Casey introduces bill to boost primary care docs

U.S. Sen. Robert P. Casey (D., Pa.) introduced legislation Monday intended to boost the number of primary care physicians, to meet the future needs of veterans and baby boomers.

In a news conference at Thomas Jefferson University Hospital, he unveiled the Resident Physician Shortage Reduction Act, which would remove the cap on the number of federally funded resident training positions at teaching hospitals in the country.

Casey cosponsored the bill with 11 other Democrats, including Majority Leader Harry Reid (D., Nev.).

"This would have a tremendous impact on our country, were we to get it enacted," Casey told a lecture room brimming with residents, doctors, and hospital administrators. "We want to make sure we give you the tools to do your job."

In 1997, Congress capped the number of residencies funded through Medicare at 26,000. Casey said his bill would provide for 15,000 new residency slots by 2019.

The legislation would also require the National Health Care Workforce Commission to submit a report on specialty physician shortages to Congress by Jan. 1, 2016, and the U.S. Government Accountability Office to report on methods for increasing diversity among health professionals.

Given the aging of baby boomers and the influx of veterans in need of care, the American Association of Medical Colleges (AAMC) predicts a shortage of 91,500 physicians by 2020, a number expected to increase to 130,600 by 2025, if Congress refuses to elevate the current cap.

While Casey enjoyed support from the staff gathered at Jefferson, several medical professionals asked how he expected to gain backing for an increase in Medicare funding in Washington.

Casey acknowledged that federal funding was a major obstacle for the bill, which he hopes to pass by the end of 2014.

"The wheels of legislation move far too slowly, even in urgent matters like this one," he said. "I hope they will be reasonable and say, 'We need to make an investment and find the dollars.' "

Geno Merli, an internal medicine and vascular medicine specialist at Jefferson, warned that the increase in federal funding needed to bring in new residents may lead to cuts in other areas, such as compensation to hospitals providing graduate education.

"The senator has to work to get those extra dollars," Merli said. "That's my biggest concern."

Casey said he planned to use the capital's current focus on Veterans Affairs reform as a vehicle for related medical legislation. On Thursday, Sens. Bernie Sanders (Ind., Vt.) and John S. McCain (R., Ariz.) introduced a bill that would fund construction and staffing for 26 new veterans' medical facilities, while allowing some of their patients to seek private care outside the VA.

"We can't simply think of this as a VA problem alone," Casey said, noting that a recent audit blamed a shortage of Medicare-provided primary care doctors for dangerously long VA waiting lists. An increase in the number of resident-training positions could help address audit findings of 1,700 veterans awaiting primary care for as many as 115 days.