Friday, May 25, 2018
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The doctor crisis

Great uncertainty surrounds the future of health care, but one thing is beyond doubt: America needs tens of thousands more doctors.

The Association of American Medical Colleges says the country will have 62,900 fewer doctors than it needs by 2015, and the number could rise to 130,000 by 2025. The influx of previously uninsured people into the market because of the federal Affordable Care Act is responsible for some of that need, but broad demographic factors loom larger than Obamacare.

Federal funds pay for a large portion of the residency programs for doctors, and the number of allotted slots has been frozen since 1997. No matter how many medical school graduates there are, the number of training positions in U.S. hospitals stays basically the same.

But the U.S. population has grown by 50 million people in the past 15 years, and those people need medical care. With the biggest population bulge beginning to hit retirement age, 10,000 Baby Boomers are expected to retire every day for the next 20 years.

Their medical needs increase as they age, and the physicians among them are retiring too. Although there is no simple solution to this problem, the country can take steps now to address the shortage.

The proposed Training Tomorrow’s Doctors Today Act would help. The measure, which did not advance in the past Congress despite bipartisan sponsorship, would create 15,000 residency positions over the next five years, a boost over the current number of roughly 115,000.

Unlike similar measures, this bill focuses on increasing the number of training slots for future primary-care physicians, requiring half of the positions for that purpose. The bill anticipates a particular need as the number of uninsured Americans decreases and access to care increases under Obama-care.

In addition, the bill calls for more accountability from hospitals, to show that dollars provided for doctors’ training are used specifically for that purpose.

The legislation before Congress would solve only part of the challenge of creating the medical work force that the country requires. Regulations that allow nurse practitioners, physician assistants, and others to use the full range of their training and skills also would help alleviate the burden on primary-care doctors.

Changes in how doctors are compensated for care also is worth considering. But Congress doesn’t have to perform the equivalent of a medical miracle and tackle all of these issues immediately.

Members can make a real difference in improving access to health care by increasing the number of training slots for medical residents. Legislation to do that would accomplish far more than voting to repeal Obamacare yet again.

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