Monday, March 22, 2010

Health Reform: Prevention, Wellness, & Primary Care

"Of all the forms of inequality, injustice in health care is the most shocking and inhumane."
~Martin Luther King, Jr
Health care reform passed in the House last night, and if all goes well will become final this week. Representative James E. Clyburn of South Carolina said, “This is the Civil Rights Act of the 21st century.”

With this reform, 32 million previously uninsured people will now be insured, health insurers will be unable to deny or drop coverage to the sick, small businesses will receive tax credits for buying employees’ health insurance, and the Medicare “doughnut hole” will be closed.

In addition to all of that, there are many exciting preventive/ wellness/ primary care changes worth highlighting.

The bill will:
  • Establish a “Community-based Collaborative Care Network Program” for health care providers to create integrated health care services for low-income, uninsured, and underinsured populations.
  • Establish “The National Prevention, Health Promotion and Public Health Council” to coordinate prevention, wellness, and public health interventions.
  • Create a Medicare demonstration program called “Independence at Home” to provide primary care services in patients’ homes, allowing health professionals to share in savings from reduced hospitalizations, reduced health services, and improved health outcomes.
  • Establish a grant program to support evidence-based and community-based prevention and wellness services that increase prevention, reduce chronic disease rates, and address health disparities.
  • Provide free evidence-based preventive services (i.e. no cost-sharing).
  • Provide grants for small employers to develop “wellness programs,” and establish pilot programs to financially reward employees for participating in these wellness programs.
  • Require chain restaurants and vending machines to disclose nutritional content of each item sold. 
  • Increase residency-training positions, prioritizing primary care and general surgery in areas with low physician-to-population ratios.
  • Increase flexibility in laws regarding residency payment in order to promote training in outpatient settings.
  • Ensure availability of residency programs in rural and underserved areas. 
  • Increase workforce supply of health professionals by providing scholarships and loans for primary care training, providing grants to providers in medically undeserved areas, recruiting providers to rural areas, creating loan repayment programs, training residents in preventive medicine and public health.
  • Support the development of training programs that focus on the primary care models of medical homes, team management of chronic diseases, and the integration of physical and mental services.
  • Increase funding for community health centers. 
  • Establish new programs for school-based health centers.


  1. Less than half of U.S. primary care residencies were filled this year by U.S. medical school graduates! Check out this blog on NPR:

  2. Yeah only 45% of the family medicine spots were filled (and this is with a 9% increase in applicants from last year!)

    Hopefully loan forgiveness, increased salaries, and other programs in this bill will help attract more people into primary care...