It is time for us to create a uniquely American health system that builds on what works and fixes what is broken. We must make health care more efficient and affordable so that all Americans have the opportunity to receive quality care. And we must put doctors and patients back in charge of our health care decisions – not insurance companies.

As the health reform debate continues, the overriding goal for me is, and always will be, providing the opportunity for every American to access quality care. The debate over how we expand coverage has received the most focus and it is very important that we get it right when we develop new insurance options for patients. I will continue to advocate for a system that gives Americans more choices including a “public option.” I strongly support a public option health plan because I believe enhanced competition in the health care market will reduce cost and promote innovation.

But there are several other issues receiving much less national attention that I view as equally important to the success of our reform efforts. I have been particularly focused on ensuring that we have an adequate number of doctors and nurses to support our new health system; bringing a new emphasis to primary and preventive care so that we can catch health problems before patients become very sick and reduce cost; and finding ways to bring health services to the patient through “place-based health care.” I have introduced legislation to support each of these goals and have worked to make them a part of the broader health care reform debate.

THE HEALTH CARE WORKFORCE INCENTIVE ACT (H.R. 2929)
Align our health care workforce with current and future patient needs

If we are to successfully reform our health care system, we must create a fiscally sustainable, integrated workforce that will take into account national trends, as well as state or regional factors. An adequate and properly organized workforce is critical to supporting a high-quality health care delivery system

Health care quality, access and cost are necessarily dependent on the current and future health care workforce. Yet, the U.S. has no clear policies or regularly articulated goals guiding federal, state and local investments in the health workforce. In many areas, data to support a coordinated strategy is insufficient or irregularly collected. In order to make good policy decisions, we need to bring more focus to these issues. The Health Care Workforce Incentive Act of 2009 will:

• Establish a National Health Care Workforce Advisory Board;
• Establish a National Center for Workforce Data and Analysis;
• Provide resources for State and Regional Health Workforce Councils

Sound research methodologies are required to determine the nation’s current and future needs for physicians by discipline, specialty and geographic area. The purpose of the Health Care Workforce Incentive Act is to provide resources for federal and state review of health care workforce capacity and projected needs and make recommendations directly to Congress concerning workforce priorities, goals and policies. Specific topics would include current health workforce demographics, skills sets and needs; training capacity; health care workforce implications of Federal policies; health care workforce needs of special populations; and other high priority topics as determined by the Advisory Board or Congress.

THE PRIMARY CARE TRAINING ENCHANCEMENT ACT OF 2009 (H.R. 2930)
Adequate access to primary care means improved health outcomes and lower cost

The Association of American Medical Colleges estimates that there will be a shortage of 46,000 primary care doctors by 2025. Yet, two-thirds of the U.S. physician workforce practice as specialists and the number of young physicians entering primary care is declining. We must provide incentives for medical students and young physicians to enter medical fields that are experiencing shortages or to practice medicine in places that have the most need.

To help address these problems, Congressman Sarbanes recently introduced the Primary Care Training Enhancement Act. This bill will:

• Establish new teaching health centers to train primary care doctors with a focus on preventive and community based care.
• Ensure adequate resources for medical resident positions dedicated to training primary care doctors.
• Expand medical training in ambulatory and community-based settings to prepare young physicians for current patient needs.
• Enhance and target scholarship and loan forgiveness programs to ensure an adequate and properly organized health workforce.

THE HEALTHY SCHOOLS ACT OF 2009 (H.R.2840)
Bring health care to our schools and ensure access to quality care for all children

This Congress made a historic commitment to providing health coverage for children when we expanded the SCHIP program earlier this year. But there are still many barriers that keep children from getting the care and preventive health services they need. By supporting school based health centers, we can ensure that all children have regular access to high quality health care.

It is well established that regular access to primary care results in better health outcomes and lower total costs. Children spend five days a week in school and there is no better place to deliver regular primary and preventive care.

School based health centers are not a new concept. They exist in many schools around the country. However, services provided at school based health centers are not currently eligible for reimbursement under Medicaid. These same services are eligible for reimbursement if provided at other sites such as physicians’ offices and hospitals. The Healthy Schools Act of 2009 will correct this discrepancy and bring health care to more children by authorizing Medicaid funds for care provided at school based health centers. By doing so, we can maximize the chances they will receive regular check-ups and catch health problems sooner.

Apart from their direct impact on improving health, SBHCs have been shown to:

 

• decrease student absences;
• reduce academic failure rates;
• reduce health inequities;
• and mitigate important health-related risks such as school violence, injury, asthma, obesity, and tobacco use;

School based health centers represent a practical but innovative approach to health care delivery. It is a common sense solution that will make our health care system more efficient and provide parents with more choices when they make health-related decisions for their children.

THE PLACE BASED HEALTH CARE ACT OF 2009 (H.R. 3158)
Bring health care to the patient to make regular checkups more convenient

As we reform our health care system, we must find ways to deliver care more efficiently to the people who need it. We can accomplish this by giving providers incentives to “go where the people are.” “Place-based health care” will create health homes for specific communities like children, seniors, and workers. This method of delivering care is a paradigm shift that will ensure regular primary and preventive care for patients, keeping them healthier and reducing cost. The Place Based Health Care Act of 2009 builds on the Healthy Schools Act of 2009 and accomplishes these goals by bringing health services into schools, workplaces or senior service facilities.

Specifically, the Place Based Health Care Act of 2009 would:

• Provide incentives to establish more school based health centers by authorizing Medicaid funds for their establishment and the services provided there with the goal of ensuring universal primary care for children – Among the 41 million people without health insurance in the United States are millions of school-age children, and multiple barriers keep children who are insured from getting the care and preventive health services they need. Children spend five days a week in our schools. They could be accessing high quality health care through expansion of and coverage of school based health centers.
• Offer tax credits to businesses that make health clinics available to their employees in the workplace – Research has consistently shown that bringing medical services in-house can enhance productivity at businesses while curtailing health care costs. Companies that invest in the health of their employees by providing a broad array of health and wellness initiatives should receive tax benefits for doing so.
• Provide incentives through Medicare for providers to establish healthy aging centers at senior service facilities – Borrowing on the school based health center concept, providers would partner with state or local aging departments and other stakeholders to provide heath services at senior centers or low-income senior housing facilities. These healthy aging centers would ensure that seniors receive regular care as opposed to only when they are sick. By providing health and wellness services in places where seniors ordinarily gather, we can establish a healthy community ethic and improve health outcomes.

Watch video of Congressman Sarbanes speaking on the House floor about health care:

Fixing America's health care system

Statement in support of H.R. 3200, America's Affordable Health Choices Act of 2009