The outline of the House version of the health care reform bill is now circulating on Capitol Hill, as is the Senate bill. You can read its "talking points," released by House Ways and Means staffers, here. Under its workforce development section, the legislation calls for expanding the National Health Service Corps, a small program in the Health and Human Services Department that allows prospective physicians to earn medical school tuition by promising to serve for five years as a primary care physician in underserved communities across the U.S.
In one of my last efforts at the Center for Science in the Public Interest, I was tasked with trying to gain more attention for health promotion and disease prevention in the health care reform debate. In pursuit of those duties, I wrote the following op-ed (now published on GoozNews). It never ran, but suggests how this relatively obscure program could play a major role in reversing some of the major epidemics ravaging this country, and simultaneously begin to redress the nation's chronic shortage of primary care physicians.
President John F. Kennedy created the Peace Corps to improve the lives of the global poor. Bill Clinton created AmeriCorps to foster domestic service. Many health care observers wanted President Obama to follow in their footsteps by creating a Health Corps.
Alas, it wasn't in his first budget. But there's still time for Congress to act as it gears up to consider health insurance reform.
The new Health Corps should be seen as an essential part of that reform effort. Its mission would be to improve the nation's health by focusing like a laser beam on disease prevention -- a task largely ignored by our existing sick care system.
Despite spending more than any country on earth caring for the sick, the U.S. ranks below many other advanced industrialized nations in life expectancy, infant mortality and other key health measures. In part that's because the existing sick care system ignores people at risk of chronic diseases like heart disease and diabetes, which account for three-quarters of all health care expenditures.
What are the most significant risk factors for these diseases? Untreated hypertension, high blood sugar, high cholesterol, and obesity. The new Health Corps could deploy prevention warriors to combat these conditions in communities most at risk.
The idea isn't new. A poorly funded National Health Service Corps already exists within the Health and Human Services department. It sends a handful of primary care physicians into underserved rural communities in exchange for medical school tuition reimbursement.
A vastly expanded and emboldened Health Corps would go far beyond that limited objective. It would supplement the existing health care system by sending not just physicians, but physician assistants, nurses, dietitians, counselors, and aides into communities across the nation. This will create jobs for those hardest hit by the current downturn.
The corps would conduct mass screenings for blood pressure, blood sugar, and cholesterol. It would provide appropriate care, referrals, and counseling. And, most importantly, its staff could conduct appropriate follow-up visits to maximize the number of people sticking with the program.
The Health Corps could also train community-based para-professionals to set up group counseling programs in concert with local non-profits like the YMCA for people willing to take on the difficult tasks of quitting smoking, ending alcohol abuse, reversing sedentary lifestyles, and losing weight, which are among the leading causes of ill-health in this society.
Countless studies have demonstrated the direct relationship between wealth and health. The modern epidemics of heart disease and diabetes fall disproportionately on poor and lower-middle-class communities. The Health Corps would be an ideal way of targeting programs to those communities most in need of prevention education and services.
The president, a basketball buff, could use the bully pulpit to launch a stepped up national awareness campaign about disease prevention. He could then send the Health Corps with its wellness message into every nook and cranny in the nation.
The Health Corps could also redress imbalances in the existing system of physician training by reinvigorating the flow of doctors into primary care. The U.S. has far too few primary care physicians and far too many specialists, another reason our health care costs are skyrocketing out of control.
The long-term intangible benefits of the Health Corps are immeasurable, but just as real. Joining will affirm the idealism that leads so many intelligent Americans to enter the health professions in the first place. Throughout their working lives, they will carry the knowledge that they began their careers promoting wellness in the Health Corps.