Neil Meltzer is known in Baltimore circles as the head of Sinai Hospital, but he has also become a player in shaping health care reform.
Meltzer has been chosen as one of 15 people to serve as a member of the Government Accountability Office's National Health Care Workforce Commission.
Meltzer, chief operating officer and president of Sinai Hospital and senior vice president of LifeBridge Health, was told this month by Gene Dodaro, acting comptroller general of the United States and head of the GAO, that he had appointed to the commission.
Meltzer became known in national circles through his work with the American Heart Association, which included a one-year stint as the former national chairman of the board. The organization played a visible role in lobbying for more accessibility to health insurance during the early debate over health care reform.
The commission will look at ways to strengthen the country's health care work force in preparation for reform. Members will look at everything from training and diversity to financial issues.
Meltzer talked to The Baltimore Sun about his new role and the issues the health care work force faces as hundreds of thousands of people gain access to health insurance under reform, which has potential to put unprecedented strain on existing resources.
Question: How did you get chosen to serve on the commission?
Answer: I was approached by folks from both the American Heart Association and others from around the country, including a couple of members of Congress, about serving on this commission. I had been involved with the health care reform through my association with the American Heart Association during the health care reform debate. I had a number of conversations with [Speaker of the House Nancy] Pelosi, [Health and Human Services Secretary Kathleen] Sibelius and others. My name was known among many people.
Q: How was the American Heart Association involved with the reform debate?
A: The association was involved in all aspects of reform dealing with assuring accessible care, the elimination of pre-existing conditions, affordable care and other aspects to assure the population has access to preventive care.
Q: What is the mission of the commission?
A: I'll be honest with you, we haven't met yet and we haven't even communicated by telephone yet. There are special topics to be reviewed: current health care work force supply and distribution, demand, skill sets for the next 10 to 25 years, health care work force education. … We'll be making recommendations about changes in policy and perhaps appropriations. We'll be making recommendations for revisions of national repayment of loans for all health care-related students. Looking at what we can do to serve medically underserved communities. There are several high priority areas.
Q: What is the most pressing problem we face with the health care work force as reform is implemented?
A: My concern is that the number of people who will be insured is going to skyrocket in the next four or five years and we have a real shortage of primary care workers, and we have an aging health care work force generally. There will be a need for someone to provide primary care. I'm not even saying physicians because we don't know who will be doing the care.
Q: How do we solve the shortage of primary care physicians?
A: That's what we are going to be talking about. At this point I'm reluctant to say anything until we meet as a group. We're going to have to increase the number of primary care workers. We will have to look at other medical professionals that can provide certain types of care, whether screening or wellness or vaccination or checkups. This will be one of several components formed from health care legislation.
Q: Will there be people who won't be able to find doctors?
A: I think there are people who will have trouble finding a primary care physician. It is going to be hard, with the capacity, to handle the volume of patients who are going to enter the market with insurance. We're beginning to see that problem now even in the Baltimore region.
Q: Why is it hard to get medical students to become primary physicians?
A: Clearly, people look for more lucrative opportunities. People come out of medical school with expensive loans that they need to pay back. It's difficult to be a primary care physician because of the workload unless you're part of a much larger group.
Q: Do you think nurses and physician's assistants should fill in until we get enough primary care doctors trained?
A: I don't want to determine that yet until I hear all sides of the argument. I can tell you I think there are certain aspects of primary care that can be and are done by mid-level practitioners and that includes nurse practitioners and physician's assistants.
Q: What is LifeBridge doing to prepare for health care reform?
A: We constantly have residence programs. … What we are trying to do is encourage folks to enter the primary care market, hiring more physicians who want to serve in the local area to serve our population. … We're trying to position ourselves to be able to offer [services] from wellness through post acute care services.
Q: Is there anything that worries you about health care reform?
A: We're still trying to understand the legislation. … This is coming about as people craft the details associated with a broad policy which is health care reform. It is a lack of details and knowledge and the lack of ability to fully prepare until some of these details are fleshed out.