Primary Health Care Crisis

Solutions to severe shortages in the nation’s primary care workforce were examined at a Senate hearing on Tuesday. “In the United States today, some 45,000 people unnecessarily die each year because they don't get to a doctor in time,” Sen. Bernie Sanders said. “Major reforms in primary care will save lives and save billions in health care costs,” he added in his opening statement at the hearing he chaired of the Senate Subcommittee on Primary Health and Aging.

Today, one in five Americans live in an area with a shortage of primary care providers. The shortages will get worse next year when insurance coverage is expanded to 30 million more Americans under the Affordable Care Act. By 2025, more than 50,000 new primary care doctors and thousands of other providers will be necessary to meet the projected need.

The hearing explored the need to substantially increase the number of primary care practitioners by encouraging medical schools to make primary care a priority and by supporting nurse practitioner programs that place 70 percent of graduates in primary care practices.

Deborah Wachtel of Essex, Vt., president of the Vermont Nurse Practitioner Association, testified that nurse practitioners are a critical part of the primary care workforce in Vermont.

Sanders also called for expanding federal support for community health centers that provide 22 million Americans with affordable medical, dental and mental health care as well as low-cost prescription drugs. “Community health centers provide some of the most cost-effective health care in the country and serve as a medical home for millions with nowhere else to go. This excellent program has been expanded in recent years but much more needs to be done,” Sanders said.

He advocated training more primary care residents through the Teaching Health Center program, which received only $230 million over the last five years compared to the $50 billion going to train residents in traditional hospital-based settings over the same period. And he called for expanding the National Health Service Corps, which provides loan-forgiveness and scholarships to students who provide medical, dental and mental health care to more than 10 million people in underserved areas.