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NYT: Doctors Aren’t Practicing In Poor Areas

From the New York Times:

Doctor Shortage Likely to Worsen With Health Law

By ANNIE LOWREY and ROBERT PEAR | Saturday July 28, 2012

RIVERSIDE, Calif. — In the Inland Empire, an economically depressed region in Southern California, President Obama’s health care law is expected to extend insurance coverage to more than 300,000 people by 2014. But coverage will not necessarily translate into care: Local health experts doubt there will be enough doctors to meet the area’s needs. There are not enough now.

Other places around the country, including the Mississippi Delta, Detroit and suburban Phoenix, face similar problems. The Association of American Medical Colleges estimates that in 2015 the country will have 62,900 fewer doctors than needed. And that number will more than double by 2025, as the expansion of insurance coverage and the aging of baby boomers drive up demand for care. Even without the health care law, the shortfall of doctors in 2025 would still exceed 100,000.

Health experts, including many who support the law, say there is little that the government or the medical profession will be able to do to close the gap by 2014…

“We have a shortage of every kind of doctor, except for plastic surgeons and dermatologists,” said Dr. G. Richard Olds, the dean of the new medical school at the University of California, Riverside, founded in part to address the region’s doctor shortage. “We’ll have a 5,000-physician shortage in 10 years, no matter what anybody does.”

But the growth in the number of physicians has lagged, in no small part because the area has trouble attracting doctors, who might make more money and prefer living in nearby Orange County or Los Angeles.

A government council has recommended that a given region have 60 to 80 primary care doctors per 100,000 residents, and 85 to 105 specialists. The Inland Empire has about 40 primary care doctors and 70 specialists per 100,000 residents — the worst shortage in California, in both cases.

Moreover, across the country, fewer than half of primary care clinicians were accepting new Medicaid patients as of 2008, making it hard for the poor to find care even when they are eligible for Medicaid. The expansion of Medicaid accounts for more than one-third of the overall growth in coverage in President Obama’s health care law…

Temetry Lindsey, the chief executive of Inland Behavioral & Health Services, … “We know we are going to be overrun at some point,”… She added that hiring new doctors had proved a struggle, in part because of the “stigma” of working in this part of California.

[Another] factor increasing demand, along with expansion of coverage in the law and simple population growth, is the aging of the baby boom generation. Medicare officials predict that enrollment will surge to 73.2 million in 2025, up 44 percent from 50.7 million this year. “Older Americans require significantly more health care,” said Dr. Darrell G. Kirch, the president of the Association of American Medical Colleges…

Medical school enrollment is increasing, but not as fast as the population. The number of training positions for medical school graduates is lagging. Younger doctors are on average working fewer hours than their predecessors. And about a third of the country’s doctors are 55 or older, and nearing retirement.

Physician compensation is also an issue. The proportion of medical students choosing to enter primary care has declined in the past 15 years, as average earnings for primary care doctors and specialists, like orthopedic surgeons and radiologists, have diverged. A study by the Medical Group Management Association found that in 2010, primary care doctors made about $200,000 a year. Specialists often made twice as much.

The Obama administration has sought to ease the shortage. The health care law increases Medicaid’s primary care payment rates in 2013 and 2014. It also includes money to train new primary care doctors, reward them for working in underserved communities and strengthen community health centers.

But the provisions within the law are expected to increase the number of primary care doctors by perhaps 3,000 in the coming decade. Communities around the country need about 45,000…

Dr. Mark D. Smith, who heads the California HealthCare Foundation, a nonprofit group, … said building more walk-in clinics, allowing nurses to provide more care and encouraging doctors to work in teams would all be part of the answer. Mr. Corcoran of the California Medical Association also said the state would need to stop cutting Medicaid payment rates; instead, it needed to increase them to make seeing those patients economically feasible for doctors…

This is a typically long anecdote-filled article from The Times. In it, they chronicle how even though medical coverage will be expanded under Obama-Care, there will be fewer doctors to meet the increased need.

But The Times never blames the lower doctors’ fees and greater requirements in Obama-Care as the cause of doctors hanging up their shingles. Instead, the real point of the piece is that something must be done to make doctors go to ‘economically depressed’ areas, instead going to the ‘rich areas’ where they like to practice now.

And, as we know, thanks to the government’s control over student loans, it is only a question of time before the government will tell doctors where they have to practice if they want to go to medical school. And this is really just the beginning of the drumbeat for that.

Which, by the way, is how doctors used to be controlled in the USSR and Red China, and still are controlled in North Korea, Cuba and Venezuela.

This article was posted by Steve Gilbert on Monday, July 30th, 2012. Comments are currently closed.

3 Responses to “NYT: Doctors Aren’t Practicing In Poor Areas”

  1. Rusty Shackleford

    Strangely, this article looks familiar……

    hmmmmmmmm

    No worries. Glad it’s in today’s mainline subject-matter.

    Yup, the NYT makes a fairly loud trumpet call for the socialist practice of placing doctors “where they’re needed” as in the UK and all other socialist nations.

    The government always does things so well…so efficiently and FAIRLY above all else. The equal sharing of misery cannot be far behind. Yay.

  2. Rahm Emmanuel famously said, “Never let a crisis got to waste.” That’s the ‘progressive’ modus operandi.

    “If necessary, create a crisis so we can move our political machine in to ‘fix’ it.” That’s the part they will never say.

    We now see how well the machine works in Chicago, with Emmanuel running it.

  3. Astravogel

    I well remember when Canada socialized the medical profession. Our state
    got lots of new doctors, and even better, our gun club got lots of new members!
    Plus, their children stood up when their teacher entered the room. Wow! (of
    course, this only lasted one year.)


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