Neal: Obama wants investments in primary care

Second District Congressman Richard E. Neal was among the House Ways and Means Committee Democrats who spent about an hour meeting with the president at the White House earlier today to discuss health reform and global warming.

On health care, Neal said the president was as focused on cost as he was on coverage and spoke extensively about a widely noted piece by Dr. Atul Gawande, an author and surgeon at Brigham and Women's Hospital, in the June 1 issue of the New Yorker. The article, "The Cost Conundrum," attempts to explain the dramatic differences in health spending between two neighboring Texas towns with similar demographics, drawing its thesis from researchers at Dartmouth who argue healthcare spending varies widely by geographic region largely because of stylistic differences in how doctors practice medicine -- how often they do procedures, recommend specialists or order tests.

Neal said Obama placed a special emphasis on the need to invest in primary care. Many health policy specialists believe that excellent primary care and strong relationships between patients and their doctors can prevent the overuse of expensive specialists and hospitals. At present, however, primary care accounts for a small and shrinking share of national spending on healthcare. Health policy specialists increasingly worry about a shortage of primary care doctors because medical students are increasingly choosing higher-paying speciality work instead. Neal said Obama spoke about providing financial incentives to primary care doctors, such as help with student loans.

Neal said Obama also emphasized his desire for the House and Senate to pass healthcare bills by August so they can resolve the differences in the fall and produce a single bill for him to sign.

Republicans have criticized early Democratic proposals as too expensive and involving excessive government regulation, but Neal, a veteran of the Clinton healthcare battles of 1993-4, said Obama was still seeking a bipartisan compromise.

"The game plan is to keep the Republicans in the room," he said. "He was very clear about that."