Symposium explores solutions to the health care crisis
April 18, 2013 - “Primary care is our best bet to get out of this health care crisis.”
That's what Dr. Andrew Morris-Singer, president and principal founder of Primary Care Progress, told the medical and legal professionals gathered on April 13 in the School of Law Center for the inaugural Primary Care and the Law Symposium.
The keynote speaker painted a graphic picture of a “dysfunctional health care system” which consumes 17 percent of our gross domestic product (GDP), wastes one out of every three dollars spent, and devotes a paltry 5 percent of its resources to primary care. So desperate is the current reality that Morris-Singer analogized it to the chaotic Omaha Beach landing in the film Saving Private Ryan, where a soldier asks, “What’s the rallying point?” and Captain Miller answers, “Anywhere but here!” Morris-Singer’s clear message was, anything would be better than what we have now.
That’s not to say that Morris-Singer, who brought a background in grassroots organizing into the medical profession and who avidly blogs, speaks at medical institutions and conferences around the country, appears on or in major media outlets like NPR, CNN and The New York Times, and testifies before Congress, doesn’t have a prescription for change. For Morris-Singer, the solution lies in primary care, to which he observed 20 percent of our population lacks regular access.
Morris-Singer cited several reasons that primary care was crucial. Everyone needs primary care, it’s the base of the health care pyramid and it’s the best chance to treat the “whole person,” reducing missteps and waste in the process. Morris-Singer cited both anecdotal evidence and studies showing that a team-based approach to primary care holds the most promise. “Fortunately, we don’t have to start from scratch,” said Morris-Singer. “We’ve got new models of payment coupled to new models of delivery, and where they’re happening they’re making a profound difference.”
The problem is, Morris-Singer explained, primary care has been so marginalized that there are too few practitioners available already. “We’ve been hemorrhaging people from the primary care pipeline for years.” His twofold solution? First, changes in medical reimbursement are needed to reward a team-based approach to primary care and make a primary care practice more sustainable. Second, we’ve got to “hold graduate medical education accountable or we’re just not going to have the primary medical care practitioners we need.”
The difficulty in bringing about change, Morris-Singer observed, is that there are numerous powerful groups committed to keeping their stakes in that 17 percent of the GDP spent on health care. “But we also have leverage,” he said. “Our problems pale in comparison to the problems that our patients have getting access, to the problems of corporations going out of business, to the problems of politicians faced with Medicare budgets, Medicaid, and constituents coming to them saying what are you doing about our access to primary care?”
To be more effective, Morris-Singer concluded, “we’ve got to stop talking about the problems that are affecting us and start talking about the problems that are affecting other people, because that’s what they care about.”