America’s internal medicine physicians have a prescription for reforming the U.S. health system. It’s a chicken-in-every-pot solution of:

1. A primary care doctor, and
2. Affordable and accessible health care for all.

This solution comes out of the American College of Physicians‘ (ACPs’) view that primary care is in crisis mode in the U.S. The signs of crisis, according to the ACP, are:
  • Too many uninsured and under-insured people.
  • Too few primary care physicians.
  • Getting a poor return-on-investment on health spending.
  • Putting wasteful administrative burdens on doctors that take away from time to care.
  • Not putting the patient at the center of care.

In their latest annual survey on The State of the Nation’s Health Care in 2009, the ACP points out that the gap between supply of and demand for primary care doctors is growing: this is due to the two main drivers of an aging population coupled with a growing number of people who need to manage multiple chronic diseases.

You want proof of the positive impact of primary care on citizens’ health outcomes? The ACP’s been collecting the evidence base on the primacy of primary care; some headline points are:

  • States with higher ratios of primary care physicians to population have better health outcomes — such as fewer deaths from cancer, heart disease, and stroke.
  • Each 10th percentile increase in primary care physician supply results in a 4% increase in early-stage breast cancer diagnosis.
  • An increase of 1 primary care physician per 10,000 population in a state was associated with decreased overall spending by $684 per Medicare beneficiary.
  • Increased proportions of primary care physicians across all U.S. counties was associated with significantly fewer hospital admissions, outpatient and emergency visits, and surgeries.

Health Populi’s Hot Points: Five years ago, the ACP’s State of the Nation’s Health Care Report in 2004 pointed to, “Better Coverage, Less Red Tape, Better Use of Health Information Technology, and
Improved Access to Primary Care Doctors” as the 4-part Rx to improve American health care.

Five years later, these 4 issues remain the very problems with front-line care in the U.S.

What’s changed since then? An economic recession, more citizens feeling health and social insecurity, growing unemployment rolls….and a new President. This last point is why the ACP drafted an Executive Order on Primary Care for President Obama’s consideration.

Any health reform that the 111th Congress and President Obama consider must couple expanding access of health coverage with expanding the supply of primary care. Specifically, in the short run, plans to expand SCHIP, COBRA access for unemployed people, and Medicaid assistance to states will expand real demand for primary care. And these physicians may simply not be available in many parts of the U.S.

As the ACP has calculated, “Primary care is the best medicine for better health and lower costs.”

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