The New Health Dialogue

Since 2006 more than 340,00 previously uninsured residents of Massachusetts have gained health insurance. As The New York Times recently noted, the expansion in coverage stretched the state's health care resources, especially in primary care. That's why we were particularly encouraged to read Elizabeth Cooney's Boston Globe piece on how community health clinics in Massachusetts have successfully recruited much-needed primary care physicians through a loan repayment program.

Funded by a $5 million grant from the Bank of America and administered by the Massachusetts League of Community Health Centers, the program provides up $25,000 a year for three years to repay loans. In its first year the program recruited 47 clinicians—more than double what they expected. Before the incentives, these centers last year had been unable to fill about 10 percent of their primary care positions.

We've written before about the importance of community health centers in providing primary care to underserved populations. Finding the doctors to meet the demand is not always easy. According to the Globe, doctors working at such clinics earn noticeably less than they would in private practice (Salaries range between $110,000 and $130,000 a year in Massachusetts). But for a typical young doctor who comes out of training with more than than $139,000 in debt, the program helps both the doctors and the patients they serve.

Study after study has shown primary care to be crucial to improving the quality and reducing the costs of medical care. Dr. Roy M. Poses at Health Care Renewal writes frequently about the flawed way we reimburse primary care compared to more procedure-intensive specialties in this country. More broadly, the shortage of primary care doctors in Massachusetts and our country as whole speaks to the need to reform the way we pay for and deliver health care. The goal of the payment system should be keeping patients healthy, not just making specialists wealthy.