The Senate Finance Committee passed its version of health care reform Tuesday afternoon, but Kaiser Health News reminds us that neither this bill nor any of the others sloshing about Congress will do much about the nation's doctor shortage. Phil Galewitz reports: "Even as Congress moves to expand health insurance coverage to millions of Americans, it's doing little to ensure there will be enough primary care doctors to meet the expected surge in demand for treatment, experts say."
Primary doctors are key to rural health and there aren't enough of them. The American Academy of Family Physicians predicts a shortage of 40,000 primary care docs in the next ten years. (In the chart above, demand is represented by the blue line; supply of primary care doctors is in red.) “I don't see anything in the legislation that will greatly increase the primary care pipeline," said Dr. Russell Robertson, chairman of the Council on Graduate Medical Education. Galewitz said there's general agreement on how to increase the number of primary care doctors: open more residency positions and increase how much primary care doctors are paid. But nobody wants to add these costs into a health reform bill that has a price tag already too large for many to swallow. To add 15,000 Medicare-funded medical residency positions would cost about a billion dollars a year.
Nor has there been much luck adding to the pay of primary care doctors, since the money would have to be wrenched from specialists. But primary care physicians are key to holding down overall health care costs. They make, on average, less than half of the average for specialists.