Deputy Secretary Corr Remarks at the Summit on the Future of Primary Care

Washington, DC - August 12, 2009

Remarks as prepared for delivery

Thank you to everyone at HRSA who worked so hard to make this conference possible; to the speakers—the leading minds and advocates in public health today—and to Dr. Wakefield. 

We’re fortunate to have Mary Wakefield here at HRSA. From the rural communities of North Dakota, to policy discussions at the Institute of Medicine, Mary knows the primary care field. So do you.

This morning I’m going to talk about the primary health care workforce in the context of health care reform. In fact, reform and workforce issues are intertwined.

This week, the President is hosting several town hall meetings. Town meetings are among the democratic traditions that make this country great. They’re an opportunity for citizens and elected officials to communicate with each other directly. They’re an opportunity for all sides to state their views and have their interests heard.

Right now, when communities, providers, families, and patients all over the country are pushing for health care reform, and vested interests with money to spare are organizing against it, you have an obligation to make your views heard too. We want and need a robust discussion of the facts. This issue is too important to do anything less. But we have to make sure we dispel the myths, and you can help us with that.

For the Obama Administration, this isn’t about politics; it’s about people’s lives. I didn’t say that—the President did. But who knows better than you?

I’ll bet not a week goes by that you don’t run across someone who’s having trouble getting health insurance because he or she got sick. The need for health reform is real.

One in every three Americans under the age of 65 was uninsured at some point in 2007 and 2008. More than 80 percent of them were from working families.

Half of all personal bankruptcies are at least partly the result of medical expenses.

People can’t afford the health care they need. Employer-sponsored health insurance premiums have more than doubled in the last nine years, a rate three times faster than wages. Employers are reeling from rising health costs. For many small business owners, health care is their highest expense, just behind salaries.

Giving people the care they need is the reason you come to work every day. Providing children with well-child care—immunizations, basic dental and vision services, and advice on healthy living—sets them up for long, productive and satisfying lives.

Providing adults with preventive care, health screening, and counseling can keep disease from becoming chronic. If a patient develops a chronic disease, primary care providers ensure patients receive the care they need to stay healthy.

Without insurance, health care becomes inaccessible for millions of Americans.  

Even elderly people—protected by Medicare—will have to save nearly $300,000 over the life of their retirements to pay for health costs Medicare doesn’t cover.

You understand this—you see it every day—but you need to help people in your communities understand it as well.

Congress has been crafting health care legislation this summer. We’ve been moving ahead as well.

We’ve already taken some important steps in the Recovery Act, not only committing billions to protect people’s health care during the recession, but also making some lasting changes so the system will begin to meet people’s needs better.

We’ve begun to fund the infrastructure that will enable doctors and hospitals to make 21st century health information technology part of their daily routine.

When all the providers on a patient’s team can have a full medical history in an instant; when prescription records, lab results, treatment histories, and x-rays can follow a patient to the emergency room or to a specialist across town; when you can multiply this for every member of the community because every practitioner is part of the network, then the health of the entire community will improve.

We’ve directed $1.1 billion to comparative effectiveness research.  

People need to be able to expect care that makes them better, as well as care they can afford. But if we’re truly going to improve quality and cut costs, then we need to empower patients and their health care providers to make the best health-care decisions. You, as providers, understand this.  

Comparative effectiveness research provides the evidence base to promote high-quality care and reform a system that, at the moment, equates more expensive care with better care. 

There are communities that provide better care for less money. We need to identify their best practices, and replicate their success. Much of the time this means providing better support for primary care. But as you’ve heard over and over during this conference, there aren’t enough people joining you these days.

We hear directly from health care providers all of the time. They tell us how sick people often seek help in the emergency room first. Or, people fall through the cracks of an increasingly fragmented health care system, letting illnesses deteriorate until they are harder to treat and cost more.  Is it a surprise that health care costs are about twice as high in the U.S. as in other industrialized countries?

Twice as high…not twice as good.

Dr. Wakefield already told you about the Recovery Act’s $200 million for expansion grants to colleges and universities, to support the education of 8,000 students in primary care—enough to provide health care for an additional 2.2 million people.

Today HHS is awarding $13.4 million from these expansion grants, to nursing students and nursing schools. These funds will repay loans if new nurses choose to practice in critical shortage areas. They will enable nursing schools to support students who plan to teach nursing when they graduate.

The need for more nurses is enormous. Over the next decade, nurse retirements and an aging U.S. population will create the need for hundreds of thousands of new nurses. We intend to meet the demand, not only for nurses but for other primary care providers as well.

Every day you go to work, you see that health care—from basic prevention to modern medicine—is just not there for too many Americans. If we fail to act now, thousands of Americans will lose their insurance. We know that without insurance they will not be able to get the high-quality health care they need.

On the other hand, when President Obama signs a health insurance reform bill into law, the discrimination, dropping, and coverage gaps that riddle today’s health insurance system will be a thing of the past. Investments in primary care and our nation’s health care workforce will ensure that the health care system provides high-quality care for all who need and deserve it.

I want to close with this. Americans may soon be reminded, yet again, how critical your services are as we enter what may be a highly unusual flu season. This fall—as every fall—we not only have to plan for a new version of seasonal influenza, but in addition, another potentially serious strain, the 2009 H1N1 virus.

Primary care providers will be needed to educate patients about the pending vaccine, when they need to seek care, and when they should stay home. Patients will be relying on you to teach them to protect themselves against the flu now, and recognize what they need to do when flu season hits.

You may be called on to extend your own office hours to reduce the burden on emergency departments. You will be asked to identify your high-risk patients—children and youth, and kids that have asthma; pregnant women; people with neuromuscular conditions; clients with chronic diseases; obesity, and the like—and intervene early. You’ll want to extend these protections to members of your staff.

Finally, as a primary care provider, you’ll want to have a plan ready for securing and distributing vaccine to your staff and your patients. You are the first responders. Everyone—your patients, families, communities, and the country—will be counting on you.

You are the foundation of the public health system. So, during August, when your elected officials are reaching out to you for your views on health care reform, answer them.

Tell them: We need health care reform. We need it now. You see the results of inaction every day. It’s not about politics; it’s about saving people’s lives.

Thanks very much for your time. Enjoy the rest of the conference.