care for the country and are designed to empower communities to create locally-tailored solutions that improve access to care and the health of those they serve. 

Today, community health centers provide comprehensive primary medical care to 20 million Americans through 1,200 community-run, not-for-profit organizations in underserved rural and inner-city areas. Their doors are open to all, including patients with Medicare, Medicaid, private insurance, and those who have no insurance at all.   The centers provide their services on a sliding-scale basis, making care affordable to everyone.  No patient who walks into a community health center is turned away because he or she lacks payment.

The truth is we can do much better, and we will in the health reform package that Congress is about to pass.

The Senate-passed version of the health care reform bill includes a provision I fought hard for which provides $10 billion nationally over a five-year period to the community health centers program and the National Health Service Corps. The House-passed version included $14 billion thanks largely to the great work of House Majority Whip James Clyburn.

With such a strong commitment to health centers and primary care, the number of patients served by health centers would go from 20 million to 45 million over the next five years. We would create new or expanded health centers in an additional 10,000 communities.  The long-neglected National Health Service Corps would provide scholarships and loan repayments as incentives for 20,000 more medical students to become primary care doctors, dentists, nurse practitioners, physician assistants and mental health professionals. 

In short, we would bring about a revolution in primary health care in America.

Here’s another important point. The investment in health centers would more than pay for itself.  It would save Medicaid alone and estimated $23 billion over five years on reduced emergency room use and hospital costs, according to a study by George Washington University.  The researchers found that patients using health centers have annual overall medical care costs that are more than $1,000 lower than those who do not use a health center. That translated into big savings for the health care system last year alone. No wonder federal auditors consistently rate community health centers as one of the most efficient uses of federal funds.

It is not often that we are presented such a clear win-win situation; a program that meets critical needs while reducing expenditures by more than it costs. 

While Republicans in Congress have gone to great lengths to try to obstruct health care legislation, support cuts across party lines for the highly-effective and highly-efficient community health center program. The senior Republican on the Senate health committee, Mike Enzi of Wyoming, called community health centers “absolutely critical.”  The program that was expanded some under Republican President George W. Bush got an important boost last year in the economic stimulus bill that Congress passed and President Obama signed into law.

In the richest country in the world, no American should have to go without basic health care.  Community health centers are a critical lifeline for millions of Americans and we must build upon their success by expanding them to all those in need.  With this provision in the health bill, we are taking a giant step forward and, in the process, we are going to make a real difference in improving the lives and the well-being and the access to health care of tens of millions of Americans.

This article was published in The Hill newspaper.

Sen. Bernie Sanders, independent from Vermont, is a member of the Senate Health, Education, Labor and Pensions Committee, and the Senate Budget Committee.  Congressman James Clyburn, democrat of South Carolina, is the Majority Whip of the U.S. House of Representatives.