September 18th, 2019


Let’s Address the Primary Health Care Crisis in Vermont and America by Expanding Community Health Centers

By Senator Bernard Sanders

The Trump-Ryan-McConnell “health care” bill currently being pushed by Republicans in Washington is one of the worst pieces of legislation to ever pass the U.S. House of Representatives in the mod-ern history of our country. This legislation would throw 22 million Americans off of health insurance, cut Medicaid by almost $800 billion, significantly raise out-of-pocket health care costs, defund Planned Parenthood and do away with protections for people with pre-existing conditions. Meanwhile, it would provide $500 billion in tax breaks to the wealthiest 2 percent, insurance companies and drug companies.

I will do everything I can to defeat this bill.

But no matter the fate of this legislation, we must all recognize that the current health care system is totally inadequate. Premiums, deductibles and co-payments are too high and we pay, by far, the high-est prices in the world for prescription drugs. Further, our primary health care system is totally inadequate. Tens of millions of Americans, including many with insurance, are unable to get to a doctor or a dentist when they need to.

In Vermont, we spend more than $5.5 billion on health care each year. Amazingly, this is an amount just about equal to the entire state budget. And of that amount, we spend over $2 billion in hospitals. That’s a lot of money. In my view, an aggressive emphasis on disease prevention and expanding the delivery of primary health care will not only keep Vermonters healthy, it will save substantial sums of money by keeping people out of emergency rooms and hospitals.

Ask any doctor or nurse and they will tell you this: having reliable access to high-quality primary health care is a big part of what keeps people healthy. That’s because primary care providers are the first line of defense in health — they work to promote healthy habits that prevent disease and manage diseases so they don’t become more serious. That’s exactly the kind of care provided at Vermont’s Federally Qualified Health Centers each and every day.

In recent years, we have greatly expanded community health centers in Vermont. Today, with over 60 locations in all 14 counties, these community health centers provide vital health care services to 155,000 Vermonters, about one in four people in our state.

Our health centers treat children and adults, regardless of a family’s ability to pay. Community health centers see patients with private insurance, Medicare, Medicaid, or no insurance at all. They pro-vide primary care, dental care, mental health services and the lowest cost prescription drugs in America.

In the very rural areas of our state, health centers like Little Rivers Health Care and Northern Counties Health Care are particularly important, as they might provide the only doctor for many miles. In areas like Springfield and Randolph, health centers are partnering with local hospitals to find better ways to care for patients. In Burlington, the Community Health Centers of Burlington has gone to great length to provide culturally appropriate care to the many New Americans they treat. Each of our community health centers is unique, doing what is best to care for the Vermonters they serve.

Federally Qualified Health Centers not only provide care where it’s needed, they do it in a cost-effective way and can be economic engines in their communities. When compared to other providers, community health centers save, on average, $2,371 per Medicaid patient and up to $1,210 per Medicare patient. In one year, they generated more than $24 billion in savings to the entire national health care system. And, because community health centers help people maintain and improve their health and wellness by focusing on reasonably priced primary care, they also help people avoid bankruptcy because of unaffordable medical costs.

In addition, community health centers create jobs and are a boon to local economies in communities that are often struggling. Nationally, nearly 190,000 people are employed by a community health center and they generate more than $45 billion in total economic activity. Here in Vermont, community health centers have provided more than 1,100 people with jobs, making them equal to one of the top 15 employers in the state.

For all of these reasons and more, I have long been a strong supporter of community health centers. I am proud that legislation I first introduced in 2009 greatly expanded community health centers as part of the Affordable Care Act. But there are too many Vermonters – and people throughout this country – who still can’t access primary care. And many, many more can’t find – or can’t afford – a den-tist, a key service that contributes to a person’s overall health.

That is why I have introduced “The Community Health Center and Primary Care Workforce Expansion Act,” along with Congressman Jim Clyburn of South Carolina. This bill calls for a doubling of the number of patients served by community health centers around the country – from roughly 25 million today to 50 million people in the next decade. This will not only save lives and ease suffering, but will save taxpayer dollars by providing some of the most cost-effective care in the country.

The bill also doubles the amount of money for the National Health Service Corps (NHSC), a federal program that provides debt forgiveness for medical professionals who practice in underserved loca-tions. This is particularly important in Vermont, where we not only desperately need more doctors, dentists and nurses, but are facing a situation where nearly 30 percent of our physicians are over age 60 and may soon retire.

This bill also invests heavily in Teaching Health Centers and Nurse Practitioner Residency Training Programs — which train new primary health care doctors and nurses, the majority of whom are trained in community health centers and continue working in them after graduating.

These programs are a win-win, helping young people develop professional skills and filling a need for improved access to care in our communities.

For a full list of community health centers in Vermont, or to find one near you, visit: https://www.bistatepca.org/bi-state-members-vt

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