Health Care BS

Kevin, MD has written an open letter to John McCain and Barack Obama challenging them on the primary care crisis. He correctly points out that neither has a plan to deal with the problem:

I do not hear any solutions addressing this issue on the campaign trail. No suggestions to, i) reform the dysfunctional physician payment system which rewards expensive procedures at the expense of office visits for preventive and chronic care; ii) encourage medical students to enter primary care fields by forgiving their medical school debt; and, iii) fairly reconciling the wide chasm between specialist and generalist salaries.

Discussing Obama’s plan to dramatically expand government coverage, he says:

You assume that there will be enough primary care doctors to care for this sudden influx of newly insured patients … Implementing your plan without a solid primary care foundation will doom your proposal to failure. Universal coverage is useless without appropriate access to care.

Discussing McCain’s market-based approach to health care reform, he says:

Like your Democratic counterpart, you do not address the primary care crisis. If your plan comes to fruition, patients will be more responsible for their health spending … Without adequate access to primary care, patients will be forced to choose care at more expensive venues and sacrifice preventive care.

The primary care crisis is one of the most significant problems facing U.S. health care. Oddly, it doesn’t seem to get much coverage in the media. In fact, it gets surprisingly little play in the health care blogosphere compared to ther issues.

Kevin is right. I’m on record, of course, as being in favor of McCain’s market-based plan as opposed to Obama’s government-based plan. But any plan that doesn’t deal with with the PCP shortage will have difficulty succeeding.