Surgeon General Says Health Care ‘Moving in Wrong Direction,’ Even With Expansion of Government Entitlements
At a meeting of the Patient-Centered Primary Care Collaborative in Washington, Benjamin said it's up to health care professionals to turn things around: “I believe you and I have to be lighthouses, to stand our ground, to change the directions of those great battleships that are moving in the wrong direction. And we know we are moving in the wrong direction, she said, pointing to things “like health disparities, the uninsured, the underinsured, underfunding of Medicaid and care for the poor.”
Until she took the surgeon general post, Benjamin, a family physician, operated a health clinic in rural Bayou La Batre, Ala. “Patient-centered care is what I've been about all my life,” Benjamin said on Tuesday. She said she advocates treating “the whole family, not just the patient.”
Benjamin’s remarks were tailored to her audience. The Patient-Centered Primary Care Collaborative – a coalition of employers, consumer groups, patient quality organizations, health plans, labor unions, hospitals, clinicians – is working to develop and advance the concept of “patient centered medical homes,” which are described as healthcare settings that encourage “partnerships between individual patients and their personal physicians, and when appropriate, the patient’s family.”
In patient-centered medical homes, primary-care physicians track patients through the entire spectrum of their medical care – including visits to specialists and monitoring patients to be sure they’re taking their medication and following doctors’ orders.
Advocates believe that patient-centered medical homes – with their emphasis on patient maintenance and monitoring-- will help states lower their rapidly growing Medicaid costs.
Benjamin told the group that her own clinic in Louisiana didn’t call itself a medical home but it did practice those principles. “Our goal was and still is to meet the needs of the patient and not the needs of the doctor or the staff,” she said.
Benjamin’s comments came on the same day that President Obama signed a health care "fix" bill into law, increasing the number of Americans who will be eligible for Medicaid by as many as 20 million. The Medicaid program is administered by the states and jointly financed by states and the federal government.
Under the new health care law, the federal government (American taxpayers) will pay for the states' Medicaid expansion until 2015, when the federal funding will be sharply reduced, leaving states in a potentially worse money crunch than they are right now. Critics say the states, to avoid going broke, will have to reduce Medicaid payments to doctors, who might then stop seeing Medicaid patients.
Dennis Smith, senior research fellow at the conservative Heritage Foundation, said monetary shortfalls have forced 28 states to cut Medicaid funding in their 2010 budgets – evidence that states already are struggling to pay the medical expenses of people currently enrolled in the program, and would face even greater financial hardship as the number of enrollees increases.
Rep. John Barrow (D-Ga.), one of 34 Democrats who voted against the Democrats’ health care bill, said concerns about expanding Medicaid was part of the reason why he opposed the legislation.
“I am strongly in favor of reforming the health care system, but I don’t think this bill is going to do it, and therefore I can’t support it,” Barrow said. “It puts too much of the burden of paying for it on working folks who are already being overcharged, and that’s not fair. It threatens to overwhelm Medicaid in Georgia, and that’s not right,” Barrow said.
An Indiana television station reported on March 23 that Republican Governor Mitch Daniels, who openly opposed the health care legislation, said he and his aides are not sure how much the federally mandated expansion of Medicaid will cost the state, but he said it could raise the current bill of $1.8 billion a year by as much as a third.
‘Wellness and prevention’
Regina Benjamin told the health professionals gathered in Washington on Tuesday that her priority as surgeon general will be “wellness and prevention.”
In her personal life, Benjamin has faced health challenges, including losing her father to diabetes and high blood pressure, her mother to lung cancer and her brother to HIV.
Benjamin, 53, also has been criticized for being overweight. In an interview in January on Good Morning America, Benjamin admitted she was hurt by comments people have made about her size.
“I’m a woman just like everyone else, and most women want to be attractive,” Benjamin told interviewer Robin Roberts. “You don’t want to see negative things, people calling you names. So it was very hurtful.”
“Health and being healthy and being fit is not about a dress size,” Benjamin said. “It’s about how fit you are at a moment in time. I’m just like 67 percent of Americans. I struggle with my weight just like they do, so I understand. I want to have them help me and I will help them and we’ll work together to try and become a healthier nation.”