Physician shortage: Bad now, gonna get worse with Affordable Care Act
We have a shortage of physicians – especially primary-care physicians. The ones we have are maldistributed being concentrated in urban areas. This physician shortage will worsen with the implementation of the Affordable Care Act, according to a piece in the July 29, 2012 issue of The New York Times. The Times cited the Association of American Medical Colleges, which estimates that in 2015 the United States will be short 62,900 physicians. By 2025, the AAMC says this shortfall will be twice as high, owing to Medicaid expansion and increased demand from an aging population. According to the Times, “Even without the health care law, the shortfall of doctors in 2025 would still exceed 100,000.”
The Department of Health and Human Services recommends that a given region have 60 to 80 primary care doctors per 100,000 residents, and 85 to 105 specialists. In many areas of the country the ratio of physicians to the population falls well short of that mark.
Even when poor people find a physician, it’s difficult to get care. Fewer than half of primary care clinicians were accepting new Medicaid patients as of 2008, according to the Times. The ACA calls for adding some 30 million people to the Medicaid accounts. Those primary-care clinicians who see Medicaid patients are going to be deluged and ill-prepared to meet this surge.
The whole debate around the so-called health care reform has centered on expanding coverage and lowering costs. However, the real problem facing millions of working people in this country – especially, minority and rural populations – is access to care.
Insurance coverage is a necessary but insufficient means to obtaining medical care. We need a single-payer, national health care system so that no one is turned away from clinical care owing to cost. However, we also need to increase the number of primary-care physicians and redistribute them, covering rural and minority communities that are sorely lacking in physician services.