Improving access to primary care requires investing in it

Posted in Berita


Last month, I participated in a health care forum here in Grand Junction. The event drew front-page coverage the following morning in The Daily Sentinel given the ongoing shortage of primary care physicians and problems accessing primary care here in western Colorado. The problem will not fix itself. And, it is one of the essential issues that we must address in health-care reform locally, statewide, and nationally.

In medicine, we follow the evidence and let facts guide our diagnosis and treatment.

At the same time, that same methodical process should guide how we work to build a better health-care system here in America. Unfortunately, this is not always the case. Longstanding practices, entrenched big business, politics, and conflicts of interest have severely handicapped our ability to find reforms that really work for patients.

A change of course is long overdue.

That change may be at hand. Later this month, the state Legislature will consider a bill that would revamp the way we value primary care, specifically by putting additional dollars there, where they are proven to do the most good for the largest number and help patients get the care they need. Today, 5 to 7 cents of the health-care dollar goes to primary care. The proposal would up that to 15 cents. Data from Oregon and Rhode Island, two states that have implemented similar programs, indicate that this is paying off for the patients and for the health-care system via higher value health care.

There is a growing body of evidence, both here at home and overseas, that makes the case for greater investment in primary care. The promise of proper chronic disease management, fewer emergency room visits, reduced hospitalization rates and greater patient satisfaction are real. The evidence speaks for itself.

The evidence also shows it will save us money. When Colorado's Medicaid program turned to a model that ensured all Medicaid users were connected to a family doctor, pediatrician or other primary-care provider and invested in that system, it saved Colorado taxpayers $139 million.

Again, there are places where health systems and governments have figured this out. The lessons are there. The proof is well-documented. And, the systems and countries that are investing in connecting people to frontline medical providers are achieving an excellent return on their investment.

With proper funding flowing to primary care, new and expanded practices will have more time with each patient. We can staff our clinics with other service providers who support health and wellness, including social workers and mental health professionals. We can expand our office hours so that working families have better access to health care without taking off work.

We have underfunded and undervalued our frontline medical care in this country for decades. It has come with a significant price tag. An evidence-based approach to health reform includes substantial increases in spending on primary care. An evidence-based approach to care focuses on the patient first, supports all the care they need including behavioral health, and it helps to coordinate that care.

Patients expect the latest technology and science to guide our medical practices. We should expect no less when reforming the system that will deliver them that care. We must acknowledge the value of our family doctors, pediatricians and other frontline care providers and end the chronic anemic funding of the foundation of our health care delivery system. In health care as in life, an ounce of prevention is worth a pound of cure.

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