As primary care gets more attention in the health policy blogosphere, we are seeing increasing pushback from those who have something to lose.
Jacob Goldstein reports in yesterday's Wall Street Journal blog that "if Barack Obama makes good on his promise to increase access to health care for America's 45 million or so uninsured, a lot more people are going to be trying to squeeze in appointments with busy primary care doctors." Citing a story in Canada's National Post Goldstein writes that some Canadian doctors fear that U.S. demand might be met by recruiting their family doctors to cross the border.
(Wikepedia tells us that Canadians use eh, in place of huh? or what? ... My reaction to the idea that we'll solve our primary care crisis by raiding Canada's family docs)
Last month, in the same WSJ blog, Sarah Rubenstein wrote about ACP's proposal to use the stimulus bill to fund a 10% increase in Medicare payments for primary care.
The many comments she received are well worth review and commentary by The ACP Advocate Blog readers. Among them:
"Primary physicians really need this 10% increase in fees, at least until we decide what physicians should earn."
"This investment makes sense for the long term. 80% of our doctors are specialists while in other industrialized countries 80% of their doctors are GPs. America spends more but ranks lower than other nations so it would seem this is "carrot" to improve our primary care system will pay off."
"A highly appropriate and justified request. Primary care is a pillar of this country's health care infrastructure, it is in grave need of repair and restoration."
But not everyone agrees, to put it mildly:
"It boggles me how some of you say that primary care physicians are 'ridiculously underpaid' ... I work in 2 hospitals and I've seen the payroll and to think that they deserve even more than that is ludicrous."
"The letter from [ACP President] Dr. Harris is mostly nonsense anyway. The 'shortage' of primary care physicians in Massachusetts for example is due to the sudden increase in patients stemming from the availability of insurance to otherwise uninsured individuals. It has nothing to do with physician pay."
"Pathetic! Next the primary care docs will claim hunger and homelessness."
The comments on primary care, even the extremely negative ones, show that ACP is succeeding in making the public and policymakers aware of the crisis. Otherwise, why would people care about what we say?
But it also shows that even a very modest first step to help primary care, like ACP's proposal for a 10% bonus, will bring out opposition.
Today's questions: What do you think about the idea that the U.S. will solve the primary care crisis by taking doctors away from Canada? And how would you respond to comments like it is "pathetic" and "nonsense" to seek higher pay for primary care?