Senators pitch $26 billion plan to strengthen primary care – ‘Absolutely the right thing to do’

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A $26 billion investment in primary care could boost the workforce, improve patient outcomes, and spark new attention to the medical and financial importance of preventing disease instead of paying more to cure it later.

Sen. Bernie Sanders (I-Vermont) and Sen. Roger “Doc” Marshall, MD, (R-Kansas) announced the new “Bipartisan Primary Care and Health Workforce Act,” an agreement and legislation to address the nation’s drastic situation with primary care.

It includes training more physicians. The plan would invest $1.5 billion over five years in the Teaching Health Center Graduate Medical Education program to create more than 700 new primary care residency slots, resulting in up to 2,800 new doctors by 2021.

Another $300 million would produce another 2,000 primary care physicians by 2032, with investments in the Rural Residency Planning and Development program.

The plan will be paid for with savings culled from waste, fraud, and abuse within the health care system. The senators said it will relieve patient suffering while saving billions of dollars in the Medicare and Medicaid programs.

Senators speak

Sen. Bernie Sanders

"It is unacceptable that millions of Americans throughout our country do not have access to affordable, high-quality primary care and are unable to get the health care they need when they need it,” Sanders said in a joint statement. “Every major medical organization understands that our investment in primary care is woefully inadequate. They understand that focusing on disease prevention and providing more Americans with a medical home instead of relying on expensive emergency rooms for primary care will not only save lives and human suffering, it will save money.

“This bipartisan legislation is not only good public policy, it is cost-effective,” Sanders said.

Sen. Roger "Doc" Marshall, MD

"I've always said that I'd work with any of my colleagues as long as the person sitting across the table and I have the same common goal,” Marshall said in the joint statement. “Senator Sanders and I share our belief that every American should have access to affordable, meaningful health care."

Investing in health

Community health centers are the heart of the plan, with $5.8 billion a year in mandatory funding over the next three years. Within that, $245 million will pay for expanded operating hours and $55 million a year will cover school-based health services.

The health centers will get $3 billion in capital funding, largely to expand dental care and mental health resources in their facilities.

The National Health Service Corps funding will grow from $310 million to $950 million a year over the next three years to pay for 2,100 scholarships and debt forgiveness for an estimated 20,000 physicians, nurses, dentists, mental health providers, and other clinicians working in underserved areas.

Nursing schools will get $1.2 billion in grants to add up to 60,00 additional two-year-trained registered nurses.

Further action coming

The Senate Committee on Health, Education, Labor & Pensions, which Sanders leads, will begin markup of the legislation on Sept. 21.

A week earlier, Sanders and Marshall spoke for more than 22 minutes summarizing problems with the U.S. health care system and their proposed solutions, according to the session webcast by C-SPAN.

Physician, nurse, and dentist shortages are critical and getting worse. Nationally, the United States spends per capita $13,000 a year on patients, “an astronomical sum of money,” almost twice as much as most other countries, Sanders said. But an estimated 85 million Americans are uninsured or underinsured, some 60,000 people die a year due to lack of health care, and U.S. life expectancy is declining, he said.

Meanwhile, the senators found common ground discovering that community health centers are doing a great job for patients. They could become new epicenters of primary care, joined with dentistry, nutrition education, and mental health services, said Marshall, who worked for years as an obstetrician-gynecologist.

The plan is a thoughtful approach to refocus health care spending on primary care – without costing American taxpayers, Marshall said.

“I'm glad to see us try to emphasize maybe some better ways to spend the American taxpayer monies,” Marshall said. “But most importantly, to me, the position is just, this is the right thing to do. This is absolutely the right thing to do.”