Health Care Reform & Primary Care Physicians

By 2014, an estimated additional 32 million United States (U.S.) citizens will have access to health insurance, either from a private insurer or Medicaid, regardless of pre-existing conditions. This represents a significant increase in potential consumers seeking healthcare. In this blog, I will explore an issue relating to the capacity needs of the U.S. healthcare system resulting from enactment of the Patient Protection and Affordable Care Act (the Affordable Care Act or ACA) such as the availability of primary care physicians. I will also share with you a tip on how to take charge and control of your health as you prepare for your annual visit you’re your primary care provider.

Primary Care Physicians

The ACA includes a number of provisions to stimulate the supply of primary care physicians, such as an increase in primary care residency positions and increase in the Medicaid reimbursement rate to 100% of the Medicare rate for years 2012 and 2013.  How do we know that renewing a primary health care system will positively impact the delivery of care and consumer outcomes? The lessons learned from the Spanish health system may offer us a lesson on how to improve health outcomes in a cost effective manner by focusing on prevention and a solid primary health care approach. In 1978, Spain moved to a tax-based health system that offers universal access to care for the entire population.  A critical part of the transformation was the organization of the system at the local level around primary care teams responsible for health promotion, treatment and community care (Health Affairs, 2010). In the 30 years since the start of reform, Spain has made marked gains in improving population health at low cost relative to the U.S.  In 2007, Spain spent $2,671 per person (8.5% of gross product GDP) on health care as compared to $7,290 per person (16% of GDP) in the United States (Organization of Economic Cooperation and Development, 2009). In addition, the infant mortality is estimated at 4.21 deaths per 1,000 live births in 2010 as compared to 6.22 for the United States (Central Intelligence Agency, 2010).  Could we extrapolate the same results in the United States? The Spanish experience appears to reinforce the importance of primary care to achieving the quality improvement and cost control objectives underlying the ACA; however, it also suggests that the issue goes far beyond ensuring an adequate supply of primary care physicians.  Rather, Spain’s success is based on a complete change in focus where the care is offered and sought within each community.  Are U.S. citizens ready for this cultural change?

I am sure that many of you may know someone who is already having a hard time accessing a primary care provider. In fact, this is happening not only in rural areas but also in some metropolitan areas. As you prepare yourself for a visit to your primary care provider, think about the laboratory testing that he or she may consider for you. For example, when I prepare for my annual visit with my primary care provider, I make sure I obtain all the basic blood work included in a male comprehensive panel (complete blood count (CBC), comprehensive metabolic panel (CMP), lipid panel (cholesterol, HDL and LDL), prostate-specific antigen (PSA), testosterone, Dehydroepiandrosterone Sulfate (DHEA-S), and a urine analysis. I make a point of getting all this blood and urine analysis 7 to 10 days before my appointment so that when I visit with him he has in his hands the results of all this basic work-up and is able to conduct a complete physical exam. Imagine how impressed your primary care provider would be if you did that and how much time you both can save? I would encourage everyone to consider this practice since it also allows you to take charge and control of your health.  

Conclusion

The ACA will offer access to care to more than 32 million American citizens in the very near future. This new law will change the way healthcare is delivered and influence the overall health of the American population. The success of this reform is based on access to primary care; in other words, an expanded and easily accessible system of primary care physicians and advanced practice nurses providing care at the community level. I also invite you to take charge of your own health and share a tip on how to best prepare yourself for your annual exam with your primary care provider. In my opinion Any Lab Test Now located at 5219A W Lovers Ln is an excellent choice to obtain all your laboratory blood, urine, saliva, nail and hair testing.