Our health system is in urgent need of reform. More than 47 million Americans lack
health insurance, and this number is likely to grow with the economic downturn. Reforming
today’s system of “sick care” into a health care system that offers affordable insurance coverage
to all our citizens is essential for meeting the nation’s health care needs and strengthening our
economy for the future.
We know, however, that expanding insurance coverage alone is not enough to address
our declining state of health care. We face a severe shortage in the health care workforce,
particularly in primary care. Interest in the practice of family medicine by U.S. medical students
is at a 10-year low. The combination of a weak economy and growing medical school debt is
pushing graduates into other specialties. Last month, less than 3 percent of new residents opted
for primary care, and nurses, physician assistants, dentists, and other health care professionals
are following suit. Just this week, the doctor shortage was featured in The New York Times.
Even after enacting broad health reform, Massachusetts is facing this same challenge.
Primary care providers are the backbone of a strong health care system. Primary care
helps prevent illness and death, and leads to healthier patients and lower costs. It also has an
important role in reducing health disparities across the nation.
Community health centers and the National Health Service Corps are increasingly
important in bringing affordable, high-quality primary care to citizens in medically under-served
areas. They act as a safety net, and their massive role is effective in reducing health disparities
and saving money. A recent study by the Robert Graham Center in Washington, DC, found that
people who use community health centers as their typical source of health care have 41 percent
lower expenditures on care than people who receive care elsewhere.
Workforce development must be an essential component in any major health reform. We
can train more providers by increasing enrollment at health sciences schools and residency
programs, particularly in community-based settings. We can improve payment incentives to
make careers in primary care more attractive financially. And we can expand the National Health
Service Corps to give greater access to primary care to Americans living in rural and underserved
Our aging population and public health emergencies like the swine flu epidemic
empha the need to improve all aspects of primary care. I look forward to working closely
with my Senate colleagues on the HELP and Finance Committees and President Obama to do so.
I commend Senator Sanders for his continued dedication to community health centers and the
National Health Service Corps, and his impressive leadership in these areas of health reform. I
look forward to learning more from our witnesses today about these important issues.